Dr. Christopher Latham Phelps, D.M.D.

Not necessarily. Many times when you undergo root canal treatment, it's natural for some inflammation to build up in the bone just around the tooth root. In essence, it's like a bruise that forms and every time you bite on that tooth, you're basically biting into that bruise if that makes sense. It could also depend on the level of infection that was present around the tooth as well. While cleaning and disinfecting the inside of the tooth kills the bacteria that were escaping into the bone area around the tooth, it may take your body 7-10 days to clean up any residual bacteria that is present in that area. Typically, an antibiotic is prescribed if there is an infection present. I recommend 600-800mg of Advil (Ibuprofen) which helps reduce that inflammation around the tooth that forms after treatment. Like most things in the mouth, any symptoms should resolve within 2 weeks of the day of treatment. If not, make sure you return for a follow up and an examination to rule out other possible complications that are rare, but could be occurring.

The first question I would ask you is do you have any pain or discomfort
when hear that Pop/click and crinkle noise? If the answer is Yes there
pain or discomfort, you should seek treatment with a Dentist in your area.
Possibly Googling the phrase "Dentist, TMJ, TMD, Joint Pain", etc and see
who comes up in your area. Not all Dentists treat this type of issue and
many times it involves treatment at the Oral Surgeons office as well with
Botox injections into the joint and other remedies. If there is No pain or
discomfort, then it's usually a symptom caused by either a lack of
cartilage in your TMJ joint b/w the condyle of the jaw and the socket in
the skull to which it connects to or it could be that your cartilage is out
of position. When it's out of position and you open, your ligaments in the
area tend to pull it back into the proper position over your condyle and
it's that friction of the cartilage sliding over the bone that produces the
Pop and sometimes crinkling noises. Imagine you snapping your fingers.
It's the friction of your fingers sliding over each other that causes that
Pop. Same idea applies here. In either case, where cartilage is thin or
out of position, you have two options. Do nothing and as long as their
isn't pain or discomfort, you continue on your normal daily life. The
risk? At some point pain may develop and you'll need more advanced
treatments like what I described above. This isn't always the case as I've
had patients with that Pop for years who haven't had issues. Others it can
and has developed into worse symptoms. If you don't want to risk it, your
dentist can make you an appliance to wear while you sleep called a Night
Guard, Occlusal Guard, Brux Guard (it goes by many names). Wearing this to
bed will keep your teeth separated from one another and create space in
your joint area, decrease inflammation and help prevent the wearing down of
the cartilage that can occur. Hope that helps!

Yes. Cosmetic Orthodontic treatments like Invisalign, 6 Months Smiles,
Fastbraces or traditional metal bracket and wire systems would definitely
correct your one crooked tooth as well as straighten the others that are
pretty good. I think you're question really is do you have to move the
other teeth to get one tooth to fall into a better alignment with it's
friends around it? The answer? Sometimes No, many times Yes. Every
situation is different but if we have to move the other teeth, there
usually is good reason for it. If there really is one tooth out of
alignment and the rest match up well in our eyes, then there are some
retainer therapies you can wear in a series that will move a single tooth
back into position. The other thing you can do if orthodontic therapy is
not right for you today is get a set of retainers made. Wearing retainers
to bed every night will prevent your teeth from shifting even more.
Unfortunately, once you see tooth movement of any kind, they continue to
worsen and every 5 years you see a significant change. That means longer
treatment times to get you back to straighter teeth. Hope that helps! Dr.
Phelps

Great question. The answer is that it really just depends on the confidence, skill and expertise of that particular dentist. Technically, a licensed dentist can extract any tooth in the mouth, wisdom teeth included. Unfortunately, many did not get a lot of training or experience extracting teeth of any kind while in dental school. This is why some dentists refuse to extract any tooth in their practice and refer everything out to the oral surgeon. Those dentists who do extractions in their office are left to gain extraction experience through dental residencies, continuing education courses and through their own patient experiences. I, for instance, have no issues extracting teeth in the mouth, performing surgical extractions or handling wisdom teeth. I do tend to draw my line for wisdom teeth that are very impacted below the level of bone present and when they are near a vital nerve that gives feeling to your lip, teeth and other structures on that side of your mouth. These are the cases I tend to refer to the oral surgeon. Oral Surgeons have spent an additional 3-6 years after dental school with one of their main focuses being on extracting teeth. Most notably wisdom teeth or 3rd molars and handling these cases where that vital nerve may play a role. Because they have significantly more experience with these more challenging cases, I feel it's in my patients best interest to see them. I hope that clarifies things a bit more for you.

Assuming your dentist has ruled out active decay as the root cause of your sensitivity, there are definitely a couple of things you can do. Personally, I'm not a big fan of the sensitivity toothpastes as they treat the symptom, but don't treat the actual problem behind your sensitivity. For most, it comes from having exposed root tooth structure which is normally covered up by your gum tissues. While the enamel, or white part of your tooth is the best insulation and hardest substance in your body, the tooth structure that makes up your root surfaces are not as strong. They are very porous like swiss cheese so air, sweets, and other items penetrate through the tooth easily causing that sensitivity feeling. The toothpaste you are using works by plugging those pores temporarily which relieves your sensitivity. As soon as you eat, the pores are left open again, so you must continuously keep using the sensitivity toothpaste treating the symptom, but not the root cause.
A simple thing you can try is using a fluoride rinse like ACT, which you can buy over the counter. Swish with that twice daily and re-evaluate your symptoms in one week. Over
time, the extra fluoride your root surfaces are exposed to with the rinse will mix with the calcium in your saliva and help plug those root surface pores permanently. You can also use a prescription toothpaste that your dentist can prescribe that has the extra fluoride built into it as well, so you don't have to use a rinse. At the dental office, we usually have a fluoride
varnish we can apply to the teeth after your routine cleaning visit as well as some other products. If the problem is severe enough, there are gum graft procedures that may be an option or a certain type of filling material that can be applied to cover up the sensitive tooth structure.
Most of my patients tell me between the fluoride varnish treatments and the prescription toothpaste, they get a permanent relief of symptoms within 6 weeks or at least an 80% improvement. Hope that helps answer your question.