Failed root canal - repeat or extract?

[gruffalobuffalo]

Hi all. I had root canal carried out on a second premolar back in January after being in constant pain for two months. It still hurt after the root canal whenever I touched that particular tooth.

I started getting pain in the side of my face where the root canal was carried out. GP thought could be a problem with trigeminal nerve and I've been taking medication for this (Carbamazepine then Gabapentin). GP has referred me to neurologist but there is a six month waiting list. Dentist has x-rayed tooth several times and can't find a reason for the pain, saying the root canal was textbook. The pain in my face has stopped, just pain now in the root canal tooth and the gum around the area is throbbing and burning but doesn't look red or swollen. No other teeth are hurting. Painkillers alongside the Gabapentin take the edge off it but it is still really really painful. Brushing my teeth and talking don't set off the pain, it's there all the time but only in that tooth and the gum.

I'm at the dentist in two days time. It's supposed to be for a repeat root canal on the NHS although the dentist has said he doesn't think he can do anything different but is happy to try. Am seriously wondering if to just have the tooth pulled instead as it's making daily life so difficult being in constant pain. Has anyone had anything similar happen?

Also, do you think a second premolar extraction would show lots when I talk/smile? Dentist did mention having a false tooth and then later having a bridge - ideally I would want to stick with the false tooth as I wouldn't want to mess about with the two healthy teeth either side to have a bridge attached.

Second premolars extraction won't really show but if this is trigeminal neuralgia, don't get onto the slope of having lots of dental treatment (particularly extractions) if it's not going to fix the pain. It's really classic to see I'm afraid, lots of root canal treatments and missing teeth before the diagnosis is made.

Has the tooth been crowned?

Some bridges don't require any preparation of the other teeth, just sticking to them. A denture for one space can be quite detrimental to the health of the rest of your teeth and gums.

I have had an upper left second molar removed and you can't see it's missing. I certainly wouldn't consider a bridge or denture to replace it.
As for your 'failed' root canal treatment check with your dentist the materials he used to fill it it could be a reaction to something he used. Bleach is used to clean the canal, I once had a patient, who was a hairdresser, have a reaction after root canal treatment that we couldn't explain other than she had probably developed a sensitivity to bleach after prolonged exposure to hair bleach.
After a lifetime in the business I never dismiss reactions to the materials we use.

As a sufferer of trigeminal neuralgia I would say STOP! Don't repeat the root canal or opt for extraction. I did - and the pain continued after the tooth was removed.

My TN pain could come on from nowhere, but also if I touched the tooth or the gum around it, particularly with a cold finger.

My dentist tested the tooth for cold sensitivity with some spray on some cotton that was so cold it crackled when it touched the tooth. No reaction. But when my face was cold (in Jan) I couldn't touch anywhere around the tooth because the pain returned.

I tried carbamazepine and stopped taking it due to side effects. I swapped to gabapentin but had to keep taking it for several weeks at increasing doses before I got any substantial pain relief.