Nine days of pain after a new bridge and recent root-canal treatment deserves a careful re-evaluation, but a normal OPG and a good-looking RCT do not automatically mean the tooth must be extracted.
Pl refer my point wise reply against your query
1. Your pain can have several causes
Healing/inflammation around the root after RCT.
Bite/occlusal pressure, even if the high point has already been adjusted.
Inflammation of the ligament around the tooth.
A crack or fracture that may not be visible on a routine OPG.
Less commonly, a missed canal or persistent infection.
sensitivity after dental treatment can sometimes settle over 2–4 weeks, but persistent or worsening pain should be reassessed.
2. I would get an endodontist's examination before considering extraction.
Ask the endodontist to specifically check:
Pain on biting and on releasing the bite
Percussion and palpation
Detailed periodontal probing around the tooth
Tooth mobility
Bite/occlusion
Adjacent teeth to make sure the pain isn't coming from another tooth
The quality and length of the RCT
Periapical dental X-rays from different angles
Transillumination/magnification for a possible crack
CBCT only if clinically indicated
A cracked tooth can produce intermittent chewing/temperature pain and may be difficult to identify on ordinary X-rays.
Is extraction necessary?
Not at this stage based only on the information shown.
If examination finds a vertical root fracture extending below the gum/bone, or a crack that makes the tooth non-restorable, extraction may ultimately be necessary. But if the tooth is structurally sound and the RCT is adequate, other treatment options may exist.
Temporary pain relief
If the patient is an adult and has no stomach ulcer/bleeding,
kidney disease, NSAID allergy, blood-thinner use, or other contraindication:
Option 1: Ibuprofen 400 mg after food when required.
If pain is stronger: ibuprofen 400 mg + paracetamol 500 mg can be used together when appropriate.
NSAIDs such as ibuprofen, alone or with paracetamol, are recommended first-line options for acute dental pain.
Do not exceed the recommended doses on the package/prescription, and avoid taking multiple medicines containing paracetamol simultaneously.
Antibiotic?
Don't start an antibiotic just because the tooth hurts. Antibiotics usually aren't helpful for pain alone. They are generally considered when there is infection with findings such as swelling and/or systemic symptoms such as fever or malaise. Definitive dental treatment is more important.
Next Steps
As you already had two occlusal adjustments and a second opinion, I would get one consultation with an experienced endodontist before agreeing to extraction.
Do not rush into extraction solely because the OPG is normal but the pain continues. At the same time, don't ignore persistent pain—identify the exact source first.
Health Tips
If there is facial swelling, fever, pus, rapidly increasing swelling, difficulty swallowing, or difficulty breathing, the patient should seek urgent dental/medical care.