Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Dental Health (Expert Forum)
right sided face pain
Answered by
Jerome Bogin, D.D.S. - Dental
Questions in the Dental Health forum are answered by Dr. Jerome Tsang and Dr. Jerome Bogin. Topics covered include bridges, cavities, crowns, and x-rays.
right sided face pain
by tmv, May 23, 2007 12:00AM
Hi dr, I thought that I had a sinus infection about a month ago and was treated with levaquin 500 mg for 7 days. Now, the pain is still there an my entire right side is sensitive to heat/cold. Really, it even seems as if the bottom mandible is sensitive, but when he did the tap test on the teeth, the upper #4 was the one hurting. It is my upper #4 tooth, but the pain radiates to my temple, ear, and back to the entire upper mandible. My x-ray showed very little infection/inflamation. But he did notice what would appear to be a fracture high up in the tooth.( I apologize for the laymens terms.) He prescribed amoxicillin 500mg tid. But, they forgot to call it into the pharmacy, so I'll get it today.
This tooth was filled last fall and it was a large, deep filling. It had started to discolor prior to filling. It has always been a little sensitive, but nothing like this. He is recommending that if my pain doesn't go away in 24 hrs after ab's, then he wants to open it up and look for the fracture. Then a root canal scheduled for June 6th and finished on june 20th with prefabricated post and core. I am unfamiliar with any type of dental problems. This seems pretty drastic to me, but again I am ignorant to most of it.
1.Does this sound like usual treatment?
2.What causes the infection?
3. What would you recommend?
4. Can you explain my condition in greater detail.
Thank you so much for your time.
This tooth was filled last fall and it was a large, deep filling. It had started to discolor prior to filling. It has always been a little sensitive, but nothing like this. He is recommending that if my pain doesn't go away in 24 hrs after ab's, then he wants to open it up and look for the fracture. Then a root canal scheduled for June 6th and finished on june 20th with prefabricated post and core. I am unfamiliar with any type of dental problems. This seems pretty drastic to me, but again I am ignorant to most of it.
1.Does this sound like usual treatment?
2.What causes the infection?
3. What would you recommend?
4. Can you explain my condition in greater detail.
Thank you so much for your time.
Doctor's Answer
by Jerome Bogin, D.D.S. , May 24, 2007 12:00AM
, May 24, 2007 12:00AM
A deep filling can cause a fracture becasue the remaining real tooth structure around that filling is thin and weak. A deep filling can also cause the tooth to become symptomatic becasue the nerve gets inflamed from being encroached upon by foreign material. I personally do not prescribe antibiotics unless I am sure there is an infection present. It sounds reasonable to me that if there is no improvement a root canal procedure might be necessary.
You could try a temporary medicated filling but then you still have to crown the tooth, and there is no guarantee it wont act up later. Doing root canals AFTER crowns are placed means a hole will have to be drilled through a brand new crown. It is a judgement call but when someone has a toothache from an inflamed nerve, and the canals are fairly straight (the root canal procedure is not that difficult) I am usually inclined to do the root canal, place the post and crown the tooth and hope to be done with it. Hope this helps.
Also, I had a couple other questions: Could eating something extremely hot cause a fracture or separation of the large amalgam filling? I ate potato soup that was hotter than I thought and after biting down on it, I had extreme pain for over an hour on this new filling (at the time, last fall).
It has some rough edges and dental floss gets caught and pulls down. Could that have pulled the filling partially out but not able to be detected by radiograph or examination?
I thank you in advance for your answers!
I havent seen you or the tooth. But if you have spontaneous pain all the time at this point, the nerve is probably involved. If you have pain only when chewing or when drinking (hot or cold) it may be simply because the filling is cracked. My approach is always to remove the bad filling and the decay, and then see where I'm at. At that point I talk to the patient, discuss the situation, explain the risks, benefits and alternatives, agree with the patient on a procedure, and move along. Communcation is the key.
I'm not sure what you mean by a horizontal crack in the tooth. I cannot remember a horizontal fracture, except perhaps in a root and that is very unusual AND very obvious on a film.
Bottom line is, if it hurts, something is wrong. You have to trust your dentist if you believe you are in the right hands. If you still have any questions, get them answered satisfactorally before obeying when he says "open please..." At this point you are obviously not comfortable. You need to get comfortable or find another dentist who will take the time to explain things.