Tooth pain

[abbyg]

I have had some mild pain in tooth #14 for about 3 weeks now. This pain is generally on the cheek side of the tooth with a mild burning near the gumline. This tooth had a small piece broken off of it about 1 1/2 years ago.(the opposite side of the tooth) The tooth has a silver filling. The dentist fixed the broken area with more silver filling. It has bothered me off and on since but is generally bothering me more now. I went to one dentist who felt that the filling might not be properly seated and suggested putting a crown on the tooth which he couldn't do until the end of July sometime. I proceeded to go to another dentist who removed the filling and replaced it with a sedative filling to see if that helps and indicated that a root canal might be necessary. He said he saw nothing wrong with the one side of the tooth. The sedative filling has only been in for 3 days now but the pain is still in the same general area of the cheek side of the tooth with the mild burning near the gumline. Do you have any suggestions as to what might be causing this problem?

[Jerome Bogin, D.D.S.]

It is really difficult to diagnosis this without seeing it.Was the tooth tested to see if the nerve was vital? If the pain is above the tooth in the fold, approximating the level of the roots then it might need the RCT. I think these things have to be considered in the diagnosis.If the pain persists and all other possibilities have been explored then I think you must consider doing the root canal therapy.

[abbyg]

The nerve was not tested. Both dentists took an x-ray and everything looked normal. The 1st dentist wanted to do a crown w/no root canal and the second dentist is doing the sedative filling with possible root canal if the sedative filling doesn't help. He initially wanted to bond an area of the tooth that he said had some abrasion but then changed his mind and did the filling instead. So I guess you can tell I'm kind of confused and don't know what to trust at this point.

[mike1105]

i do not personally like placing sedative fillings. If decay or the existing cavity preparation is that close to the nerve, and the tooth is painful, I'd discuss the options with the patient but invariably suggest that a root canal procedure be performed. I then would place a post/buildup in the tooth, crown the tooth and be done with it. Even if your tooth does calm down with a sedative filling, there is a substantial likelihood that it will act up again later--- usually after a crown has been done. then the dentist has to usually drill a hole through a brand new crown to do the root canal. I personally would want a new crown. It's backtracking and It's backwards. root canals on molars, especially when done by a skilled root canal specialist with a microscope, are pretty much pain free and successful provided thee is no undetectable fracture.In your case, I would see a root canal specialist who uses a microscope and let him or her evaluate your tooth, test the nerve, and properly advise you. Most likely, unless there is active infection which in your case does not seem to be the case, it can be done in one visit and you are that much closer to getting on with your life and forgetting about this tooth. To me, sedative fillings and large silver fillings (especially in theeth that are symptomatic and already have been filled or cracked before) are just patchwork procedures and signs of indecision on the part of the dentist. Hope this helps. PS The need for a root canal does not necessarily show up on a film. Large cracks and abcesses may be obvious. Smaller hairline cracks and unhealth or inflamed nerve tissue usually do not show up at all.