Aa
new gold onlay followed by pulpitis
a week ago i received a new gold onlay in a upper back tooth after deep caries was found under an old amalgam filling. since two days ago i feel extraordinary pain that radiates to the whole right side of my face and mouth.
the doctor adjusted the surface of the gold onlay in order to determine whether the pulpitis is reversible or not.
my question is the following:
if it is determined that the pulpitis is irreversible and a root canal therapy is inevitable, does the new gold onlay need to be removed again (and a new one manufactured) or can the root canal be done through the gold inlay thus preserving it at least partially? or even worse, does the tooth have to be removed altogether?
i am asking, because the price of the new onlay was very high.
the doctor adjusted the surface of the gold onlay in order to determine whether the pulpitis is reversible or not.
my question is the following:
if it is determined that the pulpitis is irreversible and a root canal therapy is inevitable, does the new gold onlay need to be removed again (and a new one manufactured) or can the root canal be done through the gold inlay thus preserving it at least partially? or even worse, does the tooth have to be removed altogether?
i am asking, because the price of the new onlay was very high.
conclusion.
today the root canal treatment was undertaken. the gingival swelling was indeed a symptom of the pulpal necrosis, because the microbacterias had worked their way from the roots nerve endings sideways causing the infalmation / swelling there in the gingival area.
the root canal treatment was done through the gold onlay and temporarily closed thereafter. we will see how many treatments it takes. however, because of the new crack in the tooth i described in the other post i will have to replace it with a crown at some point in the near future.
when the nerve was exposed i could actually smell something very strong and foul. the doctor later asked me whether i noticed it and said that it was indeed the smell of the dead nerve.
i hope this will end my consultation in this thread. thanks for all your replys.
today the root canal treatment was undertaken. the gingival swelling was indeed a symptom of the pulpal necrosis, because the microbacterias had worked their way from the roots nerve endings sideways causing the infalmation / swelling there in the gingival area.
the root canal treatment was done through the gold onlay and temporarily closed thereafter. we will see how many treatments it takes. however, because of the new crack in the tooth i described in the other post i will have to replace it with a crown at some point in the near future.
when the nerve was exposed i could actually smell something very strong and foul. the doctor later asked me whether i noticed it and said that it was indeed the smell of the dead nerve.
i hope this will end my consultation in this thread. thanks for all your replys.
today i went to the dentist again.
the swelling was smaller than the day before yesterday when it first started.
the doctor thinks it is due to the increased mobility of the tooth, it had lengthened a bit. the doctor thinks this might be an indication of the pulp having died.
to strengthen the case, an x-ray was made, but there was no difference visible beneath the tooth than in the picture taken 2 months ago (just after the onlay was set and the extreme pain occured). a difference (the dark area being visible beneath the tooth) is expected to be seen once i return in two months or so.
than the root canal treatment should be undergone. for now, the tooth needs to get some rest.
there was another problem,
the gold onlay is put on the inside of the mole, the outside has still original tooth surface. there, a crack had developed in the original tooth material. the dentist said this is an indication of deep occlusion. so further occlusion adjustments was made.
the swelling was smaller than the day before yesterday when it first started.
the doctor thinks it is due to the increased mobility of the tooth, it had lengthened a bit. the doctor thinks this might be an indication of the pulp having died.
to strengthen the case, an x-ray was made, but there was no difference visible beneath the tooth than in the picture taken 2 months ago (just after the onlay was set and the extreme pain occured). a difference (the dark area being visible beneath the tooth) is expected to be seen once i return in two months or so.
than the root canal treatment should be undergone. for now, the tooth needs to get some rest.
there was another problem,
the gold onlay is put on the inside of the mole, the outside has still original tooth surface. there, a crack had developed in the original tooth material. the dentist said this is an indication of deep occlusion. so further occlusion adjustments was made.
Yes, it was the best news I could have received that I didn't need to pay for a new crown after having to pay for root canal treatment. You're right........definitely saves a heap of money.
Actually you don't necessarily have to have a crown removed if the tooth needs a root canal. These days dentists quite often go through the top of the crown and perform root canal treatment on the tooth and then seal the hole with a permanent filling. I'm living proof. The crown on my molar is 10 years old but still in excellent condition so I had a root canal performed straight through the top of the crown. There was no need to pay for a new crown and everything was fine. I also have 3 friends who have had root canals completed on crowned teeth by simply going through the tops of the crowns, all within the last 2 years. Dentists only seem to remove crowns if it's absolutely necessary.
If you need a root canal you always have to have the crown removed and get a new one. I have never heard of being able to keep the crown or them working through it.
COMMUNITY LEADER
Gingival swelling is generally associated with periodontal infection or periapical abscess.Apical periodontitis is generally associated with pulpal necrosis or canal instrumentation. Occlusal interference generally does'nt result in gingival swelling. Periodontal infection may result from calculus or root fracture. Administration of electric pulp test is necessary to determine vitality of pulp. Your biting condition is more closely related to occlusal interference. If the tooth tested vital, root canal treatment is contraindicated.
today i have noticed some new development around my tooth.
the outer side of the gum, directly above the tooth with the onlay seems slightly swallen and hurts. i think this is the place where the roots of the tooth are situated.
Do you think that with the symptomes above and the biting pain described yesterday this could be an indication of Parodontitis apicalis?
the outer side of the gum, directly above the tooth with the onlay seems slightly swallen and hurts. i think this is the place where the roots of the tooth are situated.
Do you think that with the symptomes above and the biting pain described yesterday this could be an indication of Parodontitis apicalis?
this episode seems to never end.
i am still having issues with the tooth. i would say that i wake up with no problems and during the course of the day a small pain develops. when i bite on the tooth it doesnt hurt sharply but it is a uncomfortable sensation that builds up if i continue to bite. it is like the whole tooth is hyper sensitive to biting pressure. i would say it is as if the tooth gets tired of biting.
i think i will request root canal the next time i go to the dentist. this is just no use.
i am still having issues with the tooth. i would say that i wake up with no problems and during the course of the day a small pain develops. when i bite on the tooth it doesnt hurt sharply but it is a uncomfortable sensation that builds up if i continue to bite. it is like the whole tooth is hyper sensitive to biting pressure. i would say it is as if the tooth gets tired of biting.
i think i will request root canal the next time i go to the dentist. this is just no use.
COMMUNITY LEADER
It depends on the cause . If pulpitis is caused by mechanical overload, pulpal tissue may heal if occlusal interference is eliminated. If pulpitis is caused by microoranism, the pulpal tissue generally undergoes necrotic. Molar tooth contains more than one root pulps, if vitality test yields positive response, it only indicates one of the pulp tissue is vital.There may be other pulp tissue necrotic. Further vitality test may be needed after 2-4 weeks.
today the pain has reduced significantly, i dont need to take strong medication any more. though there is a constant area pain on the side of the face.
today the doctor performed vital test of the pulpa. there are weak vital signs. the surface of the gold onlay was further amended.
i guess the pulpa can still heal and survive by itself?
today the doctor performed vital test of the pulpa. there are weak vital signs. the surface of the gold onlay was further amended.
i guess the pulpa can still heal and survive by itself?
COMMUNITY LEADER
If cold stimulus does not trigger pain and hot stimulus does, it suggests pulp necrosis. Electric pulp test can confirm the diagnosis. Root canal treatment is indicated if pulp necrosis is present.
thanks again for your response.
actually, the pain is very hot and throbbing and cooling the side of my mouth causes a relief. while eating hot soup today (i couldnt chew very good) i had to stop in between and drink cold water, keeping it in my mouth around the tooth in order to continue eating just after.
i than went again to see the dentist to get stronger pain killers and consulted further questions.
i had asthmatic bronchitis as a child. that is why i received a weak pain killer the first time around. due to the strong pain she increased the dosis today and already i have better results.
the clenching test was performed yesterday and in turn the doctor corrected the surface of the onlay (i think i wouldnt be able to perform the test today, because of the pain).
the doctor expects healing (decrease of pain until monday (in 3 days)), because it is most likely a result from the pressure of the new onlay. i hope so and am confident.
while removing the caries drilling went close to the pulpa, however, without touching it.
so irreversible damage caused by bacteria is not expected. according to the doctor there is a very small chance of a newly formed crack but this is most unlikely.
also, in case of a root canal therapy the onlay would be removed but it would be possible to drill into the onlay as suggested above, but only if i demanded it.
i guess i have to wait from now on. expecting a terrible weekend ;-)
actually, the pain is very hot and throbbing and cooling the side of my mouth causes a relief. while eating hot soup today (i couldnt chew very good) i had to stop in between and drink cold water, keeping it in my mouth around the tooth in order to continue eating just after.
i than went again to see the dentist to get stronger pain killers and consulted further questions.
i had asthmatic bronchitis as a child. that is why i received a weak pain killer the first time around. due to the strong pain she increased the dosis today and already i have better results.
the clenching test was performed yesterday and in turn the doctor corrected the surface of the onlay (i think i wouldnt be able to perform the test today, because of the pain).
the doctor expects healing (decrease of pain until monday (in 3 days)), because it is most likely a result from the pressure of the new onlay. i hope so and am confident.
while removing the caries drilling went close to the pulpa, however, without touching it.
so irreversible damage caused by bacteria is not expected. according to the doctor there is a very small chance of a newly formed crack but this is most unlikely.
also, in case of a root canal therapy the onlay would be removed but it would be possible to drill into the onlay as suggested above, but only if i demanded it.
i guess i have to wait from now on. expecting a terrible weekend ;-)
COMMUNITY LEADER
The first consideration is to establish a correct diagnosis.The cardinal sign of pulpitis is senitive to cold stimulus. In general, if cold stimulus triggers throbbing or pulsating pain longer than 10 seconds, it's probably irreversible pulpitis. Irreversible pulpitis indicates root canal treatment. If pain lasts less than 10 seconds, it's probably reversible pulpitis,which is commonly associated with occlusal interference of new restoration. Occlusal interference of molars is difficult to detect by many practitioners.If you clench your teeth together, and the newly restored tooth perceive pressure, soreness,or pain, it suggests occlusal interference or periapical inflammation.Healthy tooth generates negative response upon clenching test. Further challanging test is clenching a cotton roll. A perfectly healthy tooth can pass the cotton roll clenching test. However, occlusal interference is not limited to newly restored tooth. The natural teeth having occlusal interference is also common.
here is another follow up question,
if it is structurally fit, will the hole from the root canal treatment be covered with gold or another material?
if it is structurally fit, will the hole from the root canal treatment be covered with gold or another material?
thank you for the fast reply. as you may guess the pain keeps me coming back to this thread frequently.
so, what would the doctor initially do if the therapy has to be a root canal? drill through the gold onlay or remove it altogether?
such a terrible waste. i hope it heals by itself.
so, what would the doctor initially do if the therapy has to be a root canal? drill through the gold onlay or remove it altogether?
such a terrible waste. i hope it heals by itself.
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