Dr. Hall
I am 34, never had a cavity, and had been with the same dentist for 10 years. Our insurance changed so I had to change dentists about 2.5 years ago.

At the first appointment with the new dentist she said I had a cavity needing filled. I was shocked, had had no symptoms, but due to childcare complications had her fill it right then. It hurt for weeks, she adjusted and it continued to hurt.

I waited out the year and switched insurance back to my old dentist, He said I had had that shadow on my x-rays for 10 years with no change and it was likely I didn’t need the filling. He adjusted it and within days the pain stopped! However, the filling kept tearing floss and pocketing food under my gums. He recommended I have it fixed so the pocketing food wouldn’t cause an issue.

He did the repair in January. As soon as the numbness wore off, I had pain where the numbing medication had been injected and my tooth was very sore. This remained and then progressed to heat and cold sensitivity over the next few hours. I called him a week later and he had me come in. He gave me options and we decided to try steroids orally for any inflammation. I have had bad reactions to steroids in the past, but thought I would be okay to try.

It really isn’t any better, and now I am scared to go back. He said worst case scenario is removing the tooth. I am devastated but also in almost continual pain for 6 months now, especially to anything not body temperature. My appointment is tomorrow to try to brave him fixing it again. I don’t know what to do or even if I can trust him anymore. HELP ME PLEASE.

– Erin from Texas

Erin,
Boy, there’s a lot to say about your saga with this tooth.

I’d love to be able to see your tooth and see exactly what happened here. Not seeing that, I have to make some assumptions. I will tell you that it doesn’t sound to me like either of these dentists is doing good for you, but there are more problems and more serious problems with your current dentist than with the one who originally did the filling.
Let me address several of the points you bring up:

1. One dentist seeing a cavity or feeling like a tooth needs to be filled and another dentist disagreeing with that–we see that kind of professional disagreement often and there is no ill intent with either dentist. My inclination is to be more partial to the dentist who called it a cavity. As an additional point, your dentist’s explanation seems suspect to me. A shadow on your x-rays for 10 years and he never even told you about it? That sounds to me like an excuse. A dentist doing one filling–because of the overhead involved there is little to no profit in that and it is more an annoyance to the dentist, so I don’t think there was any dishonesty in the dentist who filled it. It’s more likely there was sloppiness in the dentist who let it go for ten years.

2. The tooth becoming sensitive to hot and cold after repairing the filling–that’s bad. I would assume (because the problem was the filling catching floss and catching food and because of the post-operative sensitivity) that the “repair” involved replacing the filling. For it to become sensitive to hot and cold after a simple filling replacement something had to go wrong that he didn’t tell you about. Especially since the sensitivity wasn’t immediate. Temperature sensitivity after a new filling isn’t uncommon and doesn’t mean that anything went wrong. But this wasn’t a new filling. To simply take a filling out and replace it shouldn’t be that irritating to a tooth, and based on the problems you were having, he wouldn’t have even needed to replace the entire filling.

3. Steroids? Really? Wrong treatment! The hot and cold sensitivity in your tooth indicates a possible low-grade infection in the tooth. Steroids would make that worse. Steroids block your body’s response to inflammation, but also block its response to infection. Not good.

4. Removing the tooth? Bad again. I would be scared, too, if my dentist started talking to me about extraction at this point. Things are cascading out of control quickly here. There is quite a list of steps, every one of which has to go wrong, before he should be talking about extraction.

Bottom line–I think you should find a new dentist. Between the two you’ve seen, I think you would be better off in the hands of the dentist who did the filling. Though she didn’t do great for you, you just had the one mishap, not this series of problems. But the better thing would be to get a different dentist entirely.

I don’t know what the deal is with your insurance, but I wouldn’t let your insurance hold you hostage here and prevent you from getting adequate care. Losing this tooth over this simple cavity that was apparently just a slight shadow on your x-ray, that’s too much.

I’m wondering how you ended up with two dentists, neither of which has done very well for you. Maybe the problem is that you have really cheap insurance and no really good dentists want to participate in that plan. That occurs to me. If that is the case then maybe, to get this done right, you need to go outside your insurance company’s list of “preferred providers.” From the point of view of the patient, if your insurance company is using that term, “preferred provider,” I would translate that as “cheap dentist.” That’s what insurance companies mean by preferred.

Dr. Hall

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