Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

April 21, 2018

Water relieves the pain in my tooth


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Dr. Hall,
It’s been ten years since I got my two fillings. One fell out but doesn’t hurt. The other one is still in but is causing severe pain. It doesn’t bother any to bite on it, but it hurts most of the time. The only thing that relieves the pain is water and only for a few seconds. Any advice?
– Brandon from Oregon

Brandon,
I wish I had better news for you, Brandon, but your tooth, the one with the filling, is showing classic signs of a dying pulp and you’re going to need a root canal treatment on it. I’d get the other filling replaced before it’s too late.

Here’s what’s going on. There has been some decay get into the tooth, probably getting under the filling. That decay has grown until it has infected the pulp. As the infected pulp tissue dies, it can go into a state where it is called a gangrenous pulp. In that state, it gives off gasses that increase the pressure inside the tooth and cause a toothache. When you cool the tooth with water, it causes the gas to shrink somewhat and eases the pain.

This is a classic situation. When a patient reports that cold water or ice water is the only thing that relieves their toothache, you can be 100% guaranteed that they’re suffering from a gangrenous pulp in a tooth that has almost died. Relief can be obtained by simply creating an opening into the tooth to relieve the pressure, but then it needs to be followed up with a root canal treatment to fully remove all of the infected tissue inside the tooth and seal it against further problems.

It’s a similar situation when a tooth is sensitive to heat—it’s a nearly dead tooth.

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

July 27, 2017

This is too much sensitivity – you need a root canal


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Dear Dr. Hall:
On June 26, my dentist prepared my cracked tooth number 30 (lower right first molar) for a crown. I had several problems with the temporary crown including very sore gum and pain with biting and cold sensitivity. However, since the pain was not lingering, my dentist placed my permanent crown on July 12. But it didn’t subside and in fact, it got worse. After one week, I visited him again and he took X-ray and did cold test and pressure test. He also knocked at my tooth which was not painful. My tooth was very sensitive to cold but it went away in less than 30 seconds. Also, I didn’t feel pain with pressure test although I felt pain when I bit on hard things. So my dentist said I had to wait and I had high chances to get better. He said sensitivity to pressure is normal even for 30 to 90 days. Now 10 days has passed and from my permanent crown placement, but I don’t see any improvement. Also, today I discovered my tooth is sensitive to hot food too although it doesn’t linger for a long time after the hot food is removed. I think once I realized this sensitivity with that temporary crown but didn’t care about it.
Are these reversible pulpitis symptoms? Does that heat sensitivity show my tooth nerve is dying? How long do you think I must wait before I see an endodontist?
Thanks a lot.
– Bita from Iowa

Bita,
Thanks for the clear description of your symptoms! You told me what kind of pain, what provokes it, and gave me a clear history, which makes it much easier to figure out what is going on with your tooth.
I would call the endodontist today. There are a couple of red flags here and I’d get an expert diagnosis before this tooth gets any worse. It doesn’t look good.
I don’t want to be too critical of your dentist, because I don’t know the whole story of your tooth—just what you’ve told me. But just taking what you’ve told me, some additional caution in your case seems like it would have been wise, and I’ll explain why. It also isn’t normal for a tooth with a new crown to be sensitive to pressure for more than a few days, if the occlusion is adjusted correctly.
First, you had a cracked tooth. A crack can easily involve the pulp of a tooth and by itself can cause a tooth to become infected and the pulp to die.
On top of this, you had significant cold sensitivity after the crown preparation. This could have been due to an incompletely sealed temporary crown, or it could have been due to the extra irritation to which the tooth was subjected from the crown preparation, or a combination of the two. It would have been wise to have coated the tooth with some type of desensitizing product at this point. Maybe that was done.
Also, given those two things, it would have been prudent to have temporarily cemented the crown. This is a lower first molar, so the crown would have to be made out of some strong material that could have been cemented with a soothing type of cement in hopes that it would settle down, or, if it didn’t, to allow easy removal of the crown for root canal treatment. Permanently cementing a crown is usually an additional irritation which can push a borderline tooth over the edge to needing root canal treatment.
So your dentist permanently cemented the crown and the pain got worse. Your sensitivity is headed in the wrong direction and appears that it will end up in irreversible pulpitis, requiring root canal treatment.
And now it is getting sensitive to heat. I wouldn’t go quite so far as to say that it’s absolutely certainly suffering from irreversible pulpitis at this point, but if not, it’s awfully close. The endodontist should be able to tell you for certain. There would be subtle changes in the ligament of the tooth around the end of the root that most general dentists wouldn’t see but the endodontist should.

– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

January 20, 2017

Tooth with a crown is sensitive to heat


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Dr. Hall,
I have several crowns, some on natural teeth some on implants. I have two crowns next to each other on top and front. The crowns are maybe 20 or 25 years old. 1 week ago I saw my dentist for a cleaning and today I woke with constant strong pain but much worse when sipping coffee warmer than room temperature. My dentist isn’t in for a few days and the pain seems to be growing to include the crown on the tooth next to it. Any ideas?
– Randy from Illinois

Randy,
I’m sorry to have to be the one to give you the bad news, but the pulp of your tooth is dying and it is going to need a root canal.

You have two of the classic symptoms of a dying tooth. Teeth can be sensitive to a number of things, and that sensitivity can sometimes come and go and may not indicate a dying tooth. But if you have strong pain that isn’t provoked, that’s an indication of a dying tooth. Adding to it, your pain is aggravated by heat–a doubly bad sign.

What happens is that an infected pulp will draw in body defenses including white blood cells. The tissue wants to swell, but being in a confined space, it chokes itself and then dies. As it dies, it can sometimes give off gasses. Any warming up of the tooth increases the pressure of those gasses and increases the pain. Cold will cause the gasses to contract and will generally provide relief in this situation.

So what do you do when you have a crown on the tooth that needs a root canal? It isn’t difficult to make an opening in the crown and do the treatment through the crown. However, if I were your dentist, I would want to remove that crown and find out what is going on under it. I would also want to replace the 20-year-old crown on the adjacent tooth, because something similar may be happening to that tooth.

Why is this happening? There are several possibilities. One is that decay has gotten in under the crown. This can happen through a leaky margin that your dentist didn’t catch or maybe did see but didn’t attach enough significance to it. Another could be that the tooth has become irritated through exposed root surface.

– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

July 30, 2016

My tooth was fine until my dentist worked on it


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Dr. Hall,
I went to my dentist recently and he filled a front tooth. While in the chair he stated that he saw a small crack on the rear molar on the left side, and he said it needed to be repaired. He drilled the tooth out, banded it, and filled it with composite. I called him the next day because the tooth was extremely painful. Two days after he did the procedure I was back in his office, and after a cold test he said that I needed a crown and a root canal. I had him pull the tooth. Should I pay him for the extraction when there was no issue with the tooth, before he removed half of it, other than a small crack?
– Mark from Georgia

Mark,

Nothing you told me indicates to me that your dentist did anything wrong. Yes, it’s possible, because I don’t know the whole story. But I’ve seen this sort of thing many times, and it sounds to me like your dentist did the right thing.

When you say that there was nothing wrong with this molar but a small crack, that’s not the complete story. A crack is almost always a symptom of a major underlying problem with the tooth. A tooth that is otherwise healthy will not have a small crack in it. From subsequent events, it seems clear to me that this tooth was already infected. Yes, working on it irritated it a little more and placing a well-sealed filling over the infected pulp of the tooth caused an immediate painful reaction. Had your tooth been healthy before your dentist worked on it and had merely had some accident during the procedure, your tooth would have started to get diseased and it would have taken some time for it to flare up. The fact that it was immediately painful indicates that this disease process was probably already pretty advanced.

The reason your dentist was concerned when he saw this “small crack” was that the tooth probably had a large filling in it. You didn’t say what type of filling, but almost all teeth with cracks have large fillings in them, usually amalgam fillings. The crack would probably indicate that there is some leakage around the filling, meaning that decay will be able to leak through and get under the filling.

Not being able to see the x-ray, and not having looked over the shoulder of your dentist while he was working on your tooth, I can’t say with certainty what happened, but let me tell you what probably happened, based on my experience with many of these situations. Your dentist removed the old, leaky filling, likely with some decay underneath it. The dentin that was left between the bottom of your cavity and the pulp of the tooth was thin but intact. However, dentin is porous, and because of how the tooth reacted it appears to be clear that bacteria from the decay had been able to penetrate that porous dentin to infect the pulp of the tooth, causing it to be slightly inflamed. Working on the tooth irritated it somewhat, as it always does. Your dentist then replaced the old leaky filling with a new composite resin filling, bonded to the tooth and tightly sealed. The well-sealed filling now caused the internal pressure of the inflamed pulp to increase, which is what caused your immediate painful reaction.

I’m sorry for your sake that you had the tooth pulled when it could have been saved, but that is water under the bridge now. If it was the tooth furthest back in your arch, that shouldn’t have a serious impact on your bite, but you might eventually end up also losing the opposing tooth because it now may have no tooth to chew against and will hyper-erupt.

My recommendation to you would be to have your dentist look at your entire mouth and all your old dental work with a new set of eyes, and replace any old, suspicious fillings with new, well-sealed composite fillings, to help prevent this from happening again.

– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

May 10, 2016

Is this a salivary gland stone or a toothache?


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Dr. Hall,
I had a mercury filling replaced in my bottom back tooth closest to the ear. Now pain develops and radiates into my ear. Before the filling I was experiencing the same discomfort with some earache. My ear is good. The doctor suggested I have a salivary gland stone. I tend to believe it’s a dental problem.
– Bruce from Nova Scotia

Bruce,
A salivary gland stone? That seems like a stretch for your situation.
You can get calicifications in your salivary gland ducts, but the pain would not radiate to your ear. It would be in the soft tissue, in one of your salivary gland ducts, if you had pain. A couple of those ducts are under the tongue, and one is in the middle of each cheek. A salivary gland stone will cause swelling in that duct when you eat and maybe pain, and it would show up on an x-ray.
No, pain radiating to your ear sounds very much like a toothache. And if you have had a recent filling in a lower molar on that side, that would be the first tooth to check.
I would get a second opinion.
– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

April 11, 2016

I have an awful toothache, and my dentist is trying to tell me the tooth is fine!


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Dr. Hall,
Over a month ago, I had a toothache and ended up needing a root canal treatment on a lower molar. After that was done, the tooth felt somewhat better, but has never completely settled down. Now this last weekend the pain really flared up. It actually felt like it was the tooth next to this one. It started hurting so bad it scared me. So I went back to the endodontist who did the root canal. He took x-rays of all the bottom teeth on that side. He says that nothing is wrong and I could have all the teeth on that side pulled, including the new root canal and the pain would still be there. He told me to go to a neurologist.
Do you have any advice?
– Kendra from Oklahoma

Dear Kendra,
It’s tough for me to tell what is going on without a personal examination. But I think I can be helpful.

I can tell you that it isn’t uncommon at all for pain to feel like it is coming from a tooth and that tooth is fine. There are several possibilities for pain like this:

  • One is referred pain. I have seen where an upper tooth is infected and the pain feels like it is coming from a lower tooth. Or the pain can feel like it is coming from a tooth next to it. You don’t see referred pain crossing from one side of your mouth to the other, but you do see it from upper to lower, and you do see it from teeth that are in the same quadrant.
  • A second is some type of neuralgia. Yes, this happens, and it isn’t all that rare—a nerve problem that feels like a toothache. So yes, it is possible that your endodontist is right.
  • A third possibility is some other type of pain. A sinus infection, for example, can feel like a toothache. The maxillary sinus often is very close to the roots of upper teeth and infection there can press on those roots and feel for all the world like a toothache. Or that pain could be referred and feel like it is a lower tooth. Other health problems can feel like toothaches sometimes.

I can also tell you that it is possible, from a careful reading of x-rays, to determine that a tooth and its root are healthy. If a root canal isn’t healing properly, there will be x-ray evidence of that.

So I don’t know how to tell, from here, what the problem is. My advice would be to listen to the endodontist.

However, I would allow for the possibility that this endodontist isn’t very sensitive to patients or a good listener. You get some of that in the dental profession. If you have the feeling that he doesn’t really care that much and is trying to get rid of you, it might be smart to get a second opinion, just to be sure you’re getting correct information. Find another endodontist. If there isn’t one in your town, so much the better. It would be worth a drive to go get a good second opinion. But in getting that second opinion, make sure it is a blind second opinion. DO NOT tell the second endodontist the whole story, and especially don’t give the name of the endodontist who treated you or even give any clue that you went to an endodontist. Don’t say anything about the diagnosis you’ve been told. Just say that you had this root canal a month ago and now you have pain flaring up and ask if he or she can figure out where it is coming from. If they press you for more of the story, just be frank with them—tell them you want a blind second opinion and you’re not going to say anything more. They’ve got eyes and training—they don’t need anything more than the basics of the story, their eyes, and x-rays, to come to a diagnosis. You don’t want to complicate the second opinion by having this new endodontist call your old one. They probably know each other and there will be a strong inclination of the one to want to protect the other.

I hope this is helpful.
Dr. Hall

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Read more here about failed root canal treatments.

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

January 12, 2016

The tooth extraction site is sensitive to warm food

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Dr. Hall,
I had an oral surgeon remove a wisdom tooth. About 2 weeks later I shoveled snow in 20 degree temps for about 3 hours. The tooth site felt a bit achey. Now, a week later the site still seems achey and now seems very sensitive to warm-hot food. The extraction site appears very healthy. Is there anything I might need to attend to or check? Thank you so much for your time and attention.
– Tia from Michigan

Tia,
It’s normal for an extraction site to start to ache after physical exertion, if you’ve had a recent extraction, especially for a wisdom tooth. However, the sensitivity to heat is a different matter.

I get these reports of an tooth extraction site being sensitive to cold or air after an extraction and almost always it’s the adjacent tooth, and I suspect that’s what is happening in your case. Sometimes extractions will cause the root of an adjacent tooth to become exposed and that tooth with the exposed root will become sensitive. Sensitivity to cold wouldn’t be much concern especially if it’s mild, but sensitivity to heat could potentially be a serious problem in that tooth. I’d have it checked.

When a tooth becomes irritated, it will often become sensitive to cold. If that irritation persists without getting resolved, the tooth can become sensitive to heat. That happens when the pulp tissue inside the tooth begins to die. In the process of dying, it gives off gasses. Heat causes those gasses to want to expand, but since they’re confined inside the tooth, there is no where to expand and that causes pain.
– Dr. Hall

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Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

May 11, 2012

Serious pain to biting on my tooth with the new filling

Filed under: Pain in teeth — Tags: , , , — mesasmiles @ 3:40 pm

Hi Dr. Hall
In February I went to my dentist and she told me I needed my first two fillings (I’m 23). She told me my top first left molar would be just a spot filling and my bottom first right molar wasn’t deep. On my bottom molar I opted to get a composite white filling (now I wish I had of opted for an amalgam one instead).

Everything was great for about two weeks until I would wake up during the night with pressure shocks when biting down but it did subside over time, but then it got worse. I did make an appointment with my dentist and she shaved down some of my white filling.

I went back four days ago. She said to me that she was going to take out my white filling and have a look because what I was describing to her sounded like a crack in the tooth and she would ether put in another composite or a temporary filling. Once she got into my tooth she said my filling was deep after all and it was now even deeper after her taking out the white composite filling, she went on to say there was a small crack in the tooth. She then went on to say that she would just fill it up again with a composite.

Once the procedure was done she told me that she didn’t know what the out come would be and that if it didn’t get any better I would need root canal treatment. This I am really scared of.

Since then it has been giving me shocks when I bite, and sometimes if I just touch it with my tongue. Today it’s not as bad.

What should I do from here? Should I be so scared of getting a root canal? And should I just get my tooth pulled instead? (My wisdom teeth are still coming through)

Thanks in advance
Suzanne, Northern Ireland

Suzanne,
I’m not sure what’s wrong with your tooth. It could be a crack in your tooth. It could be traumatic occlusion, meaning that the adjustment should do. Or it could be that the tooth is infected. The fact that there was no pain until a couple of weeks after the filling was done seems to suggest a cracked tooth or an infected tooth. That would mean that the cavity was deeper than you had been led to believe. But I’d have to see the x-ray and do an examination to know for sure. In the case of a deep filling or a tooth that could potentially crack, you are better off with a white composite filling than with an amalgam filling. Amalgam weakens the tooth and is more irritating to the tooth.

I’m skeptical of the skills of your dentist, so if you do end up needing a root canal treatment, I would recommend seeing a root canal specialist. Do they have those (endodontists) in your health care system? With modern root canal techniques, getting a root canal treatment is usually fairly routine. but it does have to be done carefully or there can be a risk of failure of the treatment and you could lose the tooth anyway.

Do not have the tooth pulled. Without a replacement tooth being placed immediately, at your age with your wisdom teeth still coming through, your second molar will tip forward and throw your bite permanently out of alignment, and you could end up with a lifetime of troubles, especially if you tend to grind your teeth.

But I’m puzzling over what your dentist said, that she saw a crack in your tooth when she went back in. That certainly makes it seem like that’s the cause of your pain. But if your tooth is cracked to the point where that is causing you pain, you should have a crown on the tooth, and not just a filling. It seems like she should have recommended a crown. Without a crown, sooner or later, your tooth will break. And if you don’t need a root canal yet, after it breaks you probably will.

I would ask around for recommendations and find another dentist for a second opinion. If the tooth is cracked but it isn’t yet hurting on its own, doing a crown to cover the tooth could prevent any further problems.

Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

May 2, 2012

Strange toothaches – what’s the answer?

Filed under: Pain in teeth — Tags: , , — mesasmiles @ 5:40 pm

I have several tooth aches that have already had root canals. My Dentist put me on prednisone and tylenol 3 for 6 days and the pain went away. Now that the medicine is all gone, the pain is back. He says I should see a neurologist because there is a nerve that goes to the side of my head that is telling the tooth that it is not dead. The neurologist is supposed to give me medicine which may help. Can you explain it to me a little bit better. I have good days and bad days with several teeth hurting on one side of my face. I have 4 teeth in question and they all have good root canal done. My dentist says they are all in very good condition and he doesn’t want to bother the root canals. Any advice sure would help me.

Thank you
Rose from Michigan

Rose,
I don’t know that I can explain what is wrong with your teeth. I’m not following the explanation of what you are saying your dentist told you. He apparently is trying to translate a clinical diagnosis into something you would understand, but as you relay to me that “translation”, I am not able to get anything better than a vague understanding of what is going on with your mouth.

But I can tell you this much. It does sound to me like your dentist knows what he is talking about. There are nerve disorders that can mimic toothaches. And if prednisone and Tylenol was able to get your pain to go away, it sounds like he is on the right track. And if your dentist were trying to take advantage of you or cover up for his own ignorance, he has a ready excuse for any number of treatments in an attempt to solve your pain. So I respect that he has advised against any further treatment of these teeth.

My advice would be to go to the neurologist.
Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

September 12, 2011

Dr. Hall advises patient who is worried Army will pull his tooth. Can this toothache wait?

Filed under: Pain in teeth — Tags: , , , — mesasmiles @ 6:35 pm

Hello Dr. Hall,
I am in the Army National Guard and about 15 months ago during an exam, they decided I needed to have two fillings done in order to be deployable. This exam was done in the back of a tractor trailer by the way. I have received many fillings in my life, but the two I got that day have been horrible. The EXTREME sensitivity to hot and cold started that day. As well as not being able to chew on that side of my mouth.

At every opportunity I have expressed to the Army how much pain I am in because of these two fillings, each time I was basically told if they had to do anything about it, I wouldn’t be deployable. I sucked it up, and here I am in Afghanistan. The Forward Operating Base I am on doesn’t have any doctors or dentists, and recently the molar has started hurting 24/7. What is the reason for the discomfort? I am leary of them sending me to another FOB for treatment, because I don’t just want them to pull it (The Army’s favorite fix).

Is there another way to fix it? A root canal maybe? I am almost at my wit’s end with this and ready to knock it out myself. Oh and by the way, the dentist who did this to me, in the same day he extracted 4 wisdom teeth from another soldier, and stitched his gums to the inside of his cheek. I feel I was subject to the same skill.
– Ryan, in Afghanistan

Ryan,
I feel for you. I have had a toothache like you are experiencing, and they can be miserable.

It does sound almost for certain that you need a root canal treatment on this tooth.

Let’s give the army dentist the benefit of the doubt and say that these teeth already had cavities in them that were so deep that some bacteria had already entered the pulp. And let’s say that the teeth were filled with silver amalgam. I don’t know for sure what the Army uses for filling material, but I guess that it’s silver amalgam, since that is the cheapest filling material and the easiest to place. Amalgam conducts heat and cold readily. So that means that the tooth is going to get highly irritated right after the filling is placed, and if there are some bacteria in the pulp, that aggravates the infection and the tissue inside the tooth will then flare up into a dandy of a toothache.

The good news is that this process is self-limiting. Since a tooth is unable to recover from an infection inside the tooth, the tissue inside the tooth will end up dying, and the pain will go away. The time it takes for that to occur can vary a lot from one case to another, but usually it will be a matter of a few days. Then the infection spreads into the bone from the little opening at the apex of the tooth. While this can create a rapidly swelling abscess and a toothache also, it usually doesn’t, and your body ordinarily can wall off the infection and keep it from spreading.

Now keep in mind that I haven’t examined you or seen any x-rays, so my knowledge of your situation is limited and I don’t want you to take this advice without any question. But, based on what you have told me, here is what I would do, because, like you, I wouldn’t want them to pull this tooth, so I would take the risk of this really flaring up and try to avoid that. I would wait out this toothache. It will subside. Then I would cross my fingers and hope that it becomes a mild, well-controlled abscess and not a nasty one, and when I got to a place where I could have a private dentist look at this, I would get the root canal treatment done, and a crown put on the tooth.

It could be that your army dentist drilled too far and wasn’t careful in placing these fillings. It could be that an insulating base should have been put into the tooth under the amalgam filling material. Or, if this had been filled in a private dentist’s office, it could have been filled with a composite material that doesn’t conduct heat or cold. Or it could be that the decay was already so deep that there was nothing the dentist could do to avoid what happened.

I wish you well.

And I thank you, as a fellow American, for your service to our country.
– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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