How could the dentist diagnose my sensitive tooth so fast?

Dr. Hall,
I have a molar that has a large filling, it is sensitive to cold, heat and air. I went to see my dentist, he blew some air on it in a couple of different spots, asked if it hurt, and put some desensitizing something or other on it. He said if the pain stayed he would have to remove the nerve. My question is how does he know this in 2 seconds of blowing some air? I currently have braces, could this have something to do with it? I’ve also had another thought of the filling having a hole in it or maybe being thin, could this cause the sensitivity? My dentist is very impersonal, very quick no time for questions, he does what he thinks he needs to do and that’s it, he’s gone.
– Laurie in North Dakota

Dear Laurie,
Sometimes these pain issues are very clear and sometimes they are fuzzy and take time. From what you’re telling me, yours was fairly clear.

If you blow air on a tooth and it hurts, that indicates that there is some unprotected, sensitive spot on the tooth, which can be helped by coating the tooth with a desensitizing bonding agent. If the pain is transient—it hurts for a moment and the pain goes away immediately, that’s a sign that the nerve or the pulp of the tooth is irritated, but that it could potentially heal. If, on the other hand, the air provokes pain and the pain lingers for more than a few seconds, then the irritation of the pulp or nerve is irreversible—it will not heal on its own and will require root canal treatment.

The tooth can also be tested with cold, with heat, or with electrical impulses, depending on the situation.

I don’t know the situation in your mouth, so whether this has something to do with braces or not, I couldn’t tell. That would be unlikely, but possible.

I wouldn’t think that the filling being thin would cause this sensitivity. You said the filling is large, so it would be more likely that there could be some leaking around the filling, or decay under it. Again, I don’t know what your filling looks like other than your saying it is large, so there might be reasons your dentist didn’t think these were possibilities that should be checked.

As far as your dentist not staying around to answer your questions, if I were in your shoes I would call the office and say I needed to ask some questions, and if the doctor didn’t have time for my questions I would have to find another dentist. That would almost certainly get you some attention. I would actually probably say that while I was still in the office and the assistant was dismissing me. Health care is built on trust, and the two pillars of trust are the knowledge of the doctor and the caring of the doctor. One without the other doesn’t lead to good care.

– Dr. Hall

Other links:
Click here to read about tooth sensitivity from various causes.
Click here to read about why a tooth is sensitive to cold.