Dr. Hall,
Six months ago I had a front tooth filled with a white filling. Almost two months ago, I went back to complain how floss gets stuck in a notch between my teeth and to buff the surface of the tooth where leftover filling material was a nuisance. So my dentist smoothed it out. But then I got shocking pain when I took a bite into pizza. I gave it two weeks, went back in to have the tooth x-rayed. My dentist says the tooth is still sensitive to the filling procedure and take Advil and wait it out. But for the past two weeks the pain level is such that I can’t chew bread or drink room temperature liquids.
I am now constantly on pain medicine. My choices?? If I go back in, he will probably want to redo the filling. But can the dentist tell from the x-ray if the tooth really needs the root canal or do you think the porcelain did not get bonded or filled correctly? It is my front tooth so I don’t want to make a bad decision about whether to see an endodontist or let this dentist experiment around and redo the filling.
Any help or advice is greatly appreciated.
– Lisa in Colorado
Lisa,
If the pain is as intense as you seem to say, then you probably do need to see the endodontist. A dentist should be able to diagnose this by testing the tooth, and, if they’re good, they should be able to see it on the x-ray at this point. The endodontist should be able to tell.
This isn’t just irritation from being filled, because you are telling me that it’s been six months and the pain is getting worse. When a tooth is just irritated, it hurts, but then the pain will get better–sometimes very slowly, but always getting better. When the pain progresses, it’s a sign that there is some type of infection going on.
While it’s possible the dentist did something wrong, usually when this happens it’s just an indication that there was decay under the old filling or something like that. This would cause some bacteria to get into the pulp of the tooth. Then, with the added irritation of being worked on, it’s enough to push the tooth over the edge and start to show signs of infection.
And here’s an important tip for a root canal filling on a front tooth that a lot of dentists don’t know. Ask that they leave no gutta percha (root canal filling material) inside the crown, but to trim that filling material to below the tooth attachment. This will help keep the front tooth from discoloring. You may end up needing a crown on this tooth, in which case the discoloration won’t matter. But if there isn’t a large filling in the tooth, you may not need a crown and trimming the gutta percha will help keep the tooth from turning dark.
– Dr. Hall
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About David A. Hall
Dr. David A. 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 advanced internet marketing for dentists.
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