Serious pain to biting on my tooth with the new filling

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