Hi and thank you for taking my question!

For about 2 weeks I have been having jaw and tooth pain that comes and goes and seemed to move. I went to the dentist who I have not seen before. He did X-ray and found a large cavity in a tooth that already had a filling. He said he feels there is only a 10% chance he can save the tooth because there won’t be enough actual tooth to work with and it is probably going to be extracted the same day after he cleans it out and finds how deep it is. Then he suggests an implant or bridge but leans toward a implant and bone grafting.

I strongly dislike any dental work and am petrified of all this. The tooth is 4 from the back on my right side which still has wisdom teeth. Does this sound correct to you or should I seek a second opinion? He said there was no infection he saw at this time but put me on amoxicillin for precaution since I had some pain. I have the worst fear of having some type of allergic reaction to the local anesthesia or something going totally wrong and I am having constant anxiety over this. Thanks for any advice!
– Ali from Maryland

Ali,
I can’t say for certain without seeing your tooth, but I am skeptical of what you are saying your dentist is telling you, for a couple of reasons.

First, if this is the first time you have had a toothache in this tooth, then the tooth has just recently become infected. I am having a hard time believing that this tooth is as far gone as your dentist is saying, if that is the situation. A hopeless tooth would have most likely begun hurting months ago.

Second, a tooth that has been so extensively destroyed that it isn’t savable, this would not require an x-ray to see it. It would have an obvious, big, gaping hole in it, and the filling would have fallen out long ago. Usually.

So yes, a second opinion would be smart.

A word of advice about getting a second opinion – make sure it is a BLIND second opinion. Don’t let the second dentist know what the first dentist said. You are entitled too be able to get a copy of the x-ray to take to the second dentist, but you need to conceal the diagnosis because that knowledge can possibly prejudice the second opinion.

And another point. You say you are having a lot of anxiety about facing this work and are worried you may be allergic to the anesthetic. In all my years of practice and the thousands of people I treated, I never had a genuine case of allergic reaction to any local anesthetic. I had people claim they were allergic, but upon administering the anesthetic, there was no allergic reaction. But I saw a lot of anxiety like yours. In fact, I myself am an anxious patient. You need to find a dentist who practices sedation dentistry who can give you something to take care of your anxiety. For me, if I just have nitrous oxide, that works and I’m fine. For others, they may need conscious sedation. When you have a certain level of anxiety, your body actually fights off the local anesthetic and it may be impossible to get you completely numb. And that just perpetuates this vicious cycle.

So, yes, get your second opinion, and I would recommend finding a dentist who could offer you sedation.

Dr. Hall