Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

April 21, 2018

Water relieves the pain in my tooth


We thank our advertisers who help fund this site.

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.

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below.

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.

January 20, 2017

Tooth with a crown is sensitive to heat


We thank our advertisers who help fund this site.

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

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

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.

Powered by WordPress

Follow this blog

Get every new post delivered right to your inbox.


Categories