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Pain in lower left tooth, Dr advises RCT. But this tooth was treated earlier. Need second opinion

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Dentist, Prosthodontics
Practicing since : 1995
Answered : 77 Questions
Hello. I have a question about tooth pain. I live in Japan. I am an American. I am 58. I have pain in my lower left 3ird tooth from the back. I have been to the dentist. They want to do root canal on the lower left side furthest back tooth. I really don't think it is that tooth right now that is causing me the pain though. They showed me the xrays of the back tooth and I can see that the root is almost invisible. But that is not where the discomfort is. The tooth that is causing me discomfort is a tooth which I had treated about 18 years ago. It was from an excellent Japanese doctor who had graduated from UC Berkley Dental School. Normally I would pay about 200 dollars for treatment but this filling cost 2200 dollars. The doctor did an excellent job I suppose. I have a picture of the tooth I can send. The symptoms I am experiencing are that particularly when I bend down or put my head in a particular position (like bending over) I feel sensitivity. The sensitivity seems to be at the top of the tooth. It seems, because it depends on the position of my head -usually an inverted position, that it should be some sort of nerve that is sort of loose or something and moves when I move. But the doctor thinks it is not this tooth. But it seems so clear that it is because it really depends on the position of my head (and I guess gravity) (although now it is hurting continuously). So I don't particularly want to do root canal on another tooth. I would like to get your opinion. Thank you.
Posted Sun, 17 Jun 2012 in Dental Health
Follow-up: Pain in lower left tooth, Dr advises RCT. But this tooth was treated earlier. Need second opinion 21 minutes later
I forgot to say that the dentist took an x-ray of the tooth that I feel is the problem (the one with the white porcelain top in the picture) and thought it looked healthy.
Answered by Dr. Ramesh B. Hegde 14 hours later
Thank you very much for the query. The explanation of pain in one of the tooth indicates that the tooth may have to undergo rootcanal treatment. If I am right, which tooth has to undergo treatment is the question in your mind? To decide upon, X-ray is must come to proper conclusion.
Such pain are usually radiating, many a times it is difficult to make out which tooth is giving pain. While doing the root canal of the lower 3rd molar tooth, upper 3rd molar has to be there and there should be proper mouth opening to perform root canal treatment.
Hope this answers, your query, if yes kindly accept the answer. If you have any further querries regarding this, you are well-come with the x-rays
with happy regards,
Above answer was peer-reviewed by
Follow-up: Pain in lower left tooth, Dr advises RCT. But this tooth was treated earlier. Need second opinion 5 hours later
Hello Dr. Thank you for your kind reply. I went to a doctor today to check to see if it might be sinusitus but he said probably not since there was not pain in my upper teeth or cheek. However he said that since the filling or whatever it is called on the 3rd tooth is made of 2 layers (see the photo) it is possible that the connection between the layers may have become weak (it is 18 years old). This is exactly what it feels like but my dentists did not mention this as a possibility. What is your opinion on that? Thanks again.
Answered by Dr. Ramesh B. Hegde 20 hours later
Thanks again for the query. I totally agree with the opinion regarding sinusitis given by your doctor. It's true that any tooth restoration invloving metals like silver amalgam needs a thermal insulating base [so that variation in temperature of mouth should be not transfered to the inner structures of tooth through the metal restorations]. If such temperature varation is regularly transfered to inner soft tissue of tooth, then such tooth is likely to get pain because the soft tissue is being damaged.
It's true that there is every possibilty of the 2nd layer[insulating base] in your filling may be weak and because of which you are getting symptoms.
I sincerely hope this clarrifies. If yes, kindly accept the answer. If you have any further querries with this regard you are well-come.

with happy regards,
Above answer was peer-reviewed by
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