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Old filling fell out from top left first bicuspid, sharp pain, pain killers

Seven weeks ago an old filling fell out from my top left first bicuspid. The filling was replaced but it fell out again and the dentist decided to readjust/enlarge the cavity so a new filling would stay. This procedure was done under local anaesthetic. Once the effect of the anaesthetic wore off, my tooth was very sensitive. I suffered very unpleasant sharp pain especially when drinking and eating either hot or cold. Back to the dentist to readjust the tooth (with carbon). But this didn t help. I gave it 10 days or so to see if time would heal and went back to the dentist. By that time I was using only my right side to chew . The dentist suspected that the filling was putting pressure on the tooth. They took the material away, investigated inside to check the root canal was alright and replaced the filing using less pressure (I think they also changed the type of material) and in two parts so it would impart less pressure. It did relieve the pain I was having to some extent but I was still experiencing pain regularly. Still chewing using the right side only, I began to develop pain in my jaw and cheek bones and basically, for a while, across all my teeth and my whole mouth. This lasted a week or more. I was taking pain killers (although with no efect) and had to blend my dinner as I couldn t chew properly because of the pain. Back to the dentist. I described all the symptoms mentioned above. The treated tooth was the source of the most pain: it was like biting a very small stone giving a sharp pain. Also I mentioned that food was concentrating between the tooth and its neighbouring second bicuspid and the resulting pressure was also giving sharp pain. (The filling was on the side of the first bicuspid). They investigated again, used carbon again to readjust a little more, a fracture/crack on the tooth was also investigated and the idea eliminated, took new X-rays (can be provided), and the conclusion was: We don t know why you are still in pain . Since then (a week ago) I have been suffering very acute sharp pain when I eat and drink, hot and/or cold from the treated first bicuspid to the Second molar (sometimes to the third molar inside my gum!). The pain is much the same each time and varies from tooth to tooth (all top left), but I am also having similar pain periodically now on my cupid to my second molar on bottom left. Pain, pain, pain, each time a different tooth. I am helping myself with massaging the teeth and gum. I am also taking pain killers but they have been of no help. Really don t know what to do next or who to ask for help. (fem-46yrs)
Asked On : Mon, 26 Mar 2012
Answers:  3 Views:  214
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Dentist, Oral and Maxillofacial Surgery 's  Response
Hello there. Im sorry to hear you are experiencing such problems. I will try to help.

First and foremost i cannot make any definitive decisions or a definitive diagnosis without considering your full history and undertaking a full examination, but i will use to above information to try and advice you accordingly.

Pain around a tooth can either originate from the tooth itself or from the tissues surrounding the tooth.

1 -
If the pain originates from the tooth itself it is usually either due to decay which is encroaching onto the pulp (the nerve chamber) or the filling is so deep that it is close to the nerve and some of the constituents of the filling material are stimulating pain as they find their way through the dentinal tubules into the nerve chamber. Another possibility is that a composite resin material was used (white filling) and as it contracts when cured (hardened) it pulls against the walls of the cavity which causes pain. One final posibility is that you may have a fracture through the tooth. I know you say this was ruled out, but in fact it is very difficult to rule out fractres in teeth. They certainly dont show up very well on radiographs (xrays) and they are hard to identificy clinically (in the mouth) unless they are extensive.
I would like to see the radiographs if possible. Solutions to the above problems involve removing the existing filling, check the base of the cavity, placing a sedative dressing in the cavity for a week to see how things resolved. This sedative dressing is made of Zinc Oxide Eugenol. If this temporary dressing works, then we can confirm that the pain is tooth-borne and a result of the size of the filling and its proximity to pulp (nerve chamber). If the temporary dressing does not relieve the pain then it is likely that the pain is either due to a fracture or no longer tooth-borne and the pain involves problems with the periodontal ligament (the tissue surround the tooth).

If the pain originates from the surrounding tissues it means that your nerve is damaged beyond repair and their is resulting inflammation in the tissue at the end of the root. Typical symptoms of this include, continuous pain, throbbing pain, pain when pushing the tooth down into the socket, mobility of the tooth, swelling in the gum, etc. To treat this, one would have to undergo root canal therapy to remove the nerve tissue in the camber and canals and replace it with a resin material. This will then resolve the inflammation around the root of the tooth. An alternative and more definitive and more successful treatment option is to extract the tooth. For this we would have to be confident that the tooth was indeed non-vital (dead) due to irreparable damage to the nerve.

I would like to know the following:

1-What the xray looks like?
2- Does that pain wake you up at night?
3- What sort of pain - stabbing, shooting, dull ache, throb?
4- Is the pain continuous?
5- Does anything make it better?
6- Is it worse at any particular time during the day?

Lets hope we can come closer to finding an answer for you.

Best wishes.
Answered: Sun, 27 May 2012
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Dentist Dr. Gunjan Gupta's  Response
hi,i read all the detail given by you,i will suggest you please go an endodontic as soon as possible and go for whole mouth examination,and please follow all the given did not tell that after root canal treatment you went for capping or not?this pain may be due to infection in that root canal treated tooth,fracture of that tooth etc.any ways painkillers are not the solution for permanent relief proper treatment is the only option so please go to an endodontic as soon as possible.
nothing to get worried.take care
Dr.Gunjan Gupta
Answered: Sat, 26 May 2012
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Dentist Dr. Vishal Jain's  Response

after reading your query, i would suggest that you should go for root canal treatment of that particular tooth.
the pain in other tooth is a radiating pain and its origin is that tooth only.
your dentist should have started the root canal on your second visit only as you was giving clear signs and symptom of that.

anyways its time to get the proper treatment and visit to an Endodontist as soon as possible.

Dr. Vishal Jain.
Answered: Wed, 13 Jun 2012
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