Dental Question: Is My Tooth Dissolving?

Factual Questions
1

That seems to be what is happening, but my dentist says he has never encountered this before. The boring details:

I had a bridge put in 4 1/2 months ago, lower left side, because of a tooth that was pulled years ago. I’m not up on tooth names, but it’s the second one from the back.

So, the bridge goes over the teeth on either side. The back tooth looks like it may have to have a root canal some day, but it’s not serious enough yet to fool with, might never have to, so the portion covering that tooth is metal and can be opened to allow access. The rest of the bridge looks like normal teeth and cannot be removed.

About a month ago, I began feeling pain in my gum just below where the bridge sits, but only when I touch it. It does not hurt if I don’t touch it; it hurts A LOT if I do, then stops hurting the moment I stop. The tooth itself does not hurt, even when the dentist taps hard on the portion of the bridge covering it. There is a slight, but ever so slight, swelling at that part.

Now, I was at the dentist on Friday, and he X-rayed the tooth and said it appeared the remnant of that tooth underneath the bridge was dissolving. Comparing X-rays from Friday with a few months ago, the wall of the tooth is noticeably thinner. There is also some dark matter surrounding the base of the tooth, and he cannot tell from the X-ray what that is, but I got the impression he thinks it could be the dissolving part settling down there; I think he didn’t want to come out and say it until he’s sure, especially since he’s not encountered this before. I asked if this were common, and he said he had never seen it before. All he can do is remove the bridge to see what is the matter. He told me not to worry, that he would not charge me for the new bridge that will have to replace this one, but Yikes! This is going to be an awful lot of pain and trouble.

And lest anyone be thinking, “Ha! Third World dentist” because I live in Bangkok, this man is very skilled. He’s been my dentist for years and years. In fact, 11 years ago, he put a bridge in for the same tooth on the other side of my mouth, and I’ve never had a problem with that one at all. The only difference between the two bridges is the one from 11 years ago does not have the metal part, but that covers the OTHER tooth anway, not the one I’m having problems with.

So, have any Doper dentists out there ever heard of this? I’m scheduled to return to the dentist this Friday to have the bridge cut out.

2

IANA dentist, but try visiting http://www.doctorspiller.com/Tooth_Decay.htm.

Read that page and the page on Dental X-Rays. From what I have learned from doctorspiller.com and your description, I think there is a chance that you may be getting a cavity one of the teeth under the bridge. Perhaps food/sugar is getting stuck under the edges of the bridge. Hopefully there is a full cavity and it is only a little demineralization because the enamel can heal from a little damage with good flossing and brushing.

3

*isn’t a full cavity…

4

Thanks. He’ll still have to remove the bridge? :frowning:

5

If it is a full cavity, I think so. I don’t know of any methods to deal with a cavity that don’t require some intrusion into the tooth. If it is just a bit of demineralization, I think you might still get the bridge removed for a few weeks so that you can floss daily and brush with a fluoride toothpaste to help restore the tooth.

Do you brush and floss daily? Do you use a mouthwash before going to bed? Do you avoid soft drinks with sugar like doctorspiller.com suggests?

6

Yes to all except flossing. I’m quite lazy about that, always have been.

7

I know what you mean. I’m going to sound like your dentist for a little bit…

It can be a bit time consuming and difficult to do a good flossing but I think everyone should floss once a day. Virtually everyone brushes their teeth daily but I think flossing is also essential. It gets at the bacteria and food in between your teeth and under the gum line that a tooth brush simply can’t reach.

Wikipedia says: “the ADA indicates that only about 12 percent of Americans floss daily, 39 percent floss less than daily, and 49 percent do not floss at all.”

I only started flossing about 2 years ago because I was simply never taught what dental floss did! I had to educate and experiment with what flossing did to my teeth. I can tell you that if I don’t floss for a couple of weeks that the spaces between my teeth will get filled with that white stuff that contains all that bad bacteria, acid, and food. My gums will also bleed easily when I brush my teeth. Sometimes I will get a dull pain on one of my molars that is easily explained by bacteria/food getting stuck back there.

The lesson here is: Floss daily!

Side Note: If you are rich and a bit lazy about flossing, you could try getting a dental sealant for your molars .

8

Still, my dentist IS a god one, and he says he’s never seen this happen before. He’s been practicing for well over 20 years. It did not appear to be a cavity on the X-ray, and the entire tooth wall was thinner. If it were as simple as a cavity, I’d’ve thought he could tell right away.

9

Update:

We have finally determined for sure what the problem is. It is definitely a cavity, in the middle of the tooth and completely below the gum line. My dentist has never heard of or seen this problem before in a tooth that has NOT had a root canal. But he deadened my gum so he could poke around in the gap underneath my bridge that he put in last year, and he found the cavity. So now I will have dental surgery on Friday morning. He won’t have to remove the bridge, but rather will cut open the gum and fill the cavity that way. Then we’ll wait maybe 6 months or a year to see if I’ll need a root canal. My dentist said there’s a chance I won’t need one but that if I do, I couldn’t have one without this cavity being taken care of; instead, they would just have to remove the tooth, which WOULD mean removing the bridge, also.

My dentist feels really bad about this, but I don’t blame him for the trouble. There really was nothing to see on the X-rays before he put in the bridge. I’ve seen all the X-rays myself. This just sort of cropped up. But he didn’t charge me for anything yesterday (Tuesday), even though he spent 45 minutes on me and gave me two doses of anesthetic (I seem to need extra anesthetic; a normal dose is almost never enough).