Sore tooth-Dental question (not treatment advice)

Factual Questions
1

Question: Do dental x-rays (digital ones) accurately reflect what is going on in a tooth? When you start working on a tooth, can the damage you find be worse than what is shown on the x-ray and what is visible on the tooth itself?

Back story:
Went to dentist Dec. 2007 for exam due to sore gums. Found to have moderate-severe gingivitis. Treated with Periolase. Since then: brushing teeth 2 times per day with electric toothbrush for 4 minutes each time, and using proxi-brush 2 times per day (she prefers proxi-brush over flossing) Progressive improvement in gum disease over this time. Every 3 months- sonic cleaning, salt-blasting, with variable, but decreasing, amounts of discomfort after the cleanings.

April 2010-Least amount of discomfort during and after cleaning since I have been seeing her. Yeah!! progress!! I’m doing good!! Routine x-rays show a “shadow-decreased enamel density(size not specified)” on one of my molar teeth Some darkening of the tooth surface, but no cavity. Advised I should get a filling to prevent further damage to the tooth-should not wait until it gets worse.

early May 2010- Filling done. She says it is “deep” and she put in some stuff to decrease pain and inflammation. Afterward, pain with eating and clenching teeth together. Check “bite”=adjust. Still problem, check “bite”=adjust. Now pressure on tooth in front of filled tooth, file that tooth. Now slight pressure on teeth in front to previously filed teeth. Still sore if I happen to forget and eat on that side.

4th of July- eating a piece of ham, start to bite down on filled tooth-Major pain lasting an hour. Take aleve for several days, better but still slightly sore. (Why still sore at all, 2 months after the filling ???) Don’t want to go back to dentist, don’t trust her anymore, never had problems with fillings ever before-get printout of x-rays.

Last Friday-don’t know what I did, worse pain in tooth. No gum redness or swelling or soreness so I don’t suspect abscess at the root. Stop eating any food that requires chewing. Saturday, in tears due to pain, pain along jaw up to ear. Talk to another dentist: 600 mg. Advil alternating with 1000 mg. Tylenol every three hours. I also add topical pain cream on skin of face over sore area. Finally some relief on Sunday. See this dentist on Monday, he looks at April 2010 x-ray printout, not sure, maybe, he sees the “shadow”. (“printout not as good as seeing the x-ray itself”, he says) He takes his own x-ray: Wow, that is a big, deep filling. See how close it is to the nerves. You have “pulpitis”-inflammation of nerve in tooth-will need root canal and crown to solve problems. Cost-just shy of $3,000 :eek:

I do not understand. How can I have that much damage and need such a large filling to a tooth that only has a “shadow-decreased enamel density” on the x-ray and yet have NO pain when she cleans and salt-blasts the tooth, and no pain with eating?

2

IANAD, but given the problems you had after the filling I’d say the first dentist did a bad job with it. As a minimum it was too big, but it also may be they didn’t do a good enough job of cleaning out the cavity after drilling and before filling.

3

dentist told me that a tooth is traumatized by doing a filing, larger and deeper is more likely chance. nerve damage, death and infection can result weeks later. who knows how many factors have to all happen for that result. ianad.

4

Google images of dental x-rays and teeth seem to indicate that the answer to the first question is “No”, and the answer to the second question is “Yes”

Now I just need to figure out what is the best way to deal with my current situation. A search of “Natural alternatives to root canals” really leads to some crazy sites. Conspiracy theories even in dentistry !!

5

I’ve had a root-canal four times… on the same tooth; it took 3 months, 2 doctors and 6 x-rays for them to realize the root wasn’t extracted completely. Apparently they sometimes “don’t show up”

6

Yeah, this actually happened to me. The dentist placed a filling, and warned me at the time that because the filling extended deep into the tooth, there was a very good chance that the tooth would eventually become painful and require a root canal. All was well for a couple of months, and then the tooth started to hurt like heck. The fix was a root canal and crown.