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I'd recommend a second opinion. I've had some bad experience with dentists in the past, including unnecessary root canals.
Lord Yod on
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FiggyFighter of the night manChampion of the sunRegistered Userregular
edited January 2008
Go have a second opinion. Even if forumers have had similar experiences, there are so many reasons why your tooth could be hurting that it's impossible for us to tell you what's happening, or whether or not you need a root canal.
Here's a horror story of my own that might make you go find another dentist tomorrow:
I had a pain in one of my molars for several months, and it was one of my wisdom teeth. They were supposed to be removed but I never got around to it. I didn't have insurance and I didn't really want to drop $2000. So, I let it go.
Months go by and it hurts more and more at different times.. never really sensitive to one thing or another.. just... hurting a lot sometimes.
One day, I'm playing a computer game and I feel am tonguing my tooth.. suddenly.. crack.. what the hell? Not too much pain, but a bit. I had been putting sensidyne on there so it didn't hurt so much... but now a friggin piece of the tooth had come off. Turns out, there was a cavity inside the tooth that was getting worse and worse, until finally a part of the tooth came off.
For some reason, I wasn't in enormous pain. There was discomfort.. but not terribly horrible. I didn't even end up getting the tooth extracted until a few months later.
Well, im one year away from qualifying as a dentist, for what it's worth, and ive treated this a few times. Your dentist did the correct thing as a first stage treatment, making sure the filling isnt high. How long has it been since he did that? If the filling was high, then the x-ray would show an area of inflammation around the ligament, which is very subtle, but should be visible to a dentist. If that was the case here, then the ligament can take ~4 weeks to settle down.
My take on this though, is that your symptoms describe 'cracked tooth syndrome', where a fracture in the enamel or dentine has occured, because the tooth strength is hugely reduced by a filling. It's pretty hard to diagnose, even with a patient sitting in front of you.
If i'm right, then i'd be wary about agreeing to root canal therapy before a confirmed and exact diagnosis. RCT takes out the nerve of a tooth, so sure, you wont feel any pain, but if the crack should extend onto the root of the tooth, then basically, it will fail. Sharp vision is the only realistic way to detect a fracture, but taking the filling out and having a look will enable most fractures to be spotted. Also, a 'transillumination light' is a very powerful light source that some dentists have that would let them spot cracks with 100% certainty.
As for cases with this that i've treated with only minor fractures, root canal is over-the-top treatment. I would replace the filling with a sedative temporary dressing (IRM), and see if there is improvement. If there was, then i would replace the top of the temporary with a permanent restoration. If no improvement, then you need a crown on that tooth to protect it against forces when you bite down.
I would also advise getting a second opinion, or if not that, then to stand up for yourself a bit more at the dentist, you pay him, he answers your questions, if he has a working diagnosis, ask him what it is, or what other possibilities he thinks there might be. Those are things which, since you havent brought up, i dont think he discussed adequately with you.
TLDR: So in other words, if im right and you have a crack in your tooth, root canal is overkill (and in fact doomed to failure if fracture extends to the root), crowning is the most likely fix, and in the meantime, a cheap and easy fix is a filling replacement with ZoE dressing. After that you can review the options. I'd always say though, the dentist you have, has seen the tooth and the various special tests, so if you trust him, he's pretty much your best bet at fixing it .
Posts
Here's a horror story of my own that might make you go find another dentist tomorrow:
I had a pain in one of my molars for several months, and it was one of my wisdom teeth. They were supposed to be removed but I never got around to it. I didn't have insurance and I didn't really want to drop $2000. So, I let it go.
Months go by and it hurts more and more at different times.. never really sensitive to one thing or another.. just... hurting a lot sometimes.
One day, I'm playing a computer game and I feel am tonguing my tooth.. suddenly.. crack.. what the hell? Not too much pain, but a bit. I had been putting sensidyne on there so it didn't hurt so much... but now a friggin piece of the tooth had come off. Turns out, there was a cavity inside the tooth that was getting worse and worse, until finally a part of the tooth came off.
For some reason, I wasn't in enormous pain. There was discomfort.. but not terribly horrible. I didn't even end up getting the tooth extracted until a few months later.
TL;DR: Go check it out.
My take on this though, is that your symptoms describe 'cracked tooth syndrome', where a fracture in the enamel or dentine has occured, because the tooth strength is hugely reduced by a filling. It's pretty hard to diagnose, even with a patient sitting in front of you.
If i'm right, then i'd be wary about agreeing to root canal therapy before a confirmed and exact diagnosis. RCT takes out the nerve of a tooth, so sure, you wont feel any pain, but if the crack should extend onto the root of the tooth, then basically, it will fail. Sharp vision is the only realistic way to detect a fracture, but taking the filling out and having a look will enable most fractures to be spotted. Also, a 'transillumination light' is a very powerful light source that some dentists have that would let them spot cracks with 100% certainty.
As for cases with this that i've treated with only minor fractures, root canal is over-the-top treatment. I would replace the filling with a sedative temporary dressing (IRM), and see if there is improvement. If there was, then i would replace the top of the temporary with a permanent restoration. If no improvement, then you need a crown on that tooth to protect it against forces when you bite down.
I would also advise getting a second opinion, or if not that, then to stand up for yourself a bit more at the dentist, you pay him, he answers your questions, if he has a working diagnosis, ask him what it is, or what other possibilities he thinks there might be. Those are things which, since you havent brought up, i dont think he discussed adequately with you.
TLDR: So in other words, if im right and you have a crack in your tooth, root canal is overkill (and in fact doomed to failure if fracture extends to the root), crowning is the most likely fix, and in the meantime, a cheap and easy fix is a filling replacement with ZoE dressing. After that you can review the options. I'd always say though, the dentist you have, has seen the tooth and the various special tests, so if you trust him, he's pretty much your best bet at fixing it