Is it acceptable to replace a filling over brown colour, and how to diagnose what is wrong with it now?

[Annie364]

I had a filling fall out on a molar, with no pain at all, and perfect white underneath.
My dentist said it would be fine to leave it weeks before refilling, and he could not fit me in until 7 weeks later (which was a year ago now).
By that point, it had gone brown instead of white.
When he repaired it, it was a few seconds to wipe/clean it, then he put the filling directly on the brown surface.
Is this standard practice, to replace a filling onto a brown surface?
I questioned him at the time, and he said as it wasn't soft, it's OK.

It was OK at first, from what I remember, then I had on and off pain from it for a while.

Now the pain has come back but it is a gnawing kind of pain in my jaw area, that is not too bad but annoying, and it's hard to tell even which tooth it comes from. It could be the tooth next to the re-filled one, or even the next one along. I guess the pain is dull rather than sharp. Maybe this is what nerve pain is like, I don't know.

That dentist has now retired, and before I see a new one I will be getting some CBCT scans at the endodontist to check the healing of some other teeth that were root canalled.

I'm wondering if a CBCT scan on this re-filled tooth could show if this is the one causing me pain?
Or can they just remove the filling and have a look, or would it harm a tooth removing the restoration like that?

 

[Gordon]

I'm wondering if a CBCT scan on this re-filled tooth could show if this is the one causing me pain?
Or can they just remove the filling and have a look, or would it harm a tooth removing the restoration like that?

Not likely, no.
Yes they could. Not likely to do any harm, but ask them just to look at it first!

 

[Annie364]

OK thank you so much Gordon. I was hoping the CBCT could be sensitive enough to actually make an image of a layer of recent decay under the filling and how close it was to the nerve.

If they just look at it, how can they even tell which tooth is causing the pain without opening it up though? There are 2 or 3 possible ones. They all look normal and they don't hurt if I push on them.

And was it OK to put a filling onto a brown surface like that?

 

[Gordon]

OK thank you so much Gordon. I was hoping the CBCT could be sensitive enough to actually make an image of a layer of recent decay under the filling and how close it was to the nerve.

It's not really designed to do that.

If they just look at it, how can they even tell which tooth is causing the pain without opening it up though? There are 2 or 3 possible ones. They all look normal and they don't hurt if I push on them.

Well, they're allowed to use a dental probe as well as the Mk 1 eyeball, you can tell quite a lot from those 2 things

And was it OK to put a filling onto a brown surface like that?

Really can't say without seeing it. Maybe.

 

[Annie364]

Thanks Gordon. MK 1 eyeball, I'm not sure I get it but I think it's a joke!

Basically I have a deep ache in the jaw and I can't tell which tooth it is from, it could be any of 3 teeth (one is the refilled one).

But given the teeth themselves are not sensitive or painful, and the pain is in my jaw, how can they diagnose that with just a probe, or what other diagnostic methods are there for this case?

 

[Gordon]

Probe, caries detector dye, percussive tests, hot and cold test, electronic pulp tester, palpation of jaw muscles, transillumination, x-rays, "tooth sleuth" thing for checking for cracks, diagnostic cavity... loads of stuff.

 

[Annie364]

Thank you Gordon that's really helpful.