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No pain ever, but major work needed?

F

FSom

Junior member
Joined
Dec 12, 2008
Messages
3
Hi, apologies for the length of this post! Any advice from anyone would be very welcome.

A little while ago I moved to a new town and arranged a check-up at a dental clinic. The dentists checked my teeth, found nothing wrong, but took an x-ray as it was my first time. He then came back to me and said I needed work urgently on a tooth and I should be in major pain. He also suggested that I should reduce my carbonated drink intake, stop eating highly citric fruit (he mentioned apples specifically) and the like, and wanted to initiate a root-canal filling asap. I was shocked - I don't have any pain from the tooth, I don't drink carbonated drinks or eat very citric fruits. I got him to agree to let me wait, though he assured me that within 3 or so months I would be in agony.

Now, a year later, still no pain, I sorted out my annual check-up at the same clinic. A new dentist dealt with me, and once again checked my teeth and seemed impressed with my dental hygene, no gum desease, no need to see the hygenist, etc. Then he looked at the same tooth that was supposed to be giving me pain and insisted that he x-ray it. He asked me to wait outside and after a pretty long wait (10 minutes maybe) invited me in and said he couldn't understand how I wasn't in pain, but that tooth was in terrible condition. Once again I was told that I needed work badly or I would suffer the consequences. This time I asked what the worst case sceanrio was, and he said the tooth could drop out and you might then want an implant. The x-ray showed extensive decay right through the tooth, it really was totally dark. He did say that if I had work on the tooth he wouldn't guarantee it wouldn't hurt for years, whereas it migth never hurt without any work (and he said this without me asking). Nevetheless he said that although he felt that I would want to get this done quickly (presumably because he didn't believe I wasn't in agony!) he would deal with it in January so I wasn't in pain from the treatement over Christmas. So I booked an appointment for early January.

I have no fillings, no pain at all, and never have had any toothache at all except for briefly when my wisdom teeth came through (and they all did so perfectly well), there is no history of any tooth problems in my family to speak of, and so I really don't know what to do. Should I get major work on a tooth which seems perfectly fine, no pain, no sensitivity (I can drink a hot drink then have an ice cream, no problem).

What is the worst case scenario - is it an implant? If so, I am tempted to say that I will just wait for the tooth to start hurting (which might be a long wait if my past experience is anything to go by) or is loose and get an implant?

Is there ever a situation, no matter how unusual in which an x-ray might be misleading?

I should add that the dentist was fairly convinced that on the basis of the x-ray he should x-ray my entire mouth and that he would need to start filling teeth fairly extensively. I amm really very confused and I would appreciate any advice you might give as soon as possible as I have some tough decisions to make!

Many thanks!
 
Hi there.


I am sorry to that you have had dental worries.

It is certainly possible to have a large cavity without having any symptoms. Normally, one does get some twinges that tell you that something is not quite right. However, I have seen the situation you describe many times over the years, when checking my patient’s x-rays.
You could of course do nothing. Eventually the tooth will either break or you will get pain from an infection forming. At this point the tooth will be beyond repair and will have to be extracted. However, it sounds like the decay is so advanced that even if the dentist tried to fix it now it would still be a little dodgy.
If you did lose the tooth you may or may not choose to have it replaced by an implant or other means. It is not compulsory!
My advice to you, would be not to leave it, as it will eventually cause problems and these might occur at an inconvenient time, or suddenly cause you a lot of pain out of the blue.
I would suggest you ask the dentist if he thinks it is really worth trying to save, as there is no point is having a heavily filled tooth that is likely to cause you further problems.

You may wish to get a second opinion to put your mind at rest especially if the dentist is proposing to do work on several other teeth.

Hope this helps

Best of luck

Lincoln Hirst
 
Many thanks for all your help.

I think Dr Hirst's advice was especially useful - the dentist I talked with seemed to think the tooth was in severe difficulty, but he himself couldn't offer an implant, so it may be that he couldn't recommend it for that reason. I think I will ask the dentist again whether he feels it is worth saving, and since it is giving me no problems I will perhaps look into implants a bit more carefully (and a second opinion makes sense too) with a view to getting it removed once it starts to hurt or gets infected (presumably infection will result in pain!).

The lack of pain still seems odd, but it is useful to know that this is not unheard of! I have tried hot/cold and tapping myself, and the dentist was fairly extensive with his tapping of the tooth, but no noticeable pain, though I do realise that pain may come suddenly and be severe!

Many thanks again!
 
Hi Dr Hirst, I read again your point about not leaving it. I think I will ask my dentist how quickly he could respond to a plea for it to be removed. In the past the clinic I use have responded very quickly to my wife's problems (same day) so hopefully he can reassure me on that front, though there is nothing stopping problems emerging on weekends or during holidays I guess. Not a happy thought! Thanks again.
 
Delighted to have been of assistance FSom
 
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