Pain, dentist wants to do RCT but I have no confidence

[Niki87]

Hi, so I’m going to try and keep a long story as short as possible.
I’m from the UK, I have been having problems with a lower left molar for some time now. I’ve always had a lot of anxiety visiting the dentist after a bad experience when younger. However I’ve always known the importance of taking care of your teeth. So I’ve always managed to go for check ups, and I’m pretty ok when I know nothing is going to happen there and then.

So, I’ve had a few fillings over the years, all 4 wisdom teeth were extracted in my late 20’s so I only have 8 molars, 4 upper and lower and my pre molars. All my first molars have fillings although my upper 2 were both amalgam done about 30 years ago, I only had to have one replaced as it was cracked a couple of years ago, composite replacement no issues since.

My lower first molar had two fillings, the second one being pretty deep and had on/off sensitivity for years but was manageable. Then it started hurting when I bit on it. My then dentist tapped the filling, said it’s fine and I kept complaining about it and he didn’t think anything needed doing. I was losing confidence and felt it wasn’t being addressed and was concerned it would get worse. The annoying thing was this guy was sooo lovely and calm but I just felt it wasn’t right and he didn’t seem to want to do anything.

So I saw a different dentist, had a general assessment, X-rays, couple of cavities and also showed some decay under the deep molar filling, which even I could see quite clearly. He thought it didn’t need a root canal and may be able to get away with refilling. Fast forward 2 weeks ago and that was done. He said it was close to the nerve but it wasn’t ’right there waving at him’ kind of thing. Put some stuff in before the filling he said was to keep the nerve happy and job done. He used a clamp and some ‘wedges’ that left me feeling quite bruised but otherwise ok. Went back a week later to have adjustment as it felt high. Only some mild sensitivity at this point, although as he shaved the filling down the vibration caused ‘discomfort’. Couple of days later noticed increased sensitivity to both hot and cold and pain became more constant. Not even relieved by co-codamol/diclofenac combo. I would really have to dose up at night.

I rang today and his reception rang back and said he will see you tomorrow and he may start root canal treatment. At this point panic set in! I’ve been trying to avoid this and the tooth has already had three fillings now, I’m not confident there will be enough tooth structure left, or that it will get me out of pain and I don’t know whether to just ask for extraction instead. I am also going to be out of the country in 4 weeks so worried about recovery period. Don’t know what to do? Is there any chance of this settling down on its own? Any advice appreciated,
Ps I also clench my teeth but my current night guard doesn’t fit and the new dentist wanted me to wait until all work completed before getting a new one done, which I understand.

 

[vipdent]

It's unfortunate that the nerve in your tooth is going bad. But based on this statement "increased sensitivity to both hot and cold and pain became more constant," that's what it sounds like. This can happen after a deep filling, it just depends on the body's ability to heal from any insult. Sometimes a deep filling goes well for weeks then all of a sudden the nerve starts acting up. Based on what you said, it sounds like he really tried his best to avoid you having to do a root canal. He sounds like a good dentist and I would trust him. In general, dentists don't advise root canal treatment on teeth they deem unsalvageable.
Once the root canal is started, your tooth will feel much better. No, your tooth will not settle on its own. I strongly advise you to consider the root canal first before extracting it.

 

[vipdent]

Good description here

 

[Niki87]

Hi, thanks for your reply and the info. I am torn, I’m not so much worried about the procedure itself as I can’t see it being much different to having a filling. It’s the outcome I’m more scared of and still being in pain afterwards and the saga continuing. He also gave the impression he does not like doing them and therefore probably doesn’t do that many and it always concerns me when people say that. He is a very nice guy and explains everything well and he took his time with the filling and thought it went well. It’s just an unfortunate situation that I know can happen. I don’t have time to explore other dentists or an endodontist at this point as I only have 4 weeks and will be out of the country.

 

[Niki87]

Thought I would update. I just got back from dentist. He was really thorough explaining all my options. In the end I opted for extraction and maybe implant. The tooth in question had been an ongoing saga and the last few days have been pretty unbearable, the worst it’s ever been pain wise. He said sometimes it’s just like a final insult and the nerve says enough is enough. I was also getting referred pain in the teeth above it. He X-ray’d it again and said he could see changes around the roots compared to the last one so his feeling was it was probably on its way out. I will obviously now have to look at what I do about the gap but for now I just feel a huge sense of relief and don’t think I could have coped with the root canal process, especially if I could have still had pain or infection. Chronic pain is very wearing on you mentally. Of course I’m still comfortably numb at the moment.

 

[vipdent]

If a replacement with an implant is in the cards in your future(you should strongly consider it). You can ask them if you can have a bone graft done soon after the extraction so that your bone volume can be preserved for future implant placement.

 

[Niki87]

Thanks, are bone grafts always needed?

 

[anonfemale]

@Niki87 Hi. I just wanted to let you know that I have also been having pain for 2 weeks now and when I saw the dentist last week, she said I could have either a root canal or have the tooth taken out and that my gum is infected and my tooth is a bit loose. I am hoping that I can have an implant if I have the tooth taken out. I haven't decided which procedure to have yet. have been feeling really anxious because I have never had a root canal and never had pain in my mouth before and i havent had any teeth taken out since I was in my 20's. I'm 41 years old now. I had three teeth taken out when I was in my 20's. I just want to let you know that you have my support and you are not alone and I understand what you are going through because I am going through the same thing.

 

[Niki87]

Hi anonfemale, thanks for support, I am in my 40’s and always thought I took good care of my teeth, unfortunately a lot of my family has problems - and all on the left side weirdly. So I guess there’s some genetics at play aswell. How are you getting on?