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Question about tooth pain/malocclusion after filling

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PhoebeGnashers

Junior member
Joined
Apr 9, 2010
Messages
3
Hi there; I have a few questions; this might be long!

This fall, after getting a full-time job and dental insurance for the first time in years, I went to a new dentist. I had kept up with my cleanings with my previous dentist, but he hadn't done x-rays in about a year and a half since I didn't have insurance. The new dentist told me that I had a dozen cavities that needed fillings, all on my molars or premolars, and recommended expensive onlays that my insurance would not cover. I generally got a bad feeling from his office (it was dingy, and the assistant took over an hour to get one set of X-rays done--really unpleasant experience!), so I went and got a second opinion.

The new dentist agreed about the number of cavities, but said they were all fairly small and that I just needed fillings (his office only does white) to control them--he didn't think onlays were necessary at all. Over the past six months, I've slowly gotten them filled a few at a time. Most were without incident, but one of my premolars, #12, was really painful with biting. I had it adjusted twice, but was still having some pain occasionally. About a week after my last adjustment (on a weekend evening, of course :(), I started to have really really severe throbbing pain. Like, I was laying on the floor crying. I called my dentist's emergency number and they prescribed me some antibiotics (clindamycin--not the dentist's fault at all, but this lead me to get a nasty stomach infection a few weeks later; it didn't seem to improve things any over a 10 day course, either) and had me come in that Monday morning. The dentist did an x-ray and said he could see a dark area around the root of the tooth, but that the cavity seemed to be nowhere near the nerve. He suspected the problem was due to malocclusion and did another adjustment. The pain relief was immediate! I felt much, much better. During another filling the next week, he checked it again and did another slight adjustment on the opposing tooth. I've had absolutely no pain when biting since and only a very very slight soreness when he taps it.

However, since that time, I've developed a very small bump on my gums up above that tooth, right near where my lip meets my gums. It doesn't hurt really at all and there's no visible pus; in fact, the dentist looked at it and initially thought it was part of the gum structure. However, when I touch it I feel a slight pressure radiating down to the tooth--and it definitely wasn't there before all of this.

I've also had some sensitivity with another filling on that side which was done subsequently, number 18. It doesn't hurt when biting--but it also just doesn't feel right when I close my mouth, as if it's being hit by the opposite teeth. I've started to develop headaches on that side, and sometimes, when I wake up at night, I feel a sort of pressure in that tooth. The headaches aren't bad; I just noticed that, amidst all my recent clindamycin-induced stomach problems, I was taking tylenol in the morning more often than not.

Today I went to the dentist office for a cleaning, and told him I would need another bite adjustment. I asked him about the bump on my gums and expressed concerns that I needed a root canal. He said he's still comfortable waiting and seeing--he thinks that there's approximately a 50/50 chance that I'll need one, but he doesn't want to give one unnecessarily unless I felt really insistent. He also adjusted number 18 and said that now the weight was evenly distributed and that that might help clear up any remaining problems with number 12, and to call next week if it was still bothering me and he'd refer me to an endontist.

But, since this morning, tooth 18 still hurts and it still doesn't feel right when I close my mouth--the other side of my mouth feels fine, but it just doesn't feel like my teeth are closing correctly at the back of my mouth.

Ironically, I never really had much dental fear before this. Other than a year and a half in college, I've always gotten regular cleanings (every six months) and my husband actually makes fun of me for how much I brush and floss. In fact, I keep floss both at my work desk and my desk at home and you often find floss picks scattered around my house where I've left them--gross, I know, but it's something I do when I'm bored. I feel self-conscious about the number of cavities I've had, and sort of at a loss. I do eat sugar sometimes, but I've drastically cut back, and I'm trying to take really good care of my teeth. In 2006, I had about seven cavities, mostly on the molars and premolars as well. I don't doubt that these new cavities were there--my current dentist showed me them, both on x-ray and after he drilled--but he also did a set of follow-up x-rays and spotted two more cavities at the end of all these fillings. I'm so frustrated! And embarrassed. The hygienist today said that my front teeth are all very clean, but that I could clean the back ones better, though she could tell that I flossed. I've been using an electric toothbrush (a cheap Oral B one) and trying to be really diligent about getting all the surfaces, and I've been using gel-kam occasionally at the dentist's suggestion. Are there any suggestions for improving oral health that I should be following? I have had acid reflux for pretty much the first time (that I'm aware of) in my life recently. And the dentist who wanted to put onlays in noted that he thought it looked like I had acid reflux from the color of my molars--could that be affecting it? I'm only 26; I don't want to lose all my teeth down the line!

(And I swear I'm not lying about the flossing thing. I've gotten the feeling that all my dentists have thought that I was, because of the cavities.)

I'm starting to feel very self-conscious about returning to the dentist again and again for adjustments. It doesn't help that my coworkers have teased me about how many dental appointments I've had and that my dentist is my new boyfriend! With my molars, should I just call and ask for yet another adjustment and insist on staying until it feels right? Is it possible that these problems really have been caused by malocclusion, like the dentist says, despite the small bump on my gums? He said that I seem unusually sensitive to this kind of biting issue. Or are my nerves in deadly need of a root canal? My new dentist seems cautious and conservative about treatment--something I liked when he was giving me my treatment plan--but I really don't want to have another incident of pain like I did a few weeks ago.

Sorry this was so long. I feel all emotional even sharing this! Any advice would be appreciated.

Phoebe
 
The tooth with the bump needs to be checked out, it does sound like there's something going on with the nerve that's more than just a high filling. It would be nice to do a thing called an electronic pulp test on the tooth.
If your teeth still aren't meeting properly then the filling needs adjusted and yes, you should stay in the chair until it feels right... if I understand your question correctly?
 
Hi Gordon,

Thanks so much for your answer. I'll call up the dentist and ask for another adjustment & the endontist's number on Monday. I felt embarrassed over insisting that the bite still didn't feel 100% after my dentist did the paper test and told me the weight was being distributed evenly--like it was all in my head! But I realize that's pretty silly, I guess.

Thanks again.

Yours,
Phoebe
 
The paper itself can generate an error, or you may be biting differently during the paper test than you do at other times. The only way as a dentist you can be sure it's correct is when the patient tells you that it is!
 
Well, I ended up having a root canal performed on the tooth with the bump. The endodontist (who was very good, it was fast and I didn't feel a thing!) said that the tooth was definitely necrotic, and it didn't react at all to cold.

While I was there, I told him about the pain in my lower left molar. He x-rayed it and said that there was some pulpitis, but it could have been reversible. I could still feel cold with it--sensation was normal. Since I'm going back next week to finish the root canal, he said we could check it out again then.

In the meantime I did ask my regular dentist to adjust the bite on that side, as well as on another molar that's been giving me sharp pain when chewing. I felt some relief immediately, and it is a bit better (didn't wake up today in pain) but that was yesterday--and now things are starting to just feel off again. And the molar on the other side still hurts when I chew on food. I feel like I must seem crazy! :redface: Since I'm already going back to the endo on Monday, would it be appropriate to ask him to check my bite? If the pulpitis is reversible, I definitely don't want to exacerbate things with a screwy bite, but I don't even know if that's something that endodontists even do, since they just deal in root canals. (most of my anxiety is social, about doing things correctly or not/appearing foolish! So you can imagine how hard dealing with dental professionals who say things like "Well, you SHOULD be fine" is!) After the RC is finished, I know I'll have to have a follow-up visit with my regular dentist to see if I need a crown, so I could wait until then . . .

So frustrating.

Yours,
Phoebe
 
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