Surviving the dentist with severe tinnitus and dull pain after a small interproximal filling.

[MisterR]

Im sorry for the long post in advance.

As a child i, despite brushing twice a day, had an immense amount of cavities. Two years ago my severe tinnitus and hyperacusis (Sound sensitivity) started.

Loud sounds can cause a permanent increase in the volume of my Tinnitus. Unfortunately after having a cavity drilled in December my tinnitus permanently doubled in volume. Severe Tinnitus is a bad, life altering disease.


I have two problems which i am panicking about.

- I constantly have a dull pain after small interproximal cavity filling the last two days. Was this filling/cavity too deep? Its on the attached picture lower premolar teeth.

Its the lower second premolar. The dentist worked on it with a laser 13 days ago. It was painful, there was a dull pain for 2 days after which eventually subsided. Never had that before. I didnt opt for sedation because the laser is usually OK. This time it clearly wasnt. Even putting in the filling itself gave a stab of pain. The pain subsided as said after 2 days. Now 13 days later suddenly the dull pain is back.

Is the filling too close to the pulp? My appointment is on Monday in 5 days. I do not have a x-ray of the filled tooth yet. I have to wait because i can only go to a dentist which can use laser due to my ears.
Did the dentist fry the pulp? There is no heat or cold sensitivity on the tooth. Filling not good? Irreversible pulpitis from this cavity?

What can cause this dull constant pain without a trigger? I asked the dentist why the filling was so painful. He said he was nowhere near the pulp. Just had to drill enamel and some dentin.
i regret letting him work on this cavity so much. The tooth was asymptomatic before. What do you think? Should this cavity have been drilled?
Im scared to death for getting a root canal and crown. Not for the pain. Not for needles. But for the sound which might change my life again to the worse, thats why my second question:

Can a root canal/crown be done silently?

I can not risk any further worsening as my quality of life is already very low. I know it may sound weird but this feels like a life-or-death situation for me. The dentist is my biggest fear. You cannot be put asleep and ear plugs to not work. The sound hits your ear from the inside either way.

My second problem:

I have been having pain after a deep filling in December, starting in May this year after 5 months. Before that i was OK teeth wise. Weird thst the pain started 5 months after the filling is placed but ok. I grind my teeth at night due to stress and anxiety of the Tinnitus. New dentist pointed out that the filling close to nerve. Its the upper premolar. It seems i need a root canal. Its been 3 months and i avoid chewing on that side. without chewing no pain.

It is not possible to wear earplugs with a normal drill due to the occlusion/bone conduction effect - the drill will sound twice as loud because the sound cannot escape your ears and travels from the bone through your ear.

I switched dentist, my new dentist can use a laser to drill the cavities. I can protect myself from that sound because he does not touch the teeth directly, which is great.

Once he is in the teeth i can no longer use the protection, because touching the teeth with protection in the ears doubles the sound. The dentist can create the opening with the laser. Once in the tooth the problems will start.

- How loud are endontory rotary files? E.g. compared to an electric drill handpiece? Is the rotary file a very high pitched sound like the air drill or ultrasonic scaler? Can everything still be done manually with manual files? How many times will he have to use the rotary file per canal? assuming i have 4 canals. I strive for a single appointment (2nd appointment he has to open the teeth again, more exposure of sound)

- The suction tube spikes my Tinnitus badly, im afraid permanently. Can once the tooth is open the suction be used only sparsely? Or not at all? i know when building up the teeth it needs to be dry but can be done sparsely at that time from experience.

- Any other sounds i need to be on the lookout for?

- How long is the actual drilling time of grinding down the teeth for the crown? On youtube i found 4-5 minutes. Is suction needed when prepping the teeth? Can i just keep swallowing the water? Laser isnt possible for the crown. I know skipping the crown is not viable and i can opt for just a filling, but increased Tinnitus is for me a life-or-death situation as my situation is bad.

- If i opt for extraction, how much drilling is required for the implant? is bone drilling louder then normal drilling with an electric handpiece? Can i skip the implant for the coming years for the sake of my well being?


Sorry for the long post - i'm in a very bad situation at the moment and could use professional advice. Which scenario is less likely to harm me? I wish as a kid to have taken better care of my teeth. I am with my back against the wall and literally shaking typing this.

 

[Gordon]

Sorry, trying to spot the questions as best I can, if I miss anything let me know.

1) Can't see a filling in the 2nd premolar?
2) Rotary files are a fair bit quieter than either the high speed air drill or sonic scaler. It's possible to use manual files but takes a lot longer (time = money) so it will probably cost more if that's an issue
3) New models of rotaries can get a canal done in 2 files, not much time taken with those
4) Once rubber dam is on then the suction can be used very sparingly
5) Crown could be 5-10 minutes of drilling, I couldn't do it without suction you just can't see well enough to do a decent job.
6) Better leave that for people who've experienced an implant, there is some drilling but you have to use extremely slow speed drills, so it might be OK. Still needs suction though. Yes you can leave it for as long as you want.

 

[MisterR]

Sorry, trying to spot the questions as best I can, if I miss anything let me know.

1) Can't see a filling in the 2nd premolar?
2) Rotary files are a fair bit quieter than either the high speed air drill or sonic scaler. It's possible to use manual files but takes a lot longer (time = money) so it will probably cost more if that's an issue
3) New models of rotaries can get a canal done in 2 files, not much time taken with those
4) Once rubber dam is on then the suction can be used very sparingly
5) Crown could be 5-10 minutes of drilling, I couldn't do it without suction you just can't see well enough to do a decent job.
6) Better leave that for people who've experienced an implant, there is some drilling but you have to use extremely slow speed drills, so it might be OK. Still needs suction though. Yes you can leave it for as long as you want

Thanks a lot. Comforting to hear that the root canal is not that noisy (but the crown will be impossible for me). You answered all of the questions.

As for the filling, this is the pre filling x-ray. The decay is in the second premolar, interproximal. He filled it but i dont have an second ex ray yet where the filling is placed. The part of the filling feels very delicate. As far as i can tell there is no heat/cold sensitivity and no pain on pressure/release. It is just painful in general, even passing the tongue on the filling side. The other side seems to be totally fine which is not filled (on touch that is). The teeth itself has a dull pain that comes and goes. Its been 18 days. As soon as i touch the teeth a little bit with my tongue etc the low grade pain/irritation comes back again. It is bad enough to take paracetamol/tylenol on some days. Today the pain was less but still there on touch

I have never had this before.

Do you think based on the above x ray the decay required a deep filling which disturbed the root? Or does it sound like something is wrong with the filling, bonding issue, curing issue, not closing properly or anything? Im scared to death of yet again having to be exposed to loud sounds at the dentist. It took me some time to gather courage for that appointment. I have one more filling to go. Do you think this is simply bad luck or could it have to do with lack of skill? I switched to this dentist since this year due to my Tinnitus and his laser dentistry. Prior to Tinnitus i have had the same dentist for 25 years, never caused me any problems with any fillings, and now this!

 

[Gordon]

No, the filling is very superficial.
Yes a bonding issue could be the problem. Assuming it's a composite filling?
Lack of skill is a bit of a stretch, I'd say mostly just bad luck.

 

[MisterR]

No, the filling is very superficial.
Yes a bonding issue could be the problem. Assuming it's a composite filling?
Lack of skill is a bit of a stretch, I'd say mostly just bad luck.

Just want to thank you for your reply. We took a new x ray and the filling is small. Nowhere near the root. Dentist saw a high spot on the filling. But two weeks later pain still exists. He didnt understand especially without hot/cold pain. He claimed that the filling was ok and wasn't leaking.
I was so happy to have all of my cavities done but
the drama is not over yet.

I will go again because the tooth is still sensitive. I did notice he does not use a saliva ejector during the filling/curing/etching of my cavities. He did three fillings and im afraid for the longetivity and the bonding. He only used a cotton roll and an iron thing around the tooth for the interproximal one. Could it be that the tooth was not dry enough? Is one cotton roll sufficiently? All cavities were premolars. My old dentist always used a rubber dam or a saliva ejector during the actual filling.

 

[MisterR]

Sorry for the swift follow up, but he placed the filling in the middle of the tooth. The decay inside the enamel on the side was not filled. he said that didnt need to be filled - still in the enamel. Im very confused. Im not qualified and besides my compulsive reading have no knowledge on x rays etc so not see anything there that should be filled? I marked red where the filling is. Ill try to get the new x ray to share. Because im so phobic i regularly take pictures of my tooth when i am in pain to see what is going on. i dont see any decay on my taken photo nor my x ray. Did my dentist just drill in one of my few healthy tooth??

 

[Gordon]

Was the filling placed on the biting surface of the tooth then? In that case an x-ray is not a reliable way to diagnose decay there.
The shadow area between the teeth doesn't need filled.

 

[MisterR]

@Gordon thank you again. My last question and i will be out of here i hope...

I went again. I feel my dentist is getting a bit tired of me. My dentist says that he will add a bit of filling because he feels that there might be a micro gap. I feel like it is more of badly cured resin. Either way, he says he will add a bit of filling (?) which should help. i find this very odd. Everything i read says the filling has to be taken out in full and a new filling should be placed.

I have to wait another 4 weeks in pain before the appointment. So A does it makes sense to add a bit of filling (?), and B do i have chance of irreversible pulpitis if he waits so long with correcting this? i dont want to upset the pulp. I have no cold/hot sensitivity. .

 

[Gordon]

Depends what he means by adding a bit of filling. If he redoes the bonding process around the filling it might well fix things. Your diagnosis is incorrect, a badly cured resin is very unlikely indeed.
4 weeks isn't an issue for the pulp.