Tooth sensitivity to heat only - please help

[Dhistress]

Filling issue, sensitivity?

Hi, I had a filling done by my previous dentist. It is probably 3 years old. I have recently noticed that I’ve had sensitivity particularly to heat but it took a while for me to notice - it doesn’t happen if I drink anything or even 95% of the times I eat - but if an extremely hot (and sometimes cold) food comes into full contact on the surface of that tooth, it is sensitive. I wouldn’t consider it painful but it is definitely noticeable and uncomfortable. It goes away immediately after the stimulus is removed, or even if I’m still chewing, and it doesn’t even last for 2 seconds. However I am concerned after reading some things and I would like to know a few things:

1. My last dental checkup was 1.5 months ago with a clean bill of health. I haven’t had a cavity since I got this one filling done actually. I’ve had full X-Rays done.
2. Is this an issue such as fractured tooth, a bad filling or a debonding issue?
3. Am I fucked, will I lose the tooth?

It doesn’t really affect my day to day life - it’s just something I notice when I eat something very, very hot. It’s more uncomfortable than painful but I have heard that heat sensitivity means RCT. I have an appointment next week and I’m very anxious about it and I’m hoping someone can give me some possible suggestions on what this could be or confirm if it is most likely time for a root canal.

It is a white filling on a premolar. When my dentist filled it, there was no hole, it was just soft so he filled it and considered it a surface filling.

Thanks for reading.

 

[letsconnect]

If you got a clean bill of health a short time ago, the most likely cause is plain old tooth sensitivity:

Sensitive Teeth

What causes tooth sensitivity, and what are the best toothpastes for sensitive teeth? We looked at independent research - the results may surprise you.

www.dentalfearcentral.org

You could try rubbing some toothpaste for sensitive teeth directly onto the affected area for a couple of weeks and see if that improves it (some toothpastes work better than others, and it can be a case of trial and error to find out what works for you).

If the pain doesn't go away and you're worried, have your dentist check, just to make sure it's nothing that needs treatment.

 

[Dhistress]

@letsconnect
Hi. Thank you SO much for responding. I did get a clean bill of health but they didn’t perform x-rays this time around, only a physical exam. I did have full mouth x-rays in May of last year (per my shitty insurance) and they didn’t see anything, nor was anything seen with the eye on 11/29/2023. I always use sensitive and prescription strength toothpaste. Would you say it could still be plain old tooth sensitivity?

Either way, I am going on Wednesday to see what is going on, but it’ll cost me entirely out of pocket because they didn’t see any issues in November and thus I am returning before the 6 mo. timeframe.

Could this be something they overlooked in November? Although I didn’t have the sensitivity before, so I wonder if the cleaning removed plaque or tartar and revealed a sensitive area?

 

[letsconnect]

That all sounds normal, x-rays aren't normally done that often, nothing to do with shitty insurance (actually, in most countries, full mouth x-rays are pretty much unheard of - usually it's bitewings, typically on a two-year basis, unless there's a good reason for more frequent x-rays, for example if someone is prone to decay).

So on the face of it, tooth sensitivity is the most likely candidate - but if this is worrying you to the extent that it interferes with your life, then do see your dentist to put your mind at rest!

 

[Dhistress]

@letsconnect
Hello. Thank you for your reply.
I did end up going to the dentist and she took x rays and did an exam. I have no sensitivity to tapping, but she did say that underneath the fillings it looks “grey”. She wants to replace the filling on the tooth I mentioned but also the big one behind it that my previous dentist wanted to crown but I couldn’t afford.. and I wouldn’t really be able to afford two crowns at one time if that’s what this turns into.. either way, she warned me that heat sensitivity always means a root canal, it’s a bad sign and I should prepare myself despite the filling not being that deep and not having any pain or abscesses. I take good care of my teeth so I’m confused and I’m worried I may be taken advantage of. I can just see the fillings being unable to be replaced and I’ll be left with ugly teeth the day of. I’m so scared of root canals because I hear they only last 10/20 years so I would only be about 45.
Does all of this sound right, or should I get a second opinion before I have any work done? I thought cavities appeared as black spots in an x-ray, not grey?

 

[letsconnect]

@Dhistress if it was me, I'd probably see an endodontist (root canal specialist) for a consultation and see what their take on the situation is. They should be able to say whether root canal treatment is indicated or not, it's what they specialise in! Or else you could always get a second opinion of another general dentist, especially if you have someone in mind who's been recommended to you.

We've also got some tips for finding a phobic-friendly dentist/specialist here (in case you haven't come across them yet):

How to find a dentist for nervous patients

Discover how to find a dentist who is good with nervous, scared or phobic patients - and who to avoid!

www.dentalfearcentral.org

How to find a high-quality dentist

How do you know if a dentist really cares about the quality of their work? Here is what to look for and expect from a high-quality dentist.

www.dentalfearcentral.org

Root canal treatment (when properly done) can often last a lifetime. We have a fairly extensive FAQ section on root canals, in case it turns out that it's actually needed:

Root Canal Treatment FAQs

Get detailed answers to FAQs: Is root canal treatment painful? Why am I sore afterwards? Why do I need a crown? And many more!

www.dentalfearcentral.org

Generally speaking, cavities show up as slightly darker areas (though if there's no tooth structure at all, this would show up as black). But it's very difficult for a layperson to interpret x-rays, because they're two-dimensional images of three-dimensional structures. So you really need an expert to guide you through what those images mean (some grey areas may be totally benign or just artifacts, that is, x-ray image distortions). An endodontist may take different x-rays than a general dentist, and they may use different tests than some general dentists to figure out if root canal treatment is indicated. If you do end up seeing an endodontist and you're unhappy with your current dentist for any reason, you could also ask them for dentist recommendations in your area .

 

[Dhistress]

Okay! I appreciate this, it’s very helpful. I suppose there’s no harm in a second opinion, right? Having to potentially postpone the replacement filling appointment on the 30th wouldn’t cause any big issues if I waited a couple more weeks to get a second opinion, would it?

I just worry so much because I only have the heat sensitivity and I’m a bit skeptical that this means an immediate root canal. I’ve heard loose fillings can cause heat sensitivity also.

 

[Dhistress]

@letsconnect
Hello, sorry to bother you again and wake this thread up. I got a second opinion done this morning by another local dentist, who seemed much more thorough than the original dentist. He did the tapping test, the cold test, he flossed the area, he visually looked at and poked the teeth, and he also took 2 x-rays. He said my filling looks solid and that, although I am having some heat sensitivity, it isn’t extreme, lingering or painful. He said, sometimes this can happen in patience with some gum recession. He doesn’t wish to intervene at this time and to keep an eye on it instead. I explained to him that my other dentist wanted to do fillings, and he still says that it was OK to watch and wait. I would prefer to wait for a variety of reasons, as long as it isn’t detrimental to my tooth health.

What concerns me is when I called my original dentist and asked for a copy of my exams and x-rays for a second opinion, the receptionist became very irritated with me and said she could point the decay out to me herself, and that I was making a silly decision. Now I am having second guesses because although I had a better experience with the second dentist, not only on prognosis, but also on overall experience and bedside manner, the other receptionist has placed a seed of doubt in my mind.

Any thoughts?

 

[letsconnect]

Congratulations on getting a second opinion! That’s great that he seemed much more thorough.

Thoughts - the receptionist's behaviour (implying that she’s somehow qualified to make a diagnosis) is completely unacceptable and a big red flag

How did you feel about the new dentist you saw? Did you get on well with him?

 

[Dhistress]

@letsconnect
Yes, I was much more comfortable at this facility and the fact that he was more thorough eased my mind. I made the switch and I will be going there for my routine cleanings and any future needed dental work. Thanks for your help.