Tooth under the bridge is sensitive to temperature (hot/cold)

Thread view:

Enable EMail Alerts

Start New Thread

Thread rating:

emma - 28 Apr 2006 15:28 GMT

Hi all,

I had an inlay bridge placed for missed # 13 about 3 years ago.

About 6 month ago one of the tooth that supports the bridge , which is
#12 became sensitive to hot liquids, but I just had pain for about 1-2
seconds, then it was fine. I went to the doctor, he checked it, did
x-ray, but didn't find anything.

Yesterday it became worse and I had strong pain from the hot tea and
also from the cold for a longer time, for about 10 -15 seconds, also
the pain was much stronger.
I don't have pain from the pressure, but I have it sometimes when I
bite on that tooth 'on the wrong place'. It feels that the main problem
now is super sensitivity to temperature, especially hot or even warm
hot.

What it can be: crack, abscess, something else?
Do you think RCT may be necessary? I'd like to avoid it, especially
since this tooth is holding the bridge... If it's necessary, can it be
done without removing inlay bridge?
Any suggestions what can be done?

Thanks,
Emma

Reply to this Message

Steven Bornfeld - 28 Apr 2006 16:17 GMT

> Hi all,
>
[quoted text clipped - 21 lines]
> Thanks,
> Emma

    Sharp pain on biting is strongly suggestive of a fracture. The intense
nature of the pain is suggestive that the nerve is dying.
    If there is a fracture, it is likely that saving the bridge is moot,
but we're just guessing here. Generally true inlays shouldn't be used
as bridge abutments, since chewing contact on natural tooth surfaces
will tend to dislodge the bridge or cause fracture. I'm hoping this is
really an onlay bridge, where the entire chewing surface of the teeth
are covered.
    The problem with esp. onlay bridges is that there isn't as great of a
retentive area holding the bridge in place, and drilling through it is
very risky if it is ceramic or resin. It also increases the chance of
later dislodgement even if the bridge is metal.
    I'm only guessing here; you'll really have to be examined. Your
dentist will be in a much better position to give meaningful answers.

Good luck,
Steve

Reply to this Message

emma - 28 Apr 2006 18:32 GMT

Thanks Dr. Bornfeld. You are actually right, it's an onlay bridge,
teeth are covered completly.
If there is a fracture, can the tooth be saved with RCT? Something
else?
Is there any test to confirm a fracture if x-ray doesn't show it?
Can something be done to a small fracture under the bridge? Bridge is
metal.

Thanks again.
Emma

Reply to this Message

Steven Bornfeld - 28 Apr 2006 22:22 GMT

> Thanks Dr. Bornfeld. You are actually right, it's an onlay bridge,
> teeth are covered completly.
[quoted text clipped - 6 lines]
> Thanks again.
> Emma

    If there is a fracture, whether the bridge (or the tooth for that
matter) can be saved depends very much on the location and extent of the
fracture. Many times (esp. if the tooth has not had previous root canal
treatment) the fracture extends down and away from the chewing surface
of the tooth. If the fracture isn't too far under the gumline it will
probably be possible to save the tooth.
    Whether in this case the bridge can be saved depends further on the
amount of remaining tooth structure after the fractured segment is removed.
    I'm afraid we're getting ahead of ourselves though--I can't say that
the pain is caused by a fracture. You definitely should be examined
promptly. Even at that, diagnosing small fractures can be very
difficult and frustrating. It could be though that a quick look will
make the problem very apparent.

Good luck,
Steve

Reply to this Message

emma - 12 May 2006 05:29 GMT

OK, here is the continuation of the story. I went to the dentist who
placed the bridge, he took x-ray and found some inflammation, told that
possibly RTC may be necessary and gave me referral to endodontist.
Endo listened to my story, checked an x-ray, then tested the tooth with
hot wax, after all told me that RTC is needed, can be done through the
bridge.

Are there any special additional tests that can be done to be certain
RTC is needed?
Is it dangerous to wait if something going on with the tooth?
What chances that onlay bridge will fail after RTC done through it?

Thanks.
Emma

Reply to this Message