Hello,
Had a large, old filling about 30 years in upper (next to the last tooth)
molar. Part of the outer rim of the tooth broke off, both on the tongue side
as well as the cheek side. Put off having it repaired for about 2.5 years.
Started experiencing some pain and sensitivity and had it crowned about 3
months ago, by a new-to-me dentist. Noticed almost immediately that the
newly crowned molar is experiencing the same sensitivity as before having the
crown. Not much sensitivity to hot and cold, but to the touch or when I bite
down or chew. I also noticed that I avoid chewing on that side. When I went
back to him with my concerns, after his examination, he said I must need a
root canal.
Here are my questions:
Why didn't the dentist remove all the old filling , and is that standard
practice?
Also, with the given information, what is most likely going on with this
tooth?
THANKS!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Mark & Steven Bornfeld - 01 Aug 2006 20:43 GMT
> Hello,
> Had a large, old filling about 30 years in upper (next to the last tooth)
[quoted text clipped - 13 lines]
> tooth?
> THANKS!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Usually in the course of preparing a tooth for a crown most of any
prior fillings are removed anyhow. But it's usually a good idea to
remove all old fillings to make sure there isn't any decay, pulpal
exposures, etc. lurking beneath.
However, sometimes when there is a deep filling on an obviously vital
tooth, I will leave part of an old filling in if I think removing it
will endanger the nerve. Generally it won't be much filling, and I
don't think there is anything necessarily wrong with this approach, so
long as any remaining filling is not at or near the margin of the crown.
Sensitivity to chewing may indicate a minor bite discrepency which can
be relieved by a slight adjustment. However, it may also be a sign that
root canal treatment is necessary.
Naturally, most people will want to avoid root canal treatment if
possible. If I think a tooth being crowned MAY need root canal, I
sometimes make the crown and cement it with a temporary cement. That
way, if the root canal becomes necessary the crown can be removed easily
to do the root canal, rather than having to drill a hole through that
nice new crown.
In any case, go back to the dentist to check this out.
Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001