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Medical Forum / General / Dentistry / January 2007

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Sensitive tooth still around five months after onlay

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drhowarddrfine - 01 Jan 2007 17:08 GMT
Some time ago I wrote about how I had a large filling replaced with an
onlay (or is it in inlay?).  There is one spot near the edge of the only
near the front and edge which was sensitive then and is still sensitive
now, five months later.  My dentist and others here have said it may
just take a long time for the nerve to retract and desensitize, I'm
wondering if I've waited long enough.  It doesn't feel worse but it
doesn't feel better at all.

This past week, I've waken from sleep with a slight throbbing in the
tooth but I never notice it during the day and ibuprofen takes care of
the discomfort.

The sensitivity does not make me jump when I touch it.  I can use the
back of a toothbrush to test it.  Blowing air or hot/cold does not
bother it.  Only when touched or the food I'm eating is somewhat hard,
like taco shells, and it crunches right on that spot.

I haven't eaten on that side lately because I just had temporary
fillings put in on the upper teeth waiting for their onlays to come in
(or is it inlay?).

My dentist must be competent since he shares the office one day a week
with the President of the state dental association and was recommended
to me by his staff.  He thinks he needs to check the bite at that spot
but we've done that twice before.

Any more thoughts on this?
Dartos - 02 Jan 2007 16:32 GMT
Hindsight is always easier than foresight, but maybe the tooth should
have been crowned, or a different bonding system (or technique) used.

Could be a cracked tooth as well.

Good luck,
D

> Some time ago I wrote about how I had a large filling replaced with an
> onlay (or is it in inlay?).  There is one spot near the edge of the only
[quoted text clipped - 23 lines]
>
> Any more thoughts on this?
drhowarddrfine - 02 Jan 2007 18:35 GMT
> Hindsight is always easier than foresight, but maybe the tooth should
> have been crowned, or a different bonding system (or technique) used.
[quoted text clipped - 31 lines]
>>
>> Any more thoughts on this?

What should I expect him to do about this?  Would I be expected to pay
for any fixes?
Dartos - 02 Jan 2007 21:52 GMT
> What should I expect him to do about this?  Would I be expected to pay
> for any fixes?

Tough question.

If I feel that I made a mistake in diagnosis or treatment,
I take some (or all) of the responsibility for correcting
the problem.  (e.g. I made an upper denture and it just didn't
have any suction)

If I am repairing a tooth with a large defective restoration or
an area of deep decay, and the tooth ends up needing a root canal,
I charge for the root canal.

If I recommend that a tooth be crowned and the patient insists
on a large filling, I'll charge full fee if the filling fails.

Every dentists will vary on what they feel obligated to cover
free of charge.

OTOH, I have a patient who underwent back surgery a couple of years
ago.  During the surgery, the spinal cord was punctured, he got
an infection, and he was in ICU for weeks.  Now he has to use a
walker and is quite handicapped.

The surgeon did not discount his fee and all of the treatment to
keep him alive was tacked onto his hospital bill.

Medical/dental treatment just isn't like buying a TV.

D
drhowarddrfine - 02 Jan 2007 23:37 GMT
>> What should I expect him to do about this?  Would I be expected to pay
>> for any fixes?
[quoted text clipped - 27 lines]
>
> D

When he cleaned the tooth out and put in the temporary, he said it was
close to needing a root canal but he didn't think so.

If this needs a root canal, will he drill through the onlay?  If so, do
I lose the benefit of the only since it gets drilled into?
Dartos - 05 Jan 2007 14:11 GMT
There are two kinds of dentists.  Those that have had to do a root
canal on a tooth after an onlay/crown was cemented and they thought
the tooth would be OK, and those that haven't......YET <g>

The ones who haven't are probably recent graduates.

Many times a root canal can be done through an existing restoration
and the access opening restored with composite.

However, if I had just placed a new restoration, I would usually
comp the patient for a new one.  It doesn't happen very often, but
I can't say 'never'.

YMMV,
D

> When he cleaned the tooth out and put in the temporary, he said it was
> close to needing a root canal but he didn't think so.
>
> If this needs a root canal, will he drill through the onlay?  If so, do
> I lose the benefit of the only since it gets drilled into?
drhowarddrfine - 05 Jan 2007 14:21 GMT
> There are two kinds of dentists.  Those that have had to do a root
> canal on a tooth after an onlay/crown was cemented and they thought
[quoted text clipped - 17 lines]
>> If this needs a root canal, will he drill through the onlay?  If so,
>> do I lose the benefit of the only since it gets drilled into?

What do you mean "comp the patient"?
Thanks
 
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