I had a mild toothache and saw my dentist in an attempt to avoid a problem.
He drilled out and replaced a filling and told me that it was very close to a
nerve. I kept experiencing pain and went back to the dentist for additional
x-rays which did not show anything different. He suggested I see an
endodontist as they have better equipment (scientifically advanced technology)
to determine what was giving me the problem. I experienced horrific pain for
three weeks in the upper and lower rear jaw area, earaches, etc., before the
dentist put me on an antibiotic and pain killer, prior to my visit with the
endodontist. The endodontist took additional x-rays which failed to show
anything, tapped my teeth very hard with an object attempting to cause me
pain, and had me bite down very hard on something. My mouth felt a lot
better than it had two days ago when tapping on my teeth would have sent me
through the ceiling. He then used ice on my suspected teeth which brought
discomfort to all but one of the places done. He informed me that the odds
were that it was the lower crowned molar that needed the root canal, even
though I had experienced the filling replacement and additional pain in the
upper jaw on that side. Is this the best scientific information and testing
available to determine if a tooth needs a root canal? What if I have it done
and find that the problem has not been solved? Isn't there a more scientific
manner to determine the problem one hundred percent?
Steven Fawks - 07 Dec 2007 14:01 GMT
Isn't there a more scientific
> manner to determine the problem one hundred percent?
Short answer: No.
X-rays help determine the depth of cavities and fillings as well
as show radioluscencies in the bone (sign of infection). However,
it is a two dimensional view and does not show everything. A new
3-D type of tomography is being developed which will show a clearer
picture of what is really going on, but it still will not show
whether the pulp tissue inside a tooth is healthy or not.
Most of the time, tooth pain is fairly easy to diagnose. There is
a large cavity or an obvious defect on the X-ray to indicate the
problem tooth. Usually the patient can point to the exact tooth
that is hurting.
In a few cases, there may be no obvious cause for the pain. In others
there could be any one of several teeth causing pain and the trick is
to find out which one to treat first!
Not all tooth pain can be treated with a root canal. Some teeth may
be cracked beyond repair (though seemingly sitting there in one
piece). Some cracked teeth just need a crown or onlay. Some pain can
come from exposed root surfaces agravated by tartar control or
whitening tooth paste.
Teeth can also be painful because of occlusal trauma. A 'high'
restoration can trigger problems.
Clenching also needs to be considered. Both for damaging teeth
and causing pain in surrounding structures (TMJ, etc.).
Normally it doesn't take 3-4 weeks of significant pain to figure out.
JMO,
Steve
drsameerbhandari@gmail.com - 08 Dec 2007 09:46 GMT
> Isn't there a more scientific
>
[quoted text clipped - 34 lines]
> JMO,
> Steve
Reading the case i think that the pain is definitely with the lower
molar which is getting reffered to the upper one.in cases with acute
pulp necrosis and abscsss one may not see any abnormality in the x
rays and diagnosis is solely dependant on clinical judgement and
vitality test i think tjat your dentist has diagnosed it correctly and
you should go ahed with the treatment immediately....regards ...dr
sameer bhandari
ahuangdds2@gmail.com - 08 Dec 2007 16:27 GMT
> I had a mild toothache and saw my dentist in an attempt to avoid a problem.
> He drilled out and replaced a filling and told me that it was very close to a
[quoted text clipped - 16 lines]
> and find that the problem has not been solved? Isn't there a more scientific
> manner to determine the problem one hundred percent?
If I have a problem distinguished bad tooth between an upper tooth
from a lower tooth. I'll numb one of them, and try to see if the other
one still have pain. It is a good way to figure out which tooth is
cauing the problem. Some time.....There are more than one tooth
causing you the problem.....But that is rare............