Doc, My Tooth Didn’t Hurt Until You Fixed It

Most of the time fixing a dental problem is straight-forward. A problem is discovered, the dentist fixes it; and usually that is the end of the story.  

Occasionally patients experience symptoms after their procedure.  For example, most cavities are asymptomatic-the patient doesn’t realize they have a cavity until the dentist discovers it during an exam.  Yet when the dentist is working in the tooth (sometimes needing to work close to the nerve) there can be symptoms after the procedure has been completed. This can be frustrating and disheartening for the patient as well as the dentist. It is a Catch 22: the dentist sees there is a problem, even though the patient cannot feel it. If not treated, the problem likely progresses and eventually destroys the tooth.  Yet when the issue is treated, it may save the tooth, but there can be post-treatment discomfort as a result.  Here is a general guide to what may be causing the discomfort.

Reversible Pulpitis: this accounts for much of the post-treatment discomfort patients have. Sometimes when a tooth has a cavity and the dentist places a filling, the tooth can become sensitive to cold temperatures. The nerve has some transient inflammation in response to the procedure which can manifest as temperature sensitivity. The best way to tell that it is reversible pulpitis is if the discomfort goes away soon after removing the extreme temperature.  The sensitivity can range from mild to intense. Generally, though, this should resolve with time, but it can take anywhere from weeks to months.

Irreversible Pulpitis: sometimes decay has progressed to the point where it has penetrated or come very close to the nerve. In effect, the early stages of irreversible infection have already begun. Unfortunately, this can also be an asymptomatic process. Sometimes, even if the decay itself has not physically made its way into the pulp, the bacteria that caused the decay is at the nerve. So that even if the dentist removes all the decayed tooth structure and fills it successfully the underlying problem may still be there. When symptoms from irreversible pulpitis develop, it can manifest as a more constant temperature pain to cold and hot temperatures that does not resolve on its own. If this is the case, its important to let your dentist know about it. It can mean that even though the decay has been removed and the tooth filled, that the nerve was infected, and the tooth is still in need of treatment to fix the issue.

Biting or Pressure sensitivity: if this happens, it could mean a few different things. It could be that the patient is biting on a “high spot” and most often a simple adjustment to the filling can resolve this.  Sometimes it can be because of a previously unseen crack in the tooth. Cracks in teeth can come from a few different sources.  Sometimes the crack that was too small to see during routine exam can grow larger during the process of treatment (like from the dental instruments during removal of decay)to the point where it now has symptoms.

Your dentist wants to know if you are experiencing any of these symptoms, so call and let them know. If you are experiencing a tooth ache or discomfort feel free to give Spring Smiles a call at 919-753-1280. We are here to help!

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