yet more problems with white fillings

Ellie2758

Ok, the story so far. I had two white fillings done by an NHS dentist but paid privately. One fell out but they wouldnt replace it FOC as it was done privately so I had another amalgam one. The second has just been removed because it was thought that there was decay underneath since white fillings shrink - not that I was told this at the time y'understand. Anyway, dentist took out white filling on friday morning saying what a large filling it was, would need a crown etc etc. In the meantime she would put in a temporary filling. Makes sense so far. Then she says, come back in January and I will put in a proper filling then monitor it in case it needs a root canal done before I do the crown. "Ok....but why not just do the proper filling now then?" Is what I SHOULD have said. Because now, where she has left the temp filling the inside edge of the tooth is very sharp and my tongue is permanently sore. It bloody hurts and I have hardly eaten since. I wonder why she is so keen on temporary fillings - she tried to do this to me last time but I insisted that she do the permanent thing (otherwise it means more time off work, more trips into town, more parking fees). What on earth was her reasoning, any ideas?

Ellie

SallyD

Surely an x-ray will show if you do need a root canal filling! Most folk are only too aware when they need a root canal, generally you get an abscess and pain. If indeed, your filling had shrunk it is likely decay could have crept under and around the tooth. Possible reason for temporary filling is purely to plug the hole to avoid discomfort with view to x-ray and possible treatment next visit? If tooth does not need a root canal may still need building up with filling material to get a good fix on a cap. If you are not at all happy with your dentist, change. I speak as a very unhappy patient with a dentist whom I believed was looking after me properly ,even visited every six weeks regularly to have a clean and polish. I went to Guys Dental Hospital one night with severe pain. I know to this day they did not believe me when they asked "when did you last see a dentist", I replied...........yesterday! I have undergone 2 years treatment for gum disease, which resulted in loosing a tooth, having 4 caps fitted at the front, as the previously ones were fitted so badly there was decay underneath and benefited from excellent care and attention. If you are even slightly unhappy go elsewhere, at least for an opinion. I know in some parts of the country dentists are hard to find, but they will all take your money if you go private, so ask around, get some recommendations.

Toothsmith

She probably didn't have the time to do the proper filling there and then.

If the white filling was bigger/harder to get out than she thought, or if there was more decay under than she'd thought, then it's easily possible that she would start running really late if she did the filling properly as well. (At least she didn't bodge something in there and tell you it'd be OK!)

This can happen all the time in private practices as well as NHS, although time is often much tighter in NHS places.

Temporary fillings are a bit softer than real ones, so chances are it was fine when she put it in, but between then and the anaesthetic wearing off, a bit broke off, hence the sharp bit. Also, your tongue is far more sensitive to tiny little edges than the dentist's eyes! It could be that it's just a tiny little sharp edge that she missed. Either way, you need to pop back and just get the edge smoothed before your tongue is cut to ribbons. Again though, it's a common problem.

As to the X-ray, an X-ray will only show up a problem/infection under a tooth if it has been there for some time, and the bone around the root has changed. it will not show up an abscess in the early stages. Also, people can have abscesses for years without knowing they are there. It's only when they go through a very active time and try to expand really quickly that they hurt.

It's possible that removing the very deep decay in this tooth has been 'the last straw' for the nerve in that tooth and it is very sensible to wait a while to see if anything happens. Even if nothing does after a few weeks, it doesn't mean it never will, and a close eye will need to be kept on that tooth for a while yet. It's quite a guess though as to when the crown should be done. If you wait too long, the tooth may break/decay further and then there'd be nothing too crown. Do it to early, and there is a chance that an abscess might be developing but not shown itself yet.

Root filling it just 'to be on the safe side' shouldn't really be done either, as a dead/root filled tooth goes very brittle and can break much more easily, either with a crown on or without.

It does sound like your dentist is taking a sensible approach. If only she worked in a system that could allow more time!

Ellie2758

The x-ray has already been done though. That was why she removed the filling, it "appeared" there was decay underneath but she didnt actually find much when she took out the filling. It didnt take long to remove the filling, I did have an appointment but still ended up with a temporary filling It is actually a piece of tooth that is so sharp, I think.

Have heard from all and sundry that root canal removal is most unpleasant :eek: so will hope to avoid that.....

Ellie

CIS

my wifes just had a temp filling put in and told to come back in january as she needed a crown and he said there was no point sending for it now as it wouldn't get done.

He has a habit of stalling and taking his time though, he repeatedly gives temp fillings instaed of sorting the problems

Teerah

Ellie2758 wrote:

The x-ray has already been done though. That was why she removed the filling, it "appeared" there was decay underneath but she didnt actually find much when she took out the filling. It didnt take long to remove the filling, I did have an appointment but still ended up with a temporary filling It is actually a piece of tooth that is so sharp, I think.

Have heard from all and sundry that root canal removal is most unpleasant :eek: so will hope to avoid that.....

Ellie

As toothsmith has said, infection around the root of the tooth are not immediately obvious on an xray until they become well established. Therefore the dentist has placed a temporary dressing as an interim step in case the tooth does develop problems. If the filling is quite a substantial size then there is a chance that the nerve of the tooth will die, in such cases it is wise to proceed with caution rather than rush in and place a filling or crown on a tooth that will then perhaps suddenly develop severe toothache due to infection. Your dentist may have placed a sedative dressing to ensure you do not encounter any problems over the holidays

As for root canal treatment, well its like everything else, you only hear about the bad experiences!!

As for the sharp edge of tooth, either return and have the temporary filling reshaped or added to, or if you are unable to return keep placing a piece of sugar free gum around the offending edge until it can be sorted. Will protect your tongue!

Teerah

CIS wrote:

my wifes just had a temp filling put in and told to come back in january as she needed a crown and he said there was no point sending for it now as it wouldn't get done.

He has a habit of stalling and taking his time though, he repeatedly gives temp fillings instaed of sorting the problems

At this time of year it is not uncommon to have dental treatment which requires lab work postponed until after the new year as many labs take holidays at this time. Better to have the work done in january than have impressions taken now and left lying around until january and then have wasted appointments if things dont fit properly!

blossom30

Hi sorry to hear about your wee problem Ellie. I have a similar problem I thought one of my fillings came out last week from upper left as that was where the pain seemed to be coming from. After being kept up all night Sunday I got an emergency appointment on Mondayand got x-rays done and my dentist thought it was the back tooth bottom left and that it needed root treatment estimated at £87.20 . She started the treatment yesterday and boy was it painful (and I'd had the anaesthetic). This seems to have been the right courseof treatment for me as the pain has reduced to the area. I hope your teeth are sorted.

Ellie2758

Teerah wrote:

As toothsmith has said, infection around the root of the tooth are not immediately obvious on an xray until they become well established. Therefore the dentist has placed a temporary dressing as an interim step in case the tooth does develop problems. If the filling is quite a substantial size then there is a chance that the nerve of the tooth will die, in such cases it is wise to proceed with caution rather than rush in and place a filling or crown on a tooth that will then perhaps suddenly develop severe toothache due to infection. Your dentist may have placed a sedative dressing to ensure you do not encounter any problems over the holidays

As for root canal treatment, well its like everything else, you only hear about the bad experiences!!

As for the sharp edge of tooth, either return and have the temporary filling reshaped or added to, or if you are unable to return keep placing a piece of sugar free gum around the offending edge until it can be sorted. Will protect your tongue!

Thanks Teerah, this business about the root dying...........I'm confused. There has been a large filling there for years, has it always been at risk of the root dying? Or is there something specific that would cause this? Oh, and why is root canal treatment so painful despite anaesthetic?

Ellie

Ellie2758

shrewdal wrote:

Hi sorry to hear about your wee problem Ellie. I have a similar problem I thought one of my fillings came out last week from upper left as that was where the pain seemed to be coming from. After being kept up all night Sunday I got an emergency appointment on Mondayand got x-rays done and my dentist thought it was the back tooth bottom left and that it needed root treatment estimated at £87.20 . She started the treatment yesterday and boy was it painful (and I'd had the anaesthetic). This seems to have been the right courseof treatment for me as the pain has reduced to the area. I hope your teeth are sorted.

Sounds nasty, Shrewd :eek: glad you got it sorted for christmas.

Ellie

Teerah

Ellie2758 wrote:

Thanks Teerah, this business about the root dying...........I'm confused. There has been a large filling there for years, has it always been at risk of the root dying? Or is there something specific that would cause this? Oh, and why is root canal treatment so painful despite anaesthetic?

Ellie

Hi Ellie,
to a certain extent, yes, every tooth that has a large or deep filling has an increased risk of nerve death. This is because, the action of placing a filling combined with the original decay that the tooth suffered have caused stress and trauma to the tooth that can filter through to the nerve in the centre of the tooth. Also fillings are obviously not exactly the same as the original tooth substance so they may conduct heat through to the tooth centre more or they may shrink or expand at different rates to the tooth substance. All these things stress the nerve tissue and increase the chance of nerve death if it finally has enough!

On the subject of painful root canal work. As I said, the vast majority of this treatment is pain free and problem free, it is only the painful ones that you hear about. They can sometimes be painful depite having been given anaesthetic, this is true. Usually this happens if the nerve tissue is very inflamed or if there is a lot of localised infection which is thought to prevent the anaesthetic reaching its target. Often the surrounding area may be completely numb except for the tooth in question! However, if this is the case, the placement of a sedative dressing (with or without an antibiotic if indicated) should settle the tooth enough to enable successful painfree work on the following visit.