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  • FIRST POST
    • treecol
    • By treecol 22nd May 19, 8:55 PM
    • 296Posts
    • 35Thanks
    treecol
    Dentist , what a pain
    • #1
    • 22nd May 19, 8:55 PM
    Dentist , what a pain 22nd May 19 at 8:55 PM
    It seems that a new dentist (private) who has given my husband a filling may have exposed the nerve. He's in a lot of pain and the dentist has re xrayed the tooth and said all looks as it should be. She's given hi a course of anti biotics as a precaution saying the tooth should settle but so far it's getting worse.
    She didn't charge for the visit to recheck the tooth, just £8.50 for the antibiotics.
    So my question is, if she has exposed the nerve, I think the only remedy would be root canal and obviously that would need crowning afterwards, so who foots the bill? He had no pain from the tooth and was unaware a filling was needed. The dentist said it showed up on his new patient xrays. As far as I understand, once the root has been exposed, the nerve being removed is the only remedy. But is the dentist at fault for exposing a nerve during what she said would be a small routine filling? If so, how should we proceed?
    Thank you in advance.
Page 1
    • brook2jack
    • By brook2jack 22nd May 19, 10:01 PM
    • 4,354 Posts
    • 4,016 Thanks
    brook2jack
    • #2
    • 22nd May 19, 10:01 PM
    • #2
    • 22nd May 19, 10:01 PM
    Any decay in a tooth has the potential to cause the nerve to die off. Some people have quite large nerves in the tooth so even a small amount of decay can cause a problem.

    X rays are taken so decay can be spotted before it causes pain. As a rule of thumb decay that causes pain is a lot of decay in a tooth.


    When a dentist does a filling they remove as much decay as they can . Sometimes I'm removing the decay they get close to the nerve , that can't be helped they have to remove the decay. Sometimes the tooth settles down , sometimes the nerve dies and the tooth needs either taking out or root treatment.

    In other words any filling can cause a nerve to die off , it is not the dentists fault there was decay in the tooth and it needed filling , if further treatment needs doing your husband will have to fund it.
    • treecol
    • By treecol 23rd May 19, 6:08 AM
    • 296 Posts
    • 35 Thanks
    treecol
    • #3
    • 23rd May 19, 6:08 AM
    • #3
    • 23rd May 19, 6:08 AM
    Thank you for your answer, at least we know.
    • treecol
    • By treecol 3rd Jun 19, 7:08 PM
    • 296 Posts
    • 35 Thanks
    treecol
    • #4
    • 3rd Jun 19, 7:08 PM
    • #4
    • 3rd Jun 19, 7:08 PM
    Posting again as this problem with DH's tooth is still ongoing. He's still in a tremendous pain. He went back to the dentist and she took xrays saying she was surprised he had any pain at all as it was only a small filling and she did not expect any issues. She took an xrays and said all appeared as it should be. She suggested he leave it a few more days to give the nerve chance to settle.
    So by the end of last week he was in terrible pain and cannot eat on that side or eat/drink anything hot or cold. Went back to dentist who suggested she put a sedative dressing and temporary filling in. She did and as soon as the anaesthetic were off, banging pain again. She has said it will have to be root canal next.
    So my friend who is a dental hygienist says the nerve has obviously been exposed and that the dentist should not have done that if she was competent. She says it's obviously irreparably damaged.
    So my question is, should we now have to foot the huge bill as thus was apparently just a small filling and no risk was mentioned -the dentist was even surprised at the after pain.
    Now I'm not one to seek compensation and realise things happen. But this is costly and we are completely ignorant of anything to do with teeth. If we're told we need dental work, how do we know that's correct?
    I just want to check what we should now do.
    • brook2jack
    • By brook2jack 3rd Jun 19, 7:36 PM
    • 4,354 Posts
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    brook2jack
    • #5
    • 3rd Jun 19, 7:36 PM
    • #5
    • 3rd Jun 19, 7:36 PM
    As said before, any amount of decay of any size has the potential to cause a nerve to die off. Any filling of any size has the potential to cause a nerve to die off. If a dentist sees decay on a x ray ,unless it is so tiny it is reversible , they have no option but to fill the tooth, the decay ,once it reaches a certain size, will not get any better.

    The dentist has done all they can to preserve the nerve. Your friend , the hygienist is wrong , the nerve is not necessarily exposed , a tooth that is not even decayed or that hasn't got a filling can die off . The anatomy of root canals (nerves) can be very complex and there can be tiny microscopic extensions that cannot be seen on an x Ray.

    Removing the filling and putting a sedative dressing in is absolutely the right thing to do, but it is 50/50 whether the nerve will settle down or not.

    The tooth had decay , it needed filling. Unfortunately any filling can cause the nerve to die off. The dentist has done their best to avoid root treatment but it is looking like this is necessary now. It is not the dentists fault your husband needed a filling in the first place . Unfortunately he now needs to decide if he is going to have the tooth out or pay for root treatment.
    • treecol
    • By treecol 3rd Jun 19, 9:10 PM
    • 296 Posts
    • 35 Thanks
    treecol
    • #6
    • 3rd Jun 19, 9:10 PM
    • #6
    • 3rd Jun 19, 9:10 PM
    Again, thank you. If it weren't for our friend saying the things she had, we would have accepted the situation without question. Although she is a hygienist one would hope she would have some knowledge about teeth.
    He needs to keep the tooth as he has a plate and the loss of a tooth could cause the others to move and give him more problems. So we'll just go ahead with r/canal.
    • Toothsmith
    • By Toothsmith 4th Jun 19, 6:01 AM
    • 9,120 Posts
    • 10,966 Thanks
    Toothsmith
    • #7
    • 4th Jun 19, 6:01 AM
    • #7
    • 4th Jun 19, 6:01 AM
    I would agree with all that Brook has said, and I'm pretty sure I'd have done exactly what your dentist did if faced with similar circumstances. In fact - something extremely similar happened to me just a few weeks ago, and it was to the (grown up) child of one of my staff!

    A very routine & unremarkable filling (which just happened to be the first filling they'd ever needed) really gave some pain & sensitivity for a while afterwards. Fortunately, this tooth DID settle down after a couple of weeks without further intervention. If drilling at a tooth has caused it to go sensitive - then if you feel it might settle down, the last thing you want to do is take a drill to it again! So giving it a chance to settle is generally the first thing you should do!

    With my patient, a careful eye will need to be kept on this tooth to check it is still alive, and the reason for it calming down isn't that it has just died quietly!

    Your husband's dentist has done just what I would have done. You said that first review appointment wasn't charged, and I think you'd have mentioned if the second, and changing the filling for a sedative dressing was charged. I'm assuming therefore that they weren't either, so from a 'customer service' point of view, she's also done what I would have done. If that dressing had worked, then I'd also have replaced the proper filling with no further charge. The root filling though is a more involved and complex treatment, and the thing that has 'caused' it was the decay, not the dentist.

    In all this tale so far - the person acting most improperly would seem to be your hygienist friend! She should not be making judgements on what has happened. You're quite right. She should have a wider knowledge about tooth matters, and she should know that something like this, whilst rare, is perfectly possible.
    Last edited by Toothsmith; 04-06-2019 at 6:04 AM.
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
    • treecol
    • By treecol 4th Jun 19, 7:19 AM
    • 296 Posts
    • 35 Thanks
    treecol
    • #8
    • 4th Jun 19, 7:19 AM
    • #8
    • 4th Jun 19, 7:19 AM
    Thank you for that very helpful reply. As I said in my previous reply, it was only at the insistance of my friend we began to question the whole thing. As DH said, in any line of work, his included, there is always the chance of unseen complications.
    It's like anything, being totally ignorant of dentistry, one feels totally reliant on the dentists advice and once seeds of doubt are sown by another.....
    Thank you for the clarity.
    • treecol
    • By treecol 7th Jun 19, 5:12 PM
    • 296 Posts
    • 35 Thanks
    treecol
    • #9
    • 7th Jun 19, 5:12 PM
    • #9
    • 7th Jun 19, 5:12 PM
    So DH had the first phase of his root canal today. The dentist said it bled a lot and that she was not surprised he had been experiencing pain due to the pressure building up in the tooth. She also said not to be surprised if the pain was still there for a few days and that if it doesn't settle to let her know.
    Fast forward to local anaesthetic wearing off and yes, he is in pain. In my ignorance, I presumed having the nerve removed from the tooth, would get rid of the pain. At this, all be it early stage, am sceptical it will slove his problem.
    • brook2jack
    • By brook2jack 7th Jun 19, 5:48 PM
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    brook2jack
    If you had surgery for, say an inflamed appendix (appendicitis) would you expect to be pain free immediately after surgery?

    Root treatment is microsurgery on an inflamed nerve. The inflammation affects not only the nerve but also the tissues around the tooth.

    Removing all of the nerve is not always easy as the anatomy can be very complex with many small branches which are impossible to get down. The dentist will have placed a disinfectant in the tooth which will help to clean out and remove any residual infection and lingering bits of nerve . Normally you expect the pain to settle down over the course of a few days.
    • treecol
    • By treecol 8th Jun 19, 5:28 AM
    • 296 Posts
    • 35 Thanks
    treecol
    No, absolutely wouldn't expect no pain after any other type of surgery. I suppose it's an ignorant presumption that removing the nerve = no more pain. Appreciate you confirming it's normal, that is reassuring.
    We've both had years of bad dentists on the NHS so now we are private, the worries about correct/necessary treatment still remain. Thank you again. Hopefully it'll settle over the weekend.
    • treecol
    • By treecol 15th Jun 19, 5:55 PM
    • 296 Posts
    • 35 Thanks
    treecol
    So here I am again, simply because another opinion is a great help. Obviously I do realise without being the dentist treating DH and without seeing xrays, an opinion is all I can get here. But just over a week after the 1st stage of root canal where the nerve in the tooth has been removed, he is still in a tremendous amount of pain. He cannot eat on that side, it is sensitive to hit and cold and he is still in constant pain. He has his next appointment tomorrow but the dentail nurse called to check how he was mid week and said after relaying the news to the dentist, said the dentist has said she doesn't know what is causing it and doesn't really have a solution????
    Since he's had to eat on the other side only the tooth she filled on that side is niw very painful causing difficulty eating. I have a painful tooth making eating on that side impossible and the same dentist has said that the inlay I have in it looks ok so she's inclined to leave it alone.
    With the greatest respect to any dentist here, are we in the hands of someone whose standards of treatment are not good. I really am beginning to wonder now.
    • McKneff
    • By McKneff 15th Jun 19, 7:21 PM
    • 36,570 Posts
    • 47,181 Thanks
    McKneff
    I am a coward. I would have it out and either get a tooth added to the denture or a completely new denture,.
    Job done, no pain...
    make the most of it, we are only here for the weekend.
    and we will never, ever return.
    • treecol
    • By treecol 15th Jun 19, 10:28 PM
    • 296 Posts
    • 35 Thanks
    treecol
    Well yes, that may be an option but if the nerve has been removed from the tooth and he still has pain, has she got the wrong tooth? If she removes it, what if the pain continues and it's another tooth, what if she can't identify which tooth it s and ends up taking out tooth after tooth?
    My worry is she can't get rid of the pain no matter what she does and with each treatment she keeps saying that it will do the trick and it doesn't. What exactly should one do in circumstances like this?
    • Toothsmith
    • By Toothsmith 15th Jun 19, 11:34 PM
    • 9,120 Posts
    • 10,966 Thanks
    Toothsmith
    This is really difficult, as from the things you write about this dentist from the steps she's taken, and the customer service side, including ringing up midweek to see how things are going, this is obviously a dentist who cares about what she's doing, and is approaching things in a logical order.

    Sometimes strange things do happen.

    Sometimes pain thresholds are a bit skewed in people in different parts of their bodies - causing minor stimulations to be translated as great pain.

    Sometimes there are problems in more than one tooth at a time, and it can take a while to realise what else is going wrong.

    What doesn't happen very often is a caring dentist turns out to be crap! But we do all have bad days, or miss something obvious very occasionally.

    If I have cases where something extraordinary seems to be happening that I can't figure out, I do have a practice in a nearby town which is a referral practice full of various specialists. As I've referred harder stuff to them for many years now, if I have a patient like your husband, I send them off to let someone there have a look at them and see what they think. As this doesn't happen very often, they will often not charge the patient for this assessment, or do it at a big discount. I have been qualified a fair while now, so have generally seen most 'beartraps' before, so don't need things like this very often at all now, but a couple of times in the last 4 or 5 years, I've been glad of their help.

    Maybe your dentist knows a practice like this? It would be better to go and see someone she knows of, and where she can accurately describe what has happened so far to them and then let them take a look, than for you to just randomly pick another dentist to go and see and let them try and work out what has happened.

    From how you've described her actions so far, I'm sure she'd be perfectly happy to refer you up to someone for another opinion.
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
    • welshdent
    • By welshdent 19th Jun 19, 8:21 PM
    • 1,890 Posts
    • 1,247 Thanks
    welshdent
    I third everything said by TS and brook.

    No dentist drills to expose a nerve. All dentists remove decay. IF it happens the decay is close to the nerve then tats where you have to go. It is what it is. The inflammation is ultimately caused by bacteria for the most part.

    As for who foots the bill... well the dentist didnt cause the problem. They just tried to treat it. There is not a practicing dentist in the world who has not done a "small" filling which has resulted in the tooth flaring up. I had 2 last week. Prior to that I hadnt had one for 6 months. Its rare but obviously frustrating when it happens.

    Regards the pain persisting after - again this can happen, Usually removing the top portion of nerve tissue settles the pain 9 out of 10 times. If it doesnt settle it is not because of incompetence it is because of the quirks of the human body. Why dont every single re set fractured arm heal exactly the same each time? Why do some people have post operative infections but others dont when treated by the same people at the same time for the same thing in the same place?

    My advice would be to go back and perhaps the dressing could be re done with a little more cleaning inside. These so called hyperaemic teeth which are exquisitely inflamed and bleeding a lot internally or VERY difficult to manage in the early stages because they are hard to anaesthetise then when you DO manage that, they are hard to find all the important anatomy because the bleeding obscures things.

    ALL dentists have these issues. We cant all be incompetent
    • Newly retired
    • By Newly retired 21st Jun 19, 8:43 AM
    • 2,418 Posts
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    Newly retired
    I am sure all the advice given is great and I think the second opinion idea is good.
    I am just going to report my own experience.i had a filling and was left in pain which became unbearable. I went back to the practice and a different dentist saw me. He removed the filling and put in a temporary dressing. He said a nerve had been exposed and air left in a gap when the filling was put in. After this I changed dentist, as this person had previously extracted the wrong tooth from my husbandís mouth. So I think he was incompetent. Fortunately our new dentist was excellent. Sadly many years later he has just retired so we have had to find another. It seems a bit of a lottery. My new dentist seemed to do a good job on a filling this week, but I have had a series of mouth ulcers ever since.
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