Hi Sandy!
You have described your dental situation....perfectly! My opinion based on what you have written is that tooth 31 may also have some bone loss issues just like 29 and 30 did and this tooth is also taking a beating when chewing because it is all by itself. The bone loss causes portions of the root to be exposed... and the exposed portion can be extremely tiny but it can still be enough to make the tooth very cold sensitive. The crack in the amalgam will also cause cold sensitivity as well. Either of these conditions (the crack in the filling and/or the root exposure) make this tooth more prone to decay because the open filling allows bacteria to get in underneath and the exposed root now has no enamel to protect it. GelKam and sensodyne are not going to cure this problem, you are right.
The impacted wisdom tooth may or may not be an issue if you were to remove #31. It all depends on how close they are to each other and if there is any bone dividing them. However, an experienced oral surgeon would be the one to take it out. Having a root canal on #31 may take away your cold sensitivity but you then risk getting an infection in the bone at the site of the wisdom tooth because all root canaled teeth have some degree of bacterial infection. Your wisdom tooth is in a vulnerable place and it wouldn't take much bacteria to cause a problem there. If that were to happen, then you would have no choice but to remove 31 and 32.
Cold sensitivity indicates an open contact as in a filling or crack in the tooth or root exposure in a "live" tooth. Heat sensitivity indicates the nerve in the tooth is dying and infection is brewing. With that said, you may consider having a crown put on #31 and see if that takes care of the cold sensitivity.
If you were to root canal #31, you run the risk of infection spreading as I mentioned before. Putting a bridge from #28 to 31 with 29 and 30 as fake teeth will not be stable irrelevant of whether the anchor teeth are root canaled or not. Because of the bone loss in 29 and 30 area, the bone level is very low making the dynamics or design of the bridge nearly impossible or at best very compromised. There would be alot of pressure on #31 when chewing which in of itself could cause the tooth to dye and/or become infected.
What about..... crowning #31 and wearing a removable partial denture to replace 29 and 30? Are you missing any other teeth in your lower jaw that could be replaced with a lower partial?
Bryanna
Quote:
Originally Posted by sandy60
Hi Bryanna, you helped me through an ordeal last year and hoping you can answer a question. I had tooth 29 and 30 extracted several years ago due to bone loss, they were loose. Now 31 has become sensitive to cold and it has a large old amalgam filling. I see a crack but the dentist wasn't concerned as it doesn't seem to go down far. He told me to use Gel-Kam and Sensodyne but it is not helping.
I know that you are not an advocate of root canals but he says he can't use a sealant because he doesn't so them on the part near the gum (just on the top of the tooth). If I have the tooth extracted, there will be nothing there to oppose the upper teeth. He hasn't offered me a solution and I am getting really angry about this. I hit the ceiling with even a piece of cheese from the refrigerator, but it's only for a second so I am not sure if it warrants a root canal.
Would crowning the tooth ever help? It seems that they'd have to drill more away and I don't know if this will worsen the sensitivity. I am also afraid of extracting because I have a horizontally impacted wisdom tooth so close to it and I wonder if this can mess that up. They don't want to ever touch that as long as it never gave me a problem. I am in my sixties and it's been ok...and I know that it should have been removed when I was young.
Is there any treatment that can make this sensitivity go away? I can't see spending the rest of my life like this. I know I asked a lot of questions but would so appreciate your advice on each one. I'm a nervous wreck over this. Also, if I DID get a root canal and ever decide to get a fixed bridge, tooth 28 is also root canaled so with 2 root canaled teeth as an anchor...just doesn't sound strong enough. I can't get implants, neurologist doesn't want me to, so not an option. Thanks.
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