Hi Gretchen,

You are welcome Thanks for being so receptive to my... honesty ~)

Okay so this tooth has a fracture and had a deep mercury filling. Depending on where and how big the fracture is, it could cause a vulnerability in the structure of the tooth which may not be able to be remedied with a crown. If that is the case, then the tooth would remain cold sensitive and bacteria would continue to seep in resulting in recurrent decay and infection. Mercury fillings expand and contract with temperature changes which causes cracks and fissures to occur within the tooth. The deeper the filling the deeper the cracks will be within the tooth. Over time this causes irritation to the pulp area and nerves of the tooth. Sometimes a tooth like this will be symptomatic on and off, other times it's relatively quiet. It may shows signs of a problem as you found out on the tooth next to it that was extracted. The tooth becomes additionally irritated from the drill prepping the tooth for a new filling or crown. However, sometimes it does calm down.. again depending on the circumstances. What you need to know most importantly just in case this tooth does not calm down is that a root canal will not "favorably" alter the condition of this tooth. In fact it will cause it to become more fragile because the blood supply will be cut off and the tooth will become non vital.

I'm sure the assistant did the best job she could in adjusting it. But when a patient presents with several symptoms as you did with a temp crown and the history of this tooth is what it is.... the dentist should be the one to adjust the bite because it could make a huge difference in the final outcome.

For you to be prescribed vicodin for the post op of a crown prep may indicate an anticipated problem........

**The dentist may have had to prep a lot below the gum line to obtain enough tooth structure to hold the permanent crown on. He also may have had to do this to bypass the fracture in the tooth. This means that the crown margins would sit sub gingival... below the gum line... which is not ideal because the gum tissue may then be chronically irritated. SO ASK THE DENTIST IF THE CROWN MARGINS ARE GOING TO BE BELOW THE GUM LINE (SUB GINGIVAL) AS OPPOSED TO AT THE GUM (SUPRA GINGIVAL).?? IF HE SAYS YES, ASK WHY?? BY THE WAY.. MANY YEARS AGO MOST CROWNS WERE MADE TO SIT BELOW THE GUM TISSUE BUT FOR THE LAST 15 YRS OR SO THAT WAY OF THINKING HAS CHANGED TO AT THE GUM LINE TO LESSEN THE IRRITATION TO THE TISSUE.

***The dentist may have suspected that this tooth would act up after being prepped and is leaning towards the possibility that you will have it root canaled and wanted to minimize your pain. You need to make your decision about root canals clear to him at this point. This way the two of you can come up with a plan in case this tooth acts up.

If the gums are actually swollen, they you may be sensitive to the temp material. Please have the dentist evaluate that possibility.

When was the most recent xray taken of this tooth? If it was more than 3 months ago, ask the dentist to take a new one. This will show if there are any changes that have occurred, it will show the depth of the crown prep and it will show if there are any open margins in the temp along the gum line that is causing exposure of some dentin.

I really hope things start to improve for you!
Please let us know how it goes tomorrow

Bryanna