Hi-

I had a composite filling in tooth #3. I was never advised the problems which could arise from this type of filling. I did not experience pain after the novocaine wore off....a few days later I did..so I went back to the dentist at about 3 weeks post filling, he did a bite test and said it was OK, he rubbed a blob of fluoride on it, and said to wait a while. That if it still bothered me, he would remove some of this filling , place some type of desensitizing filling in.

**Of course my dental insurance ceased at the end of June.

I have experienced so much pain, to heat, after I eat the articulating lower tooth hurts, my cheeks hurt as well as my mandible & maxilla. I went back to him a few days ago,5-6 weeks post original filling, He took an Xray and said it looked good. Then he referred me to an endodontist, saying "the endo had special tools to determine whether the nerve was necrotic ( and how much) or if it was fine. If the nerve was necrotic, I would require a root canal, which he wanted the endodontist to perform. As I do not have insurance, I know this is going to cost me quite a bit~ $1000+.

After reading some of the posts on this forum, root canal frightens me. I already have had 5-6 TMJ operations(w/impants) and I can barely open my mouth...so I am a fanatic about cleaning my teeth & flossing...which is why I was surprised that I had a cavity. At most of my biannual check ups, they hardly had to remove any plaque.

I am also a little ticked off, well a lot, at this dentist as I was a loyal customer for over 10 years..he knows my dental insurance ended.

Does this vitality "tool" exist? Is this normal?


Stacy

Hi Stacy,

The vitality test is called the cold test. All you need is an ice cube to perform it. There is also another test called a pulp test which is a little battery operated hand held device that can measure the vitality of the tooth. It is not 100% accurate.

I cannot tell you about this particular filling as I cannot see you clinically and you have not posted a xray. The filling could be deep and irritating the pulp... it could be fractured... it could be too high in your bite as you move your jaw from side to side.

Having a chronic TMJ issue tends to make me think that your bite changes according to the level of inflammation in your joint and ligament. Anything that causes you stress will tighten that ligament and alter your bite even more.

Did you have any problems with that tooth prior to the new filling being placed? What filling material was in there originally?

Bryanna

Thanks Bryanna-

Both TM joints are ankylosed, my side to side movement maybe 1-2 mm, I cannot move my mandible foreward and my opening is 10-12 mm. I have been operated on numerous times, and I keep forming adhesions. I know have dura covering the condyles and cadaver bone in the fossas ( I previously had metal implants & also became ankylosed...disaster).

I am new to this site and do not know how to post an Xray. He printed one for me to take to the endodontist, so I have a copy. That tooth was a vergin tooth. There was no filling.

I am thinking he was speaking of the pulp test. What do they do with an ice cube??

Thanks,

Stacy

Hi Stacy,

Wow, you have a messed up TMJ for sure! You poor thing

So the tooth had some decay and that's why the filling was put in. Was it a large filling? Was the decay deep?

To post an xray here if it is a digital xray ... you would have to have the dental office email it to you, then you would post it here as an attachment.

The endodontist may take an xray of his own.. which would be wise as it would be of better diagnostic quality over the copy.

The cold test is when the dentist takes a small piece of an ice cube or sprays a cotton tip with cold ice and places in directly on the tooth. It is normal for a healthy tooth to react to severe cold and then quickly recover once the cold is removed. If the tooth has little to no reaction to the cold then that can indicate a decrease in vitality. If the tooth does not quickly recover from the cold that can indicate a hypersensitivity from a fracture in the tooth or opening in the filling.

Bryanna


QUOTE=Stacy_11;1005874]Thanks Bryanna-

Both TM joints are ankylosed, my side to side movement maybe 1-2 mm, I cannot move my mandible foreward and my opening is 10-12 mm. I have been operated on numerous times, and I keep forming adhesions. I know have dura covering the condyles and cadaver bone in the fossas ( I previously had metal implants & also became ankylosed...disaster).

I am new to this site and do not know how to post an Xray. He printed one for me to take to the endodontist, so I have a copy. That tooth was a vergin tooth. There was no filling.

I am thinking he was speaking of the pulp test. What do they do with an ice cube??

Thanks,

Stacy[/QUOTE]

Thanks Bryanna-

I just put an ice cube between most of my teeth and it did not bother hardly any of them...maybe I am doing it incorrectly? For a few weeks hot coffee was REALLY flaring up the pain. In fact, i could not even eat hot food on the opposite side of my mouth. If anything hot touched my palate, the pain was excruciating. Now it is not.

I will try to post the Xray.

I guess instead of an RC would be to have the tooth extracted. But my wisdom teeth were impacted by bone and they are gone, so I only have tooth #2 on the upper right.

Hi Stacy,

Yea, it's a little more involved than just touching your teeth with ice. There are certain areas of the tooth that the cold is applied to and it is purposely kept there until the patient responds. Teeth can generally take some degree of cold without any reaction as in eating cold foods.

Was the cavity deep or the filling deep?

Bryanna

I am trying to attach the xray now.

Hi Stacy,

Thanks for posting the xray. It came out legible

The filling does not appear to be near the pulp. However, it is a large filling and it is actually on the cusp of the tooth. The cusps of the teeth take a lot of abuse when chewing and generally a filling replacing a cusp would extend a bit farther into the occlusal (biting) surface of the tooth for better retention. I'm not sure why he didn't do that. Did the cusp of this tooth break off and he replaced the missing piece with a composite filling?

Bryanna

Thanks Bryanna-

You may think I am nuts, but now the tooth feels like I can move it with my tongue.

Nothing broke off. I went in for my bi-annual, feeling fine. So do you think it needs to be redone?

ACtually, I think I had this cavity/decay at the last appt, because it was a non xray appt, and I remember when he probed my mouth (less than 30 seconds), he was probing that area...and I said then, if I have a cavity, even if it is small, fill it now. He said it was OK.

I was looking for some natural dental products at CVS and could not find any.

Hi Stacy,

I think the filling may be in a weird spot. On the xray (which is only 2 dimensional) it appears that it has taken the place of one of the cusps on the tooth. If you can picture the pointy cusps on the tooth, there are say 4 of them on this tooth. He removed one and put a filling there. This type of restoration is prone to fracture because the cusps take a lot of abuse when chewing. So even if it had a hairline fracture in the filling you would get some sensitivity to temperatures and/or discomfort or pain or a feeling of something loose depending on how you bit down on it. Am I being clear on that explanation? If the restoration were to be redone, he could extend the filling into the biting surface of the tooth a little bit to give it more retention.

Also, if this restoration is not fitting properly into your existing bite then as you grind/clench or chew you are hitting into it unnaturally and that would cause the ligament to become inflamed which could also cause the tooth to feel loose. This situation eventually leads to an irritated nerve and then onto an infection.

Healthy oral products are often found in health food stores, some really big drug stores and online. I buy many products online from vitacost.com. They have a great selection and great prices!

Bryanna