[threeputt]

I turn age 67 in 6 days so my teeth are old
I was just a the dentist for my yearly checkup on the 5th of this month.
X-rays were done and also cleaning. The told me all was good and to keep up the good work. Thursday night I noticed tooth number 24 would hurt when I would tap on it. No pain felt unless I eat or tap something on it. I could not reach my dentist as they are closed on Friday. This morning I decided I needed to find at least a doctor. They give me some antibiotics and told me to get to the dentist Monday. I sure don't want to mess with a tooth infection. There is no swelling on the gum and just looking at the tooth it looks fine. I cannot remember ever having any problems with these front teeth. It just strange that all of sudden a tooth starts hurting. I need advice to what step I need to take. I sure hate to have this tooth pulled but if it has to go then so be it. The pain is not as bad as it was yesterday but its still there. Thanks for any help. Tom

[razzle51]

your bite could be off a little or could have root exposure .... Just go to the dentist for peace of mind.....

[Bryanna]

Hi Tom,

Long time since we've "seen" you..... how's your golf game?

Tooth #24 is one of the lower front teeth. These teeth are generally smaller and they often have a small root structure compared to other teeth. They are prone to recession and also to fracture more so than most other teeth.

When a tooth is tender or hurts to tap on it, some causes of that would be...... inflammation from the bite being off..... inflammation from the periodontal ligament that holds the tooth in the bone..... a deep pocket that is harboring bacteria ...... a fracture in the root ...... or an infection.

Your recent cleaning could have stirred up some bacteria around that tooth which may have caused inflammation. Did the hygienist take xrays of your whole mouth or just the 4 bite wings to check for cavities on the posterior teeth?

I suggest that you go back to the dentist and have them take an xray of that area. Even if they took one at your cleaning appointment... take another to compare.

Hope all else is well by you! Keep us posted
Bryanna

Originally Posted by threeputt

I turn age 67 in 6 days so my teeth are old
I was just a the dentist for my yearly checkup on the 5th of this month.
X-rays were done and also cleaning. The told me all was good and to keep up the good work. Thursday night I noticed tooth number 24 would hurt when I would tap on it. No pain felt unless I eat or tap something on it. I could not reach my dentist as they are closed on Friday. This morning I decided I needed to find at least a doctor. They give me some antibiotics and told me to get to the dentist Monday. I sure don't want to mess with a tooth infection. There is no swelling on the gum and just looking at the tooth it looks fine. I cannot remember ever having any problems with these front teeth. It just strange that all of sudden a tooth starts hurting. I need advice to what step I need to take. I sure hate to have this tooth pulled but if it has to go then so be it. The pain is not as bad as it was yesterday but its still there. Thanks for any help. Tom

[threeputt]

Good to hear from you Bryanna and thanks for asking about the golf game . Its still good if I could only stay healthy . Today the tooth is not hurting. I am assuming the antibiotics did the job so the problem could be worse than I thought ?.

I have never had any problems in this area of my teeth. They did do two tiny filling when I went to the dentist for cleaning but both on top. Did not even need a shot but it did hurt a tiny bit.

I do see some gum recession on these front teeth and lets hope it can be saved. I sure don't want to loose any on the front.

Now that you mentioned it I don't think they did xray the front teeth. I will try and get in today and have them take a look. I will report back and let you know. Thanks for helping me again. Tom

[threeputt]

Bryanna, here is what happened. I just got back from the dentist and of course I knew the answer before I went this morning.

When I was at the dentist a few days ago I found out they did do one tiny filling on tooth number 24. I had actually forgot which two they filled. I am betting this is what caused it.

The doctor said now she wish she had not seen the cavity on number 24 but it needed repairing. Of course you know what they want to do. Root canal.

I hate to loose this tooth but to pay $489 for the root canal and then have to go back later and have it removed because it didn't work is not something I really want to do. I have had some root canals done many years ago but can't remember why they were done. I don't remember having pain being the reason I had them , they just told me I needed one.

$85 to pull the tooth and I should be pain free from now on but I will not have to good smile I have now. I have always been a critic of someone who has missing teeth . Just does not look good. I know as I continue to age I may face more problems with infections being I have this one now. Maybe my immune system is not strong enough to fight off things like this.

I got a few days to decide on what I do being the antibiotic is doing its thing but not sure how long before something needs to be done. Maybe you can help me make a move on this but I know you really are not a fan of root canals. Thanks again so much for you expert advice and I will wait and see what you tell me. I got golf to play when I get better which I hope is soon. Tom

[threeputt]

I may not be able to wait Bryanna as I am running a fever tonight and feel terrible. I can see the gum begging to swell around the infected tooth. I think I will call in the morning and see if they can get this abscessed tooth out. The dentist did admit that when she filled the tooth is when the problem started. This has been going on since late week and its time for the tooth to go. I will deal with the space later but for now I think it needed to be pulled. I still will wait for your reply and if I do not hear from you wish me luck. Tom

[Bryanna]

Hi Tom,

You know what my reply is going to be to you about keeping an infected tooth. It is never a wise idea to retain an abscessed tooth and root canal therapy does not remove all of the necrotic tissue from the tooth..... meaning you are left with an infected tooth. You have been there and done that before, right?

This tooth will need to be replaced as the adjacent teeth will shift towards the open space. Discuss replacement options with your dentist and let me know what she says. You have a little time after the extraction to decide on the replacement.

A note on dental implants..... if the bone is adequate and healthy after this tooth is removed, you may be a good candidate for an implant. I feel an evaluation with an oral surgeon regarding this idea would be wise as they are often better at making that judgement call than a general dentist.

Tom, I have a question about this tooth.... you said the cavity was small and even forgot she filled this tooth. How then could it be that it abscessed so quickly after the filling was done? Did she tell you the cavity was deep or that she uncovered a pulpal exposure while drilling? Did she just patch up the tooth and tell you that it was not in good health?

Bryanna

Originally Posted by threeputt

I may not be able to wait Bryanna as I am running a fever tonight and feel terrible. I can see the gum begging to swell around the infected tooth. I think I will call in the morning and see if they can get this abscessed tooth out. The dentist did admit that when she filled the tooth is when the problem started. This has been going on since late week and its time for the tooth to go. I will deal with the space later but for now I think it needed to be pulled. I still will wait for your reply and if I do not hear from you wish me luck. Tom

[threeputt]

Tom, I have a question about this tooth.... you said the cavity was small and even forgot she filled this tooth. How then could it be that it abscessed so quickly after the filling was done? Did she tell you the cavity was deep or that she uncovered a pulpal exposure while drilling? Did she just patch up the tooth and tell you that it was not in good health?

Bryanna, I am confused on exactly what is going on. When I was in the office the first week of August for regular cleaning she noticed I had a small cavity in number 24 and another one on top. I had forgot which one they did do but after the visit yesterday she told me she did put a small filling on #24.

I was a little nervous about even getting any filled because I take good care of my teeth and this took me by surprise. She never mentioned anything to me about uncovering a pulpal, she just sort of patched it up I guess ? I think when she opened it up to fill it the problem started.

I know when I would eat the next few days it seems like several of my teeth were sore which I found to be odd. The pain went away until this past Thursday night and then number 24 started hurting all of sudden. I have no pain in it now but for some reason I run a slight fever last night and the night before. Not much, just enough to make me feel bad.

I am waiting on a call from them now. They said they can pull that tooth and do a bridge the same day, of course with temps. Is this possible ? I would think I should wait until the tooth heals before a bridge process is started.

They can pull the tooth at 3:30 tomorrow or do the bridge at 1:30 which was originally supposed to set up to do the root canal. I am at lost on what to do. I got today to think about this but I sure want to feel better soon. Thanks again for your support here. I will get back to you on what happens. Tom

[Bryanna]

Tom,

Thanks for getting back to me today.

I believe there is more to this story than I think you realize or have been informed of by your dentist. The sequence of events is suspicious to me especially since your dentist seems so nonchalant about the "instantaneous" infection. If I were to try to read between the lines and base my opinion on my professional experience... ...here is what I would come up with....

Perhaps.... tooth #24 has been in question for awhile. Meaning it had some decay for quite some time and/or had some subtle radio-graphic signs of infection... maybe some periodontal involvement. Perhaps the decay was around an old filling and/or was on the root surface of the tooth. Either of which could contribute to the onset of infection because they indicate the tooth was compromised in some way. You may or may not have been informed of any or all of that by your dentist or hygienist. Any chance you could post an x-ray of that area?

Drilling into a small cavity does not cause the tooth to become instantaneously infected unless the decay was very deep, the tooth was already compromised and/or the pulp of the tooth was injured during the drilling. For those reasons I'm leaning towards the possibility that this tooth had "problems" prior to being filled. Your dentist would know the answer to ... if the tooth were ill prior.... if the decay was deep ... if she went into the pulp when she drilled.

The other possibility.... if the tooth were healthy prior to having it filled and the decay was not deep nor did she hit the pulp when drilling..... that something occurred during the cleaning that either stirred up bacteria that was present below the gum line or bacteria entered below the gum line via a dirty instrument.... both of which can cause or contribute to the infection. All of these scenarios would contribute to discomfort or pain in various areas of the mouth due to the inflammation.

The slight fever could be due to any number of things. So it may or may not be related to this particular incident.

Before I would do anything else with her..... I would ask her what the health status of this tooth was prior to the filling. Ask her about the depth of the decay.... about the health of the gum tissue and bone and is there bone loss..... is it severe or mild? If severe, how did it get that way if the tooth was healthy? Do you see where I am going with these questions? She needs to be accountable to you for not only her actions with this tooth but with the health of all your other teeth as well. Otherwise you could be walking around with other teeth in a similar condition and not even know it.

It is common to prep for a bridge at the time of the extraction. Sometimes this is the best time because this way there is no lag time for the adjacent teeth to move towards the opening of the removed tooth. However, it is important that you know which teeth she is preparing for the bridge, how many teeth .... and are those teeth healthy enough to handle the bridge??

If you had time.... and infection wasn't an issue... I would suggest that you get a consult with a new dentist.... have new xrays and a new examination and see what their findings are as this dentist may not be disclosing everything to you. Not that you want to hear any more bad news... but you are concerned about how this all came about and it is suspicious that it happened so suddenly.

I'm going to let you... and half the world.... in on a little secret. Perhaps I have already mentioned this here... I don't remember. It is fairly common for dentists to not disclose all of their findings to the patient and for a variety of reasons..........

For instance, sometimes the patient gives the impression that they are only interested in doing the minimal preventive dental work and only as needed.

Sometimes people don't see the value in spending money on their teeth "if they look good" what's the problem.

Sometimes people are very reluctant to spend the money on their teeth and only want to do what is absolutely necessary at the time.

Sometimes the dentist is just neglectful.

So you can see how things can go wrong along the way.

Keep me posted.... hope you feel better soon

Originally Posted by threeputt

Tom, I have a question about this tooth.... you said the cavity was small and even forgot she filled this tooth. How then could it be that it abscessed so quickly after the filling was done? Did she tell you the cavity was deep or that she uncovered a pulpal exposure while drilling? Did she just patch up the tooth and tell you that it was not in good health?

Bryanna, I am confused on exactly what is going on. When I was in the office the first week of August for regular cleaning she noticed I had a small cavity in number 24 and another one on top. I had forgot which one they did do but after the visit yesterday she told me she did put a small filling on #24.

I was a little nervous about even getting any filled because I take good care of my teeth and this took me by surprise. She never mentioned anything to me about uncovering a pulpal, she just sort of patched it up I guess ? I think when she opened it up to fill it the problem started.

I know when I would eat the next few days it seems like several of my teeth were sore which I found to be odd. The pain went away until this past Thursday night and then number 24 started hurting all of sudden. I have no pain in it now but for some reason I run a slight fever last night and the night before. Not much, just enough to make me feel bad.

I am waiting on a call from them now. They said they can pull that tooth and do a bridge the same day, of course with temps. Is this possible ? I would think I should wait until the tooth heals before a bridge process is started.

They can pull the tooth at 3:30 tomorrow or do the bridge at 1:30 which was originally supposed to set up to do the root canal. I am at lost on what to do. I got today to think about this but I sure want to feel better soon. Thanks again for your support here. I will get back to you on what happens. Tom