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Dental Hygiene/pain from new filling

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Hi paul
I had some work done about 3 weeks ago. I had 3 old caps replaced, 2 eye teeth, 1 front tooth(motorcycle accidend) and 2 silver fillings on my upper and lower molars, right side. I had the original caps done about 12 years ago and cand remember it took a while for my bite to feel comfortable, same this time. However in this instance my bite was concentrated directy on my new fillings, after 4/5 days i noticed pain in my bottom molar and went back to my dentist and i had apparently broke a piece of the bottom right molar. My dentist patched me up but my bite still doesnt feel comfortable, my upper right molar is now very sensitive to hot and cold and the right side of my jaw (muscular) feels sore all the time. Im hoping u could help me as i do like my dentist and havent had any problems before but im thinking of goin elsewhere.

Answer

Hi Brian

My goodness, you have certainly gotten quite a dental experience so far. I sympathize with your situation, but must share with you that there could be so many possibilities to explain what is happening.Moreover, without the benefit of an examination and X-rays, it is next to impossible to sit here on the internet and type out an accurate diagnosis and recommendation.

Now having said that, just to better frame the issue, I would like to describe three scenarios  for you to consider.  Again, these should be viewed simply as points to consider given that I have absolutely no diagnostic information such as x-rays or the benefit of an actual in person examination.

Possibilities:

1) The lower right molar which you describe often is very susceptible to dental decay and trauma from tooth grinding. As such not only is the enamel structure sometimes compromised, but root fractures may also occur. These are very difficult to diagnose. If decay was present, it may have extended very far into the tooth bordering the pulp chamber or that "inner guts" so to speak of the tooth. If this is the case, then some sensitivity can be expected. A return to the dentist for a radio graph or follow up valuation should not be ruled out.

2)  The upper right molar issue may or may not be related. I am not sure what role the trauma from the motor cycle accident may have played. The dental restorations sometimes can benefit from a follow up adjustment to make sure that the contacts are optimized. That is to say, if a restoration on one tooth prematurely  contacts the opposing tooth when biting down, the force of contact can lead to sensitivity. This requires what is termed an " adjustment to the occlusion". again, if this is the case, it is a procedure for the dentist who did the restoration, not an orthodontist.   Asi said Brian, there are simply so many  many possibilities here.

3) Finally, I would like to ask your to check out what Endodontic or Periodontal issues may be present. An x-ray of the molars may reveal small changes in the area of the bone around the tip of the tooth. This is an indication that there may be an infection in the tooth, and what is called a  root canal is sometimes warranted. again, I can say nothing without the benefit of x-rays; I am simply pointing towards possible scenarios. A second issue may be a periodontal concern. If there is sufficient recession of the gum and bone structure, the roots of a molar can be expose. When this happens sensitivities can occur. The treatment procedures for this vary, but include possible gum and bone  grafting prcedures. Again, let your  family dentist give you guidance.

Brian, in closing, I would ask your  dentist to check up on the previous procedures to see if any adjustments to the bite or occlusion can help. Moreover, multiple problems may exist. If this is the case,ask him/her if a referra to a specialist would be helpful. The specialist you would want to contact are :  1)  Endodntist for root canals ; and 2)  Periodontist for gum and bone loss evaluation.

Brian, I think i am going to have to tell allexperts.com to put a small disclaimer in their information to let patients know that difficult clinical cases like your are really sometimes too difficult to answer without an exam and x-rays. I do hope,given the limited information n your original query, that the above few paragraphs have been helpful. I have a motor cycle license myself...ride carefully  and I hope you can get everything resolved to your satisfaction. Please get back in touch if you wish.

Paul Supan,  DDS, MA, MPH
http://www.Braces.com
http://www.LeesburgBraces.com  

Dental Hygiene

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Paul Supan, DDS, MA, MPH

Expertise

Basically anything clinical. I am not able to answer questions about equipment repair. I am also not able to comment on manpower issues, salaries, or legal questions.

Experience

I actually hold a Dental Specialty Certificate in the ADA recognized Specialty of Dental Public Health. Dental Public Health, if you do a background check, focuses on prevention of disease. Dental Hygiene is basically prevention oriented and seeks to prevent dental disease (cavities, periodontal gum diseases, etc.) from occurring. I happen at this time also to be the expert on Orthodontics here on allexperts. You can check the type and length of the answers I am providing as well as the feed back. I am a practicing orthodontist, and am constantly evaluating dental hygiene and referring patients back to their dental office to have the hygienist help them with cleaning and maintenance. I also used to be co-editor of my Dental School Newspaper at the Medical College of Virginia School of Dentistry.

Organizations
American Dental Association- ADA American Association of Public Health Dentistry - AAPHD American Association of Orthodontists - AAO College of Diplomates of the ABO - CDABO OSAP - Office Sterilization and Asepsis Procedures Virginia Dental Association - VDA Academy of General Dentistry - AGD ( Fellow )

Publications
Upon Request

Education/Credentials
DDS Degree Medical College of Virginia MPH Degree - Masters of Public Health - Harvard University BS Degree College of William and Mary in Virginia Specialty Certificate in Dental Public Health - NIH & US Public Health Service.

Awards and Honors
Upon Request

Past/Present Clients
Upon Request

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