Dental Hygiene/pain from new filling
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.
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.
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