Expert: Frederick R. Liewehr DDS, MS, FICD - 10/28/2008

Question
Hello

I had my first filling done about 3 months ago and for about 2 months it was fine. Then I started developing a nerve pain in the tooth, whenever I ate. It does not hurt at any other time, I can hit the tooth, clench my teeth etc etc and it won't hurt.

I went to the dentist and they took the filling out and put some medication in there and refilled. The dentist had said there were no fractures and no further decay. Initially the tooth was better, but a week later it has started hurting again.

The dentist suggested that if this didn't work I should have root canal treatment. I'm not sure whether I should wait (and how long I should wait) to see if the pain goes away, as I am assuming now this will not cause any damage, but would like to know if this is the case.

In general I would like some advice as I can barely afford to have any more treatment and after having perfect teeth for 26 years am reluctant to have root canal unless it is absolutely necessary.

Kind regards

Kate

Answer
It sounds like you have what we call an irreversible pulpitis, which is an inflammation of the pulp, or "nerve" in your tooth. It is normal to have a reversible inflammation following placement of a filling, which you perceive as increased sensitivity to cold usually. This sensitivity decreases as the inflammation resolves, usually in a week or so. If the pain persists, or worsens, then the inflammation is not resolving, and probably won't. This requires root canal therapy, which is the removal of the damaged pulp. No damage will occur if you put off treatment, but you increase your chance of either having a very bad toothache, or of the pulp dying and becoming infected, which could lead to an abscess. It would be best to have it done as soon as you can.