Expert: Gary Backlund, DMD, MSD - 12/2/2009

Question
Dear Doctor,

20 years ago, my mother had some bridge work done.  She has been complaining of some pain which is not easily identifiable.  When "tapped" she does not experience pain.  She denies pain to touch, cold, heat, air or when she bites down.  The molar that she is complaining about is #31 (her bridge extends from tooth 28-31).  Her x-rays do not show any signs of abscess or inflammation and tooth the 31 is vital, the only thing is that it is holding the bridge.  She has been told that they may need to remove the entire bridge to "explore," however, doing so will be very costly because the bridge will be cut and will need to be replaced.  I was told that maybe she should see an Endodontist who may be able to drill a hole in the molar without removing the bridge work and test the "pulp" to determine if the cause is a root canal that needs to be done.  This situation is quite frustrating since the type of pain cannot be easily described (not sharp, dull, throbbing) but severe enough to wake her up in the middle of the night.  I would truly appreciate your input and I know that it may be difficult to exactly state what the cause may be, however any light that you may shed will be greatly appreciated.  She has only a few days to decide on what to do?

Thank you.

Answer
Hi Josephine,

I'm sorry to hear your mother is going through all this. Diffuse, non-specific pain like this can be very hard to diagnosis. Before she has anything done, I think I would get an examination from an endodontist. Rarely is it necessary to drill a hole in a bridge to make a diagnosis...only once in my years of practice. We are specialists in diagnosing pain as well as doing root canals, so I would certainly feel an exam would be the way to go. Then you could find out your mother's options and go from there. Her pain could be from a number of things, an abscessed tooth being only one. Since the pain seems to be worse at night, she may even be a tooth grinder.

Hope this helps.

Gary Backlund DMD, MSD