Expert: Frederick R. Liewehr DDS, MS, FICD - 12/5/2009

Question
QUESTION: I went to my dentist with some pain in my bottom molar, the dentist x-rayed my teeth and found that the bottom molar was cracked.  He then dug the old filling out and began to prepare my tooth for an inlay.  He filled the tooth with a temporary cement, after about 4 days I began having pain in the tooth. I went to a NHS emergency dentist and they gave me antibiotics.  I went back to my own dentist on Thursdays 03 December, the dentist finished the work with the inlay, but I am still experiencing pain.  Could you tell me what I need to do or will it get better?

ANSWER: I hope you mis-heard the dentist when he said "inlay". If your tooth is cracked, an inlay would be the last thing you would want. It could serve as a wedge and further damage your tooth. You would want an onlay or probably a full coverage crown, and should probably have the root canal done first. You had better check on this. The inlay can split your tooth.

---------- FOLLOW-UP ----------

QUESTION: On the form personal dental treatment plan it has appliances ticked, which covers inlays, onlays and crowns, and under the heading (other) it has Composile inlay, what ever that means.  The dentist said that it would probably settle down in a couple of days.  When I eat or drink on that side of my mouth where I have had the work done, I experience a throbbing sensation, which doesn't go until I have taken some pain killers.  I am avoiding eating and drinking on that side of my mouth.  I don't want to loose my tooth.  As I had a bad experience with my other back bottom molar.  I think it might be an onlay or crown as he had to make and prepare for this by taking impressions and send these of to the lab and then I had to go back for the fitting.  Will he be able to remove the inlay or crown to see under the tooth and will a root canal stop this throbbing sensation.  Please help.  

Answer
Sounds like you have an irreversible pulpitis. Root canal therapy will fix that, but then you will need to have a crown placed on the tooth to prevent it from splitting later on. If you already have a crown or onlay, the treatment can be done through it.