Expert: Dr. Randolph Myerson - 2/10/2009

Question
Hi! I'm 25 and I had braces many years ago. I had both
molars right after my canines removed...the top ones. And
the other molars were moved up front to fill out the space.
The second molar I have on the upper left side (which will
be the third one if I had them all) had a filling, that I
lost a few years ago. It was very big, almost half of the
molar. I didn't do anything back then. Now, I'm having a
LOT of pain, it extends to my shoulder. I have an
appointment with my orthodontist and dentist on the 19th. I
want to have it extracted because I can't stand the pain
anymore, but I don't want my teeth to shift. Will they
shift if I have that molar extracted? I don't know how you
guys call it, but I also have the last 'molars' that come
up, that usually hurt a lot. The one on that same side, is
starting to move...causing even more pain. And I think the
one the bottom, which has not come out yet, is moving and
looking for a place to come out and I think all that is
what causes the huge pain that sometimes extends to my ear
and always to my shoulder. I don't know how those molars
are called because, where I come from, we have a different
name for 'em.
My question is, is the best thing to have the molar that
lost the filling extracted, I just have like half of it, I
don't think it can be fixed. Is it going to hurt a lot? Are
my teeth going to shift after? That's why I want to see my
ortho, so that he can tell me if they are going to shift or
not, which more often than not...will happen. I'm taking
pain killers, but apparently, they're not enough. What else
can I take or do while I wait for my appointment? I'll
appreciate your answer. Thanx! Have a good day!

Answer
There's not much I can tell you without the benefit of an examination.  It sounds like there's some instability in your bite right now with all the shifting that you're experiencing.  With the extraction of a tooth you can expect even more shifting to occur.  You are on the right track by consulting with your orthodontist as well as your dentist to find out your options and the consequences of each.
As for the discomfort, taking analgesic medication is a good idea.  You might also find some relief by rinsing with warm water frequently.