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Dentistry/Tooth Extraction & Nerve Damage Question

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Hi - I have a tooth that has broken off in the past, and the dentist did a repair job (at the time of xray about a year ago, and 6 months ago there was no sign of other damages to the roots or nerves from the xrays). It has been very slightly sensitive about a month ago so the dentist said to use special toothpaste on it. It hasn't caused much grief, but I was in some pain for 2 days a few days ago. Then last night most of the tooth broke off - it looks like mostly the old and new filling broke off. It has broken off just below the gum level, but left a rise at the front. I went to the dentist today and he did a tap test - I couldn't feel anything, and he did the ice test and I felt one very very slightly, but not the other 2 ice tests. I actually didn't feel anything at all. I've felt no pain at all yesterday or today, just that I know the tooth is partly missing. The dentist today (different dentist) said he believes the tooth has nerve damage and root problems and is dead (or dying) and it isn't worth saving. But I have doubts as if it was dying or nerve problems, wouldn't I feel it - like REALLY feel it? What I've felt is nothing more than a slight annoyance (when it was sensitive - and that wasn't to hot or colds more like a very slight gum ache) and a mild toothache for a couple of days. I've had severe keep me up all night toothaches and this was nothing in comparison to them. In fact as said, for 2 days now I feel nothing at all. So wouldn't I feel something if my tooth had nerver problems, and wouldn't it have shown on the xrays in July? I'm apprehensive to have them extract it so dismissively, when I wonder if there is enough to save it. He said it showed some decay and because it is a very filled tooth previously, he said after he removes the decay he doesn't think there is much tooth left to build on. But I wonder if he is more guided by the fact that he thinks my tooth is dead/dying? So I'm interested to know if you had a dying tooth if you would feel it. Or if perhaps there is a chance to save a tooth and build something on it, if the base is still there and fine (ie no root or nerve problems).

Answer
Hi Kat,

I'm sorry you're in this situation. Sometimes it's really hard to make an accurate diagnosis and often dentists make decisions based on the percentages of a good long term result. When a tooth dies, it can do so without any real symptoms or there may have been some symptoms long ago, like hot & cold sensitive, which was when the tooth started to die. Cold and X-rays are probably the best tests. Since you are concerned, I would suggest you get a 2nd opinion, perhaps from an endodontist, about whether the tooth is alive and whether it is worth saving. Obviously, since I can't exam you or see your X-rays, I can't help much with diagnosis.

Hope this helps.

Gary Backlund DMD, MSD

Dentistry

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Gary Backlund, DMD, MSD

Expertise

I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.

Experience

25 years practicing as a specialist

Organizations
American Association of Endodonists, Past President Washington State Association of Endodontists.

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