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Dentistry/Wisdom tooth


QUESTION: Hello Doctor!

I had a semi permanent filling placed in my huge lower wisdom tooth last month which apparently was very deep ( less than 1mm above the nerve) to be exact!

This tooth already had a permanent filling there for about 3-4 years before being replaced by a second filling.

Problem is - I get bouts of sharp throbbing pain off and on during the day which lasts couple of minutes then slowly fades away. There is no sensitivity with hot or cold or when I eat. The pain comes on randomly! But the is definitely a hell of pain when I tap gently on it.

Doctor, could you tell me why I might be having this kind of pain? And also, considering the tooth has such a deep huge filling, would an extraction of this tooth cause a lot of pain? Since the tooth might be quite hollow due to most of it being drilled out to make way for the filling?

Your help will be greatly appreciated doctor!


ANSWER: Good Day, Arian,

My thinking is that due to the deep restoration that has been placed that the tooth is beginning to abscess. It is not uncommon to have a delayed reaction and since there had been some kind of treatment before this second restoration was placed it indicates more of a problem.  It is possible the tooth is cracked due to the large amount of tooth structure that is missing due to the removal of a lot of decay which could also be the cause of this situation.  The sensitivity to the tapping is coming from swelling around the root in the ligament that holds the tooth to the bone and it acts like a shock absorbing part of the anatomy.  When it gets inflamed then tapping on a tooth will cause pain and also chewing on it. As your body tries to eliminate this inflammation it will feel better but then it will return. As time passes this will probably intensify and be more constant. It could eventually improve but from what you've described I doubt it.  To answer your question about the extraction, the discomfort from an extraction would be no different than if the tooth had no problem other than space or eruption pattern or any other reason.  I hope this helps you.

Dr. Karmen

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

QUESTION: Doctor, thank you so much for your brilliantly explained answer! =)

But I just had one last question - I am thinking of getting that wisdom tooth extracted soon because I don't want it become infected ( considering a part of the filling has chipped from the side).

What would be the best way for extraction that will cause least a punt of bleeding and/or difficulty - getting the filling out completely and then pulling it to just extract it like that with the filing?

I am quite paranoid about tooth extractions because I have had bad cases of unstoppable bleeding in my last 2 extractions of molars and I just don't want to go thru that hell again with this one especially since its winter where I live right now so I can't even have ice cream or anything cold after extraction... =(

Hello again,

It would make no difference with the filling in or out but from what you have just told me I suggest you see physician and be evaluated for the possibility of a bleeding disorder.  It's possible you might have some type of condition causing this and I think it is wise to have that evaluated.  To extract a tooth with or without a filling present makes little difference and I think that if I had my preference I'd leave the filling in.  If there is any infection present then clear that up as best you can.  I hope this helps again.  I am happy to be of service to you.

Dr. Karmen


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Thomas Karmen


All general dentistry questions, especially those related to fixed prosthetics. Endodontics, Periodontics, and implants, minor oral surgery I can't answer much about othodontics nor advanced treatment of carcinoma nor deep tissue surgery nor osseous surgery such as jaw reduction or advancement.


DDS In general practice and consulting with having done some lecturing for local dental societies.

ADA and Florida Dental Association and Iowa Dental association

DDS degree

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