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Dentistry/Sensitivity after filling

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Question
Dr. Backlund,

A few years ago you gave me some helpful advice - I hope you might be able to do so again.

I just had a filling replaced on a molar.  Although the new silver filling was a two-surface, there was extensive decay that went all the way down to the gumline.  The dentist told me that although the decay was not near the pulp chamber, because the filling was so large, there was a possibility I'd need RCT just from the amount of irritation to the tooth.  He gave me the contact info for an endodontist and said I should make an appointment there if I have bad pains.

Now, a few hours later, the area is sensitive.  There is a general soreness (part of which may be from the gums, which got injured while he was drilling).  Also, it stings slightly if I press down on the top of the tooth.  I had the following questions:

1.  Should I give it a day (or a few) to see if the pain goes down before going to the endodontist?

2.  Might it be worthwhile, before rushing to a root canal, to try to take out the new silver filling and try to put in a sedative filling?  What would be the indications for a sedative filling?

3.  Could taking an anti-inflammatory like ibuprofen reduce the odds of a disastrous swelling of the pulp?  If so, for how long should I take it like this, and at what dose?

Answer
Hi Jonathan,

I'm sorry to hear you have this going on. I'll try to give you some answers to help you make your decisions....

1.  Should I give it a day (or a few) to see if the pain goes down before going to the endodontist?

It never hurts to give things like this time as long as you are NOT having extreme pain. If things are healing, you should notice that over time the sensitivity will decrease. If things get worse you may need to get in to have your tooth evaluated by an endodontist. There really is no amount of time that can be specified. The real issue is are things getting better or worse....it can take even several months to finally heal from the irritation of a deep filling.

2.  Might it be worthwhile, before rushing to a root canal, to try to take out the new silver filling and try to put in a sedative filling?  What would be the indications for a sedative filling?

At this point, what you DON'T want is any more irritation to the pulp (nerve) of the tooth, so doing further treatment of any type would not make things better and could cause the pulp to die.

3.  Could taking an anti-inflammatory like ibuprofen reduce the odds of a disastrous swelling of the pulp?  If so, for how long should I take it like this, and at what dose?

Yes, that could certainly help you. My personal favorite is naproxyn ( Aleve) which is over the counter in 220 mg tablets. You take these only every 12 hours, so I would take 2 every 12 hours for the 1st 2 days, then reduce it to 1 every 12 hours for maybe the rest of a week, then see how you are feeling. Once again, if things get worse, get in to see an endodontist for evaluation.

Hope this helps...good luck!


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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