Expert: Mark Bornfeld DDS - 12/3/2006

Question
I noticed that I was missing a small chunk out of my filling/crown on #31 (my dentist called it a crown, but it was just a really BIG filling). It DIDN'T HURT AT ALL, but I knew it needed to be taken care of quickly.  I don't have dental insurance so I went to a new dentist who offers a discount to people in my insurance group without dental insurance.  
He drilled out the old filling and put a new one in.  As soon as the Novocaine wore off I was in a good amount of pain.  Within a few days I was taking pain killer every 7 hours.  I have been back for two adjustments since, but it has not gotten better.  The doctor even took another Xray and everything looked fine.  
In the last few days it feels like my inner ear is about to explode...it is so painful.  Things like cold food/drinks set it off as well as lying down.   Sometimes the pain just comes on at random times and occasionally I don't have any pain, but of course I haven't been able to chew on that side since the procedure (10/31).
I realize I have to go back to my original dentist, but I'm afraid I'll have to pay for a root canal now.  Does it sound like a root canal issue?  (The tooth didn't hurt at all before the procedure and they Xray showed no decay or problems).
Thank you for your advice
Jennifer

Answer
Dear Jennifer,

Although these long-distance diagnoses are far from reliable, the short answer is yes-- although it may well not be a root canal issue, that is the most likely diagnosis.

This is in no way intended to place fault with the dentist who placed the new filling. Even with the best of intentions and skill, repairing a tooth that has been extensively filled in the past carries risk. The long history of previous dental interventions often compromises the health of the pulp, and these teeth are often waiting for one more event (such as a new filling) to push them over the edge.

You would be well advised to attend to this tooth as soon as you are able. Pulpitis often progresses to abscess, and acute infection is more difficult to treat.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY