Expert: Mark Bornfeld DDS - 1/9/2007

Question
Hi,
I've had a whole lot of work done on my teeth lately.  This includes two crowns, 3 filled cavities, occlusal guard, etc. and further problems with the procedures.  I do take care of my teeth.  Brush twice a day and floss.

But most recently, I had a cavity filled and ever since it was filled, it has caused me pain when I bite down on something.  Once it caused me so much pain, I had thought my tooth cracked.  
So I went into my dentist to have an examination.  It wasn't cracked, but still extreme pain when biting.  The tooth was ground down to see if the bite was off.  This did not help.  The dentist gave me "sensitizer" to dull the pain and said if I was still having pain by the end of the week to schedule a root canal.  This was after an opinion from another dentist that happened to be in the office at the time.  
By the end of the week, I was having pain, not as bad, but still when chewing.  So I set the appointment.
My questions are: Why did I have absolutely no pain in this tooth and then right after the filling I experienced a lot of pain?  Can this be caused by the dentist?
Furthermore, one of my crowns causes me pain as well when chewing.  Also, my upper crown hurts in the morning after I use my occlusal guard.  I keep seeming to have problems after my teeth are apparently fixed.  Is it the dentist?This is getting very frustrating.  I barely have any place to chew anymore.  Basically, only two teeth are used to chew now due to pain either with my teeth or jaw!
Thanks for your help.

Answer
Dear Jake,

Although the timing of the events as you stated seems to implicate your dentist's therapeutic measures in causing your symptoms, this may or may not be the case. Depending on how deep the decay or other structural damage is on a tooth at the time treatment is implemented, this will influence the vulnerability of that tooth to pulpal (nerve) damage, periodontal (gum) inflammation, or other complications. In other words, badly damaged teeth can manifest postoperative pain regardless of the skill used during dental treatment.

Of course, one cannot rule out the possibility that your dentist has provided you treatment of poor quality, either. Postoperative pain can certainly be provoked by careless crown preparation or crown contour.

If you have reason to doubt your dentist's competence, you may wish to seek a second opinion from and independent dentist, who will be able to give a more fully candid assessment of the work you have received.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY