Expert: Frederick R. Liewehr DDS, MS, FICD - 2/27/2007

Question
I have a really sensitive front tooth when touched or eating it hurts it is putting pain all through my mouth made my gum tender and top lip swell. i got told that is was the nerve in my tooth and its dying and would go brown(which it didn't), i did get a sensitivity test done and didn't feel nothing on the tooth.  it happened 4 years ago and took antibiotics and it cleared up . it has now happened again am on antibiotics and pain killers though pain is alot worse would it be best going for a root canal ? or should i see if it settles and if it does settle will it likely come up again?

Answer
Hi Kim,
    I can't tell you what the problem is with your tooth without seeing you, of course. So you need to talk to an endodontist near you to be sure. You didn't tell me what happened four years ago, why you were told that your "nerve" was dying. If you fell or something, and banged the tooth, it is possible that the pulp, or "nerve" had its blood supply severed and did, in fact, die. Sometimes when this dead tissue breaks down, the products cause the tooth to darken. Not always, however. Sensitivity testing, correctly done, should tell you whether or not the pulp is still alive. However, it is somewhat technique-sensitive, and sometimes the pulp will only be injured and cause calcification, which creates thicker tooth material that may not respond normally but still be OK. It takes the expertise of an endodontist to interpret and perform these tests correctly. If the pulp has been dead for four years, it is probably bacterially infected and would have caused bone loss that can be seen on an x-ray, so that should be a dead giveaway. In this case, endodontic therapy would be required. Antibiotics can temporarily help with the systemic symptoms, but will do nothing to get rid of the bacteria inside the tooth that are causing the problem, so even it you get some relief, it will only be temporary. All in all, you need to see your dentist and get something done as soon as you can. Good luck!

Dr. Liewehr