Expert: Tony Appleton BDS DPDS - 3/28/2007

Question
My right front tooth is constantly sensitive/painful - not particularly to cold or hot, but seemingly to air, or saliva.  It has been like this for three weeks and is becoming more noticeable.  I have some acid erosion, and that tooth is uneven and slightly sharp at the edge (but only noticeable if you look closely, it's not bad enough to repair for cosmetic reasons). The feeling subsides over night, but is otherwise constant and ranges from (at its best) a sensation of being acutely aware of my tooth, to (most of the time) a dull almost-ache.  Pressing my tongue against the bottom of the tooth dulls the sensation.  Putting sensitive toothpaste on the bottom of the tooth also seems to help a tiny bit for a little while.

My dentist has xrayed and found no decay or abcess, and is stumped.  He said he doesn't even know to whom he could refer me.  He replaced an old filling in an adjacent tooth two days ago, as I wondered whether the feeling was actually in that tooth.  This has made no difference.

When I am in Australia in May I will see my childhood dentist and have a fluoride treatment, which is supposed to help with sensitivity and block up the tubules?  This is routine treatment in Australia.  I've looked online and found out about sealants, but are these only ever applied to back teeth?  I don't want any treatment that would involve the enamel being eroded further, just to protect the tooth from whatever is hurting it.

Do you have any suggestions as to what could help?

Also, any ideas for how to find a more informed dentist?  I don't mind going private for this.

Many thanks
Anne

Answer
Hi Anne

This sounds to be a bit more than just sensitivity. The pulp in the middle of your tooth is inflamed and giving you these symptoms. This could have been caused by the acid erosion or decay or a history of trauma to the tooth.

A fluoride treatment may help this, but unfortunately it sounds as though you might be headed for root canal treatment - it really depends on if, and how well, your pulp settles. If the pulp doesn't settle and starts to die then it's root canal!

If you want to get a second opinion then the best way to find a good dentist is to ask family/friends and colleagues for personal recommendations.

I hope this helps

Regards

Tony Appleton