Expert: Mark Bornfeld DDS - 9/21/2007

Question
My new dentist recently recommended that I have two teeth next to eachother re-filled.  They were both said to be "deep cavities" although neither was bothering me.  At the same time I was also diagnosed with some gum recession so I had a deep cleaning and irragation done on my gums.  He warned me that I might have heat/cold sensitivity for the next couple weeks on the teeth.  It has now been a week, and I while I do not have a strong sensitivity to hot and cold, I do have an enduring pain.  It seems to be coming from my gums not the tooth itself, but is only in the area where the teeth were filled. The pain is so strong that when my tylenol wears off it wakes me up in the middle of the night.  

I have noticed from other peoples postings two things that I think might be causing my discomfort.  The first is that my dentist left the teeth open for 1/2 an hour while helping other patients, before refilling them in.  The second is that when I run my tongue along the back i feel a significant space between the two teeth.  Do you think either of these things could be the problem, or is it possible that I need a root canal?  

I really appreciate any help you can give me!  Thanks!

Answer
Dear Jessica,

It's difficult to infer what's going on in a reliable way, because pain is a non-specific symptom-- in other words, there are quite a few different things that could manifest in the way you describe.

It could indeed be that having left a space between your teeth (you can confirm this if you can insert dental floss between the two filled teeth without encountering resistance), your dentist caused a food impaction area that is causing periodontal inflammation. On the other hand, the placement of fillings almost unavoidably inflicts minor injury to the gum, and it could be this injury that you're feeling, and you simply need to allow more time for it to heal on its own. (Leaving the teeth open after drilling for half an hour would not be expected to cause pain.)

However, pain that is sufficiently severe to awaken you from sleep suggests something more ominous, and you could indeed need root canal treatment on one or both teeth. This possibility is further supported by the fact that both fillings are known to be deep.

You always have the option of waiting more time in order to see if the symptoms resolve on their own-- at only one week postoperatively, this would not necessarily be considered unrealistic. However, only you know how much pain you are willing to endure, and as time passes without any improvement, hopes that the situation will improve on its own become increasingly misguided.

In other words, I wouldn't advise that you wait too long before you return to your dentist for further assessment.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY