Should I Fill a Cavity or Opt for Root Canal Treatment?

Should I get a dental filling or undergo root canal treatment?

Hello Dr.
Huang, I would like to ask about a tooth I had filled about a year ago (the upper left last molar).
This tooth has a bit of a fracture on the edge, and along with the adjacent molar (the second to last upper left), it becomes sensitive after consuming cold or acidic drinks.
Therefore, I went for a consultation.
The doctor informed me that the cavity was in the last molar, very close to the nerve, so they temporarily filled it and advised that if it starts to hurt, I should undergo root canal treatment.
Recently, I noticed that this tooth and the adjacent one also become sensitive after drinking cold beverages and before brushing, but there is no pain, and after brushing, I do not feel sensitivity (similar to the condition before my last visit).
However, I decided to see another dentist and informed them of the situation.
The conclusion was to proceed with root canal treatment as a precaution against future pain.
They removed the previous filling, applied anesthesia, and placed temporary filling material, so I can return for the root canal treatment next time.
I am worried that this approach might be excessive since I only feel sensitivity.
Would it be better to just fill the tooth? Or is it possible that the cavity issue is actually in the interproximal area or inside the tooth, and root canal treatment should be done as soon as possible? Thank you, doctor.

Chen Shi, 20~29 year old female. Ask Date: 2018/04/07

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Chen Shi,
Hello! In fact, acidity can be quite bothersome (leading to a decrease in quality of life and unhappiness)! If it can be addressed, it should be addressed! Post-treatment soreness indicates that the nerves may already be inflamed.
Root canal therapy can be considered at this point.
Please communicate more with your physician.
Thank you! Wishing you peace!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2018/04/07

More Info

When faced with the decision of whether to fill a cavity or undergo root canal treatment, it is essential to understand the underlying conditions of your tooth and the implications of each treatment option. Based on your description, it seems that your left upper last molar has a cavity that is close to the nerve, which raises the stakes for potential complications if left untreated.

Firstly, let’s clarify the difference between a filling and a root canal treatment. A filling is typically used to restore a tooth that has a small to moderate cavity. It involves removing the decayed portion of the tooth and filling it with a material that can restore its function and shape. This is a less invasive procedure and is often sufficient if the decay has not reached the nerve of the tooth.

On the other hand, a root canal treatment is necessary when the decay has progressed to the point where it affects the pulp (the innermost part of the tooth containing nerves and blood vessels). This treatment involves removing the infected or damaged pulp, cleaning the inside of the tooth, and sealing it to prevent further infection. Root canal treatments are more complex and typically require more than one visit to complete.

In your case, since the cavity is very close to the nerve, your dentist’s recommendation to consider root canal treatment is prudent. The fact that you experience sensitivity to cold and acidic drinks indicates that the tooth may be compromised. While you may not currently feel pain, the risk of developing an infection or severe pain in the future is significant if the decay is not adequately addressed.

You mentioned that another dentist temporarily filled the cavity and advised you to monitor the situation. This approach can be reasonable, but it is essential to keep in mind that if the tooth is already showing signs of sensitivity, it may be a sign that the nerve is under stress. If the tooth were to become infected, you would likely face more extensive treatment and discomfort.

If you are concerned about the necessity of root canal treatment, it is advisable to seek a second opinion from another dental professional. They can evaluate the tooth through clinical examination and possibly additional imaging, such as X-rays, to determine the extent of the decay and the condition of the pulp.
In summary, while filling the cavity might seem like a less invasive option, the proximity of the decay to the nerve suggests that root canal treatment may be the more appropriate choice to prevent future complications. If you are experiencing sensitivity, it is crucial to address it promptly to avoid more severe issues down the line. Discuss your concerns with your dentist, and don’t hesitate to seek a second opinion if you feel uncertain about the recommended treatment plan. Your oral health is paramount, and making informed decisions will help ensure the best outcomes for your teeth.

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