Tooth Pain: When Root Issues Lead to Complications

The tooth root is covered by soft tissue?

Hello, doctor.
About a year ago, I had my lower right wisdom tooth extracted, but the tooth in front of it had a cavity on the side that was assessed to be quite deep, and the doctor recommended root canal treatment.
Later, another dentist suggested that I should first get a filling, and if that didn't work, then proceed with the root canal.
However, recently I've been experiencing unexplained pain in that tooth.
After switching to another dentist, I discovered that the dentist who filled my tooth had placed medication inside but did not inform me that I needed to return for further treatment.
As a result, there is a crack in the filling, and food debris has become trapped in the cavity, causing decay inside.
The upper part of the tooth is about half remaining, and gas buildup is unable to escape, which is causing my pain.
Even after cleaning, I still feel pain.
The dentist assessed that the filling may not have been done properly, leading to the growth of tissue above the tooth root that is causing pain and significantly affecting me, along with a large cavity in the tooth.
During severe pain episodes, I also experience pain and swelling around the area near my tonsils.
Is this inflammation? If extraction is necessary, would it be considered a difficult extraction?

Ying, 20~29 year old female. Ask Date: 2020/03/23

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Ying,
Hello! As mentioned, it appears that the cavities are caused by the horizontal wisdom teeth, which are quite deep and covered by the gum, making them difficult to treat.
Essentially, they need to be filled properly.
If there is only a small amount of bone remaining around the tooth root and it is loose, extraction will be necessary (which is easier).

Take care! Wishing you peace and success in everything!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/03/23

More Info

Tooth pain can be a complex issue, especially following dental procedures like root canal treatments or extractions. Your situation, involving a previously treated tooth that is now causing significant discomfort, raises several important considerations.

Firstly, it is essential to understand that tooth pain can arise from various sources, including infection, inflammation, or structural issues within the tooth itself. In your case, it appears that the tooth in question has a history of deep decay and subsequent treatment that may not have fully resolved the underlying problems. The presence of a crack in the filling, as you mentioned, can allow bacteria to enter and cause further decay or infection, leading to pain.

The fact that you are experiencing pain not only in the affected tooth but also in the area around your tonsils suggests that there may be an inflammatory response occurring. This could be due to an infection that has spread from the tooth to surrounding tissues, which can cause swelling and discomfort in adjacent areas. The pain radiating to the tonsil area is not uncommon, as dental pain can often be referred to other parts of the head and neck.

Regarding the treatment options, if the tooth has a significant cavity and the filling is compromised, a root canal may indeed be necessary to remove any infected tissue and alleviate pain. If the tooth structure is severely compromised, extraction might be the best option. However, if the tooth can be salvaged, a root canal followed by a proper restoration (like a crown) could provide a long-term solution.

As for the question of whether this would be considered a difficult extraction, it depends on several factors, including the tooth's position, the extent of decay, and the condition of the surrounding bone and tissue. If the tooth is broken or has extensive decay, it may require a more complex extraction procedure, possibly involving surgical techniques.

In summary, your symptoms suggest that there may be an ongoing infection or inflammation related to the tooth that requires further evaluation. It is crucial to communicate openly with your dentist about your symptoms and concerns. A thorough examination, possibly including X-rays or a CT scan, may be necessary to assess the condition of the tooth and surrounding structures accurately. Depending on the findings, your dentist can recommend the most appropriate course of action, whether it be root canal therapy, extraction, or another treatment modality.

In the meantime, managing your pain with over-the-counter anti-inflammatory medications may provide some relief, but it is essential to seek professional dental care to address the underlying issue effectively. If you experience any swelling or fever, or if the pain worsens, you should seek immediate dental attention, as these could be signs of a more serious infection that requires prompt treatment.

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