Discomfort After Dental Filling: Do You Need Root Canal Treatment?

Discomfort when biting down on a filled tooth?

Hello.
The first lower right molar was previously filled with resin a few years ago.
After some time, I experienced discomfort when biting down on things at the filling site.
I visited the dentist, who suggested that the filling might be loose and re-filled it with resin.
A month later, I had my wisdom tooth extracted from behind that molar, and I avoided using the right side to chew until the extraction site healed.
Initially, the molar felt slightly uncomfortable, similar to before, but then it often felt sensitive and soft, so I changed the filling material to silver amalgam.
After that, the sensitivity issue resolved, but I still felt strange sensitivity when drinking cold water or milk.
Whenever I bite down on something, I experience discomfort; it becomes unbearable, and I can't chew at all.
There is no spontaneous pain at other times, but the dentist mentioned that there is a significant and deep cavity, and X-rays show it is close to the nerve.
I have used a cotton swab to poke at the filling area and felt very uncomfortable.
Do I need root canal treatment, or are there other options? (The dentist who examined me said that this situation requires it.) Thank you.

Kai, 20~29 year old female. Ask Date: 2021/03/21

Dr. Zeng Guanghui reply Dentistry

If you have already had a resin filling and then switched to a silver filling but still experience sensitivity and discomfort, it is possible that the original cavity was extensive and close to the nerve.
If the discomfort persists, it is recommended to return for a follow-up appointment for the dentist to evaluate the situation and consider a root canal treatment.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2021/03/21

More Info

Discomfort after a dental filling can be a concerning issue, especially when it involves sensitivity and pain while biting. Based on your description, it seems that you have experienced a series of dental treatments, including a resin filling and subsequent replacements with different materials. The fact that you are feeling discomfort, particularly when biting down, suggests that there may be underlying issues that need to be addressed.

When a dental filling is placed, it is meant to restore the tooth's structure and function after decay has been removed. However, if the filling is too high, improperly placed, or if the tooth has significant decay that approaches the nerve, discomfort can occur. The sensitivity to cold beverages like ice water or milk, along with the pain when biting, indicates that the tooth may be reacting to temperature changes or pressure, which could be a sign of nerve involvement.

Given that your dentist has noted that the cavity was large and deep, and that it is close to the nerve, there is a possibility that the pulp (the innermost part of the tooth containing nerves and blood vessels) could be inflamed or infected. This condition is known as pulpitis, and it can lead to more severe pain and complications if not treated promptly.
Root canal treatment (RCT) is often recommended in cases where the pulp is compromised. During this procedure, the dentist removes the infected or inflamed pulp, cleans the interior of the tooth, and seals it to prevent further infection. If the discomfort persists and is significant enough to affect your ability to chew, it is advisable to consider this treatment.
However, before proceeding with a root canal, there are a few other considerations and potential treatments that could be explored:
1. Re-evaluation of the Filling: Sometimes, the filling may need to be adjusted. If it is too high or if there are any voids around the filling, it could lead to discomfort. A dentist can assess this and make necessary adjustments.

2. Sensitivity Treatments: There are desensitizing agents and treatments available that can help alleviate sensitivity. These can be applied directly to the tooth and may provide temporary relief.

3. Observation: If the discomfort is mild and does not worsen, your dentist may suggest monitoring the tooth for a short period to see if symptoms improve.

4. X-ray Examination: If not already done, a follow-up X-ray can provide more insight into the condition of the tooth and surrounding bone, helping to determine if there is any infection present.

5. Consultation with a Specialist: If your general dentist is unsure, they may refer you to an endodontist, a specialist in root canal treatments, for a more detailed evaluation.

In conclusion, while it is possible that you may need a root canal based on your symptoms and the condition of the tooth, it is essential to have a thorough examination and possibly further imaging to confirm the diagnosis. If the discomfort is affecting your daily life, seeking prompt treatment is advisable to prevent further complications. Always communicate openly with your dentist about your symptoms and concerns, as they can guide you through the best course of action tailored to your specific situation.

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