Tooth Nerve Issues: Causes and Solutions for Sensitivity

Dental nerve issues?

Hello Doctor, about a year ago, I went rafting and accidentally chipped a small corner off my upper right second incisor, which made that tooth very sensitive, but it was still within tolerable limits, so I didn't pay much attention after getting it filled.
I didn't want to undergo root canal treatment or get a crown.
A few months ago, the filling came off again, but since it didn't affect my daily life, I didn't have it redone.
However, about a few weeks ago, I started feeling some sensitivity and discomfort in the upper right first incisor next to the chipped tooth, especially when chewing and using dental floss.
Then, on Monday night, after brushing my teeth before bed, the chipped incisor started to hurt severely, causing me to lose sleep.
The pain lasted all night, but when I woke up the next morning, it was gone.
Strangely, the usual sensitivity to hot and cold drinks also disappeared completely.
Just to be safe, I went to see a dentist.
They took full-mouth X-rays and examined that area, saying there was nothing wrong.
The dentist checked the chipped tooth and found no cavities or cracks, so they just refilled it.
I asked the dentist why I experienced that pain and the sudden disappearance of sensitivity the night before, but they didn't know.
The day after the filling, my tooth started to feel like it was having nerve pain again, intermittently.
However, I haven't been able to find time to return for a follow-up.
Therefore, I would like to ask what might be the issue in my case.
I can tolerate the pain, but I'm more concerned about the possibility of a bacterial infection in the tooth or nerve.
Thank you for your response.

Morris, 20~29 year old female. Ask Date: 2021/05/19

Dr. Zeng Guanghui reply Dentistry

If the chipped front tooth continues to feel painful after being restored, it is likely that the dental nerve has become inflamed.
It is advisable to return for a follow-up appointment.
If necessary, root canal treatment should be performed, followed by the placement of a crown for protection.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2021/05/19

More Info

Tooth sensitivity and pain can be quite distressing, and your situation seems to involve multiple factors that could be contributing to your discomfort. Based on your description, it appears that you have experienced trauma to your upper right second incisor, which has led to sensitivity and pain. The fact that you had a piece of the tooth break off and that you have had intermittent pain suggests that there may be underlying issues that need to be addressed.

First, let's discuss the potential causes of your tooth sensitivity and pain. When a tooth is traumatized, as in your case, it can lead to several complications. The trauma may cause damage to the tooth's nerve, leading to a condition known as pulpitis, which is inflammation of the dental pulp. This inflammation can result in heightened sensitivity to temperature changes and pressure, as well as spontaneous pain. The fact that you experienced severe pain one night and then had a temporary relief the next day could indicate that the nerve is in a state of irritation, which can fluctuate.

Another possibility is that the sensitivity you are experiencing in the adjacent tooth (the upper right first incisor) could be a referred pain from the traumatized tooth. The nerves in the mouth are interconnected, and issues in one tooth can sometimes manifest as discomfort in another. Additionally, if the first incisor is experiencing sensitivity, it could be due to gum recession or other periodontal issues that may have developed over time.

The intermittent nature of your pain and the fact that the X-rays did not reveal any obvious issues such as decay or fractures are encouraging. However, it is essential to monitor the situation closely. If the pain persists or worsens, further investigation may be warranted. This could include a more detailed examination of the tooth's pulp and surrounding structures, possibly through a cone beam computed tomography (CBCT) scan, which provides a more comprehensive view of the tooth and its roots.

In terms of management, since you have already had the tooth restored, it is crucial to maintain good oral hygiene to prevent any potential infections. Using a desensitizing toothpaste can help alleviate some of the sensitivity you are experiencing. Additionally, avoiding extremely hot or cold foods and drinks may help minimize discomfort.

If you notice any swelling, prolonged pain, or changes in the color of the tooth, these could be signs of a more serious issue, such as an abscess or necrosis of the pulp, which would require immediate attention. In such cases, root canal therapy may become necessary to remove the affected nerve tissue and alleviate pain.

In summary, your symptoms could be related to the trauma to your second incisor, leading to nerve irritation or pulpitis, and possibly affecting the adjacent tooth. It is advisable to keep a close watch on your symptoms and return to your dentist for follow-up if the pain persists or if new symptoms develop. Early intervention can often prevent more severe complications and help maintain your dental health.

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