Tooth Sensitivity: Causes and When to See a Dentist

Q: Tooth Sensitivity: Causes and When to See a Dentist

Hello： It is recommended to schedule a follow-up appointment for an X-ray to confirm whether there is any pulp necrosis. <br>After two and a half years, any issues with the pulp can be clearly identified through the X-ray images, allowing for further root canal treatment if neces

There is a sensitivity or discomfort in the gums at the root of the tooth when pressure is applied?

About two and a half years ago, I had a cavity filled between my upper front teeth.
The next day, one of the front teeth became extremely painful and sensitive to temperature changes; I couldn't tolerate cold or hot drinks, and even the wind caused discomfort.
After a day or two, the sensitivity improved somewhat.
However, since then, whenever I press on the upper gum area (with my finger reaching between my upper lip and gums, roughly from the right front tooth to the left canine), or press near my nostril and philtrum (especially when I partially insert my finger into the right nostril and press towards the left front tooth), I experience a throbbing sensation in that front tooth (the left one).
This sensation is most pronounced when pressing on the upper gum of the left front tooth or when pressing from the right nostril towards the left front tooth.
However, pressing near the junction of the tooth and gum or on the tooth itself does not elicit much sensation, and only the left front tooth exhibits this throbbing feeling; the other teeth do not have similar issues.
The intensity of the throbbing sensation varies but generally remains consistent, resembling a dull ache that extends from the root to the entire tooth.
Occasionally, I experience a slight throbbing sensation while brushing my teeth or drinking water without applying pressure.
There hasn't been any pus or other significant issues, and everything else seems normal; biting into food does not cause pain.
Currently, the gums appear normal without swelling or any obvious abnormalities.
I would like to know if this could be related to the filling I had done (since it started around that time).
Should I see a dentist soon? What could be causing this? (It has been about two and a half years without improvement or worsening, but I have become a bit concerned recently.)

Niming, 10~19 year old female. Ask Date: 2021/08/24

Dr. Lin Jiayong reply Dentistry

Hello: It is recommended to schedule a follow-up appointment for an X-ray to confirm whether there is any pulp necrosis.
After two and a half years, any issues with the pulp can be clearly identified through the X-ray images, allowing for further root canal treatment if necessary.
Additionally, it is advised to have dental cleanings every six months.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/08/24

More Info

Tooth sensitivity can be a perplexing and uncomfortable issue, often stemming from various underlying causes. In your case, it appears that the sensitivity began after a dental filling for a cavity between your upper front teeth. This correlation suggests that the filling procedure may have contributed to your current symptoms, but there are several factors to consider.

Understanding Tooth Sensitivity
Tooth sensitivity, also known as dentin hypersensitivity, occurs when the underlying layer of your teeth, called dentin, becomes exposed. This exposure can happen due to several reasons, including:
1. Dental Procedures: After a filling, it is not uncommon for the tooth to be sensitive, especially if the cavity was deep or close to the pulp (the innermost part of the tooth containing nerves and blood vessels). The sensitivity can be exacerbated by temperature changes, such as consuming hot or cold foods and drinks.

2. Gum Recession: If your gums have receded, the roots of your teeth may be exposed, leading to sensitivity. This can happen due to aggressive brushing, periodontal disease, or natural aging.

3. Cracked Teeth: A crack in a tooth can also lead to sensitivity, particularly when pressure is applied or when exposed to temperature changes.

4. Pulpitis: Inflammation of the pulp, known as pulpitis, can cause significant sensitivity and pain. This condition may arise from untreated cavities or trauma to the tooth.

5. Sinus Issues: Given your mention of pressure in the nasal area affecting your tooth, it’s worth noting that sinus infections or sinusitis can cause referred pain to the upper teeth, particularly the incisors and canines.

When to See a Dentist
Given that your sensitivity has persisted for over two years without significant improvement, it is advisable to consult a dentist. Here are some reasons why:
- Persistent Symptoms: Chronic sensitivity, especially if it has not improved over time, warrants professional evaluation. It could indicate an underlying issue that needs to be addressed, such as pulpitis or a crack in the tooth.

- Assessment of the Filling: The dentist can evaluate the integrity of the filling and determine if it is contributing to your sensitivity. Sometimes, fillings can become loose or may not fit perfectly, leading to discomfort.

- Examination for Gum Issues: A thorough examination can help identify any gum recession or periodontal disease that may be contributing to your symptoms.

- X-rays: Dental X-rays can help visualize the internal structure of the tooth and surrounding bone, revealing any potential issues such as decay, cracks, or infections that may not be visible during a clinical examination.

Conclusion
In summary, your tooth sensitivity is likely related to the dental filling and could be influenced by other factors such as gum health or even sinus issues. It is essential to seek dental care to accurately diagnose the problem and receive appropriate treatment. Early intervention can prevent further complications and help restore your comfort. Regular dental check-ups are crucial for maintaining oral health and addressing any concerns before they escalate.

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