Dental Fillings and Root Canal Treatments: What You Need to Know

Dental Filling and Root Canal Treatment

A year ago, I had a filling done on my lower second molar.
Last week, that same tooth started to hurt when consuming hot or cold foods, and it also hurt when not chewing.
There were no visible cavities, so I went to a nearby dental clinic where the doctor took an X-ray and said, "The second molar is slightly inflamed; I'll prescribe pain relief and anti-inflammatory medication." The X-ray showed that one of the nerves inside the tooth appeared gray.
After taking the anti-inflammatory medication with my meals, I felt some improvement, but by the third day, after eating noodles, I experienced severe pain.
The pain subsided before bed, but the next day I immediately sought medical attention again, and the doctor confirmed that I needed root canal treatment.

Upon examination, my second molar was found to have four nerves: two necrotic and two vital.
The doctor removed the old filling and liner, cleaned the tooth, and placed a hot medicament inside in preparation for the next root canal treatment.
Now, a day later, I have not experienced any pain, throbbing, or discomfort while eating.
I would like to ask the doctor if I should continue with the root canal treatment, or if it is possible to just refill the tooth since I heard from a friend that her nerve inflammation was due to an old filling, and after re-filling, she no longer had pain.
Thank you, doctor!

Yun Ting, 20~29 year old female. Ask Date: 2021/09/25

Dr. Zeng Guanghui reply Dentistry

It is recommended to continue with the root canal treatment.
The initial procedure only provided temporary relief from pain, but it is important to complete the subsequent steps of the root canal treatment, ensuring that the canal is thoroughly cleaned and filled.
Additionally, the decayed portion should be restored, and consideration should be given to placing a crown for protection.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2021/09/25

More Info

When it comes to dental health, understanding the processes of dental fillings and root canal treatments is crucial, especially when faced with symptoms like pain or inflammation. Based on your situation, it appears that you are experiencing significant discomfort in your second lower molar, which has been diagnosed with inflammation and possibly nerve damage. Let's break down the considerations and recommendations regarding your treatment options.

Understanding Root Canal Treatment
Root canal treatment (RCT) is a procedure designed to treat infection or damage within the pulp of a tooth. The pulp contains nerves and blood vessels, and when it becomes inflamed or infected, it can lead to severe pain and other complications. In your case, the X-ray indicated that two of the four nerves in your second molar are dead, which typically necessitates a root canal to prevent further infection and preserve the tooth.

Symptoms and Diagnosis
You mentioned experiencing pain with hot and cold foods, as well as discomfort when chewing. These symptoms are classic indicators of pulpitis, which can be reversible or irreversible. Given that your dentist has already identified inflammation and the presence of dead nerves, it is likely that the condition is irreversible, meaning that root canal treatment is necessary to alleviate pain and prevent further complications, such as abscess formation.

Treatment Options
1. Continue with Root Canal Treatment: Since your dentist has already initiated the process by removing the old filling and placing medication in the tooth, it is advisable to proceed with the root canal treatment. This will involve cleaning out the infected pulp, disinfecting the canals, and sealing them to prevent future infection. Given that you are currently pain-free, this is a good time to complete the procedure, as it will help ensure the long-term health of the tooth.

2. Re-evaluate Filling: While some patients may experience relief from symptoms after a new filling, this is typically only effective if the pulp is still healthy. In your case, since there is evidence of nerve damage, simply replacing the filling is unlikely to resolve the underlying issue. It could lead to further complications down the line, including the need for extraction if the infection worsens.

Post-Treatment Care
After completing the root canal treatment, it is essential to follow your dentist's post-operative care instructions. This may include:
- Taking prescribed pain relievers or anti-inflammatory medications.

- Avoiding hard or sticky foods for a period to allow the tooth to heal.

- Scheduling a follow-up appointment to ensure the tooth is healing properly and to discuss the placement of a crown, which is often recommended after RCT to protect the tooth from fracture.

Conclusion
In summary, given the current state of your tooth and the symptoms you have experienced, it is highly recommended to proceed with the root canal treatment. While it may seem tempting to try a new filling, the presence of dead nerves suggests that this would not be a viable long-term solution. Root canal treatment is designed to save your tooth and alleviate pain, allowing you to maintain your dental health. Always communicate openly with your dentist about any concerns or questions you may have during this process, as they can provide personalized advice based on your specific situation.

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