Tooth Numbness: When to Seek Dental Treatment - Dentistry

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Dental (gingival) numbness?


Hello, Doctor: I have a missing filling in my lower right molar.
After six months, I started experiencing a numb sensation when eating cold foods.
During my follow-up visit, the doctor suggested monitoring the situation, warning that it might worsen.
Recently, I suddenly experienced intense numbness (to the point of weakness in my hand).
That same day, I urgently visited another clinic, where the doctor recommended a root canal treatment.
He noted that the tooth was significantly sensitive when tapped.
For the next three days, I experienced strong numbness and was unable to bite down properly.
A week later, I returned to the original clinic for a check-up, and the numbness had decreased significantly, leaving me with only difficulty eating.
The doctor there suggested continuing to monitor the situation and to wait until the numbness or swelling became more pronounced before considering a root canal.
Another week has passed, and now I hardly feel anything when my mouth is open and not clenched, just a bit of discomfort.
However, I still cannot eat on the right side, and if I accidentally clench my teeth while sleeping, it wakes me up due to numbness.
Currently, the tooth does not feel numb when touched, but there is slight numbness with pressure.
Therefore, I would like to ask the doctor whether I should continue to observe until there is a clear numbness in my daily life, or if it would be better to return for a root canal treatment directly?

QQ, 20~29 year old female. Ask Date: 2021/10/18

Dr. Lin Jiayong reply Dentistry


Hello: If the discomfort you mentioned has significantly affected your daily life, and you have consulted two clinics with differing treatment plans from the physicians, it is advisable to visit a medical center.
Please consult with an endodontist to discuss whether the affected tooth requires root canal treatment, the timing of the treatment, and the pros and cons of the procedure.
After that, you can consider how to proceed appropriately, and avoid making decisions while in discomfort.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/10/18

More Info


Tooth numbness can be a concerning symptom, especially when it is accompanied by pain or discomfort. In your case, the numbness in your right lower molar, which has been previously treated, raises several important considerations regarding dental health and the need for further treatment.


Understanding Tooth Numbness
Tooth numbness can occur for various reasons, including:
1. Nerve Damage: If the tooth has undergone significant decay or trauma, the nerve may be damaged, leading to numbness or altered sensation.

2. Pulpitis: Inflammation of the dental pulp (the innermost part of the tooth containing nerves and blood vessels) can cause pain and numbness. This condition can be reversible or irreversible, depending on the extent of the damage.

3. Infection: An abscess or infection at the root of the tooth can also lead to numbness and may require root canal treatment.

4. Previous Dental Work: If the tooth has been filled or treated, the materials used or the technique may have impacted the nerve, leading to numbness.


When to Seek Treatment
Given your symptoms, it is crucial to monitor the situation closely. Here are some guidelines on when to seek further dental treatment:
1. Persistent Symptoms: If the numbness persists or worsens, it is essential to return to your dentist. Numbness that lasts for several days, especially if it is accompanied by pain, should not be ignored.

2. Changes in Sensation: If you notice changes in sensation, such as increased numbness or the inability to feel temperature changes, this could indicate nerve damage or infection.

3. Pain or Discomfort: If you experience any pain, swelling, or discomfort, especially when chewing or applying pressure to the tooth, it is a sign that you should seek immediate dental care.

4. Difficulty Eating: If the numbness affects your ability to eat or causes you to avoid using that side of your mouth, it is important to address the issue promptly.


Treatment Options
If your dentist has suggested that the tooth may need a root canal treatment, it is likely because they suspect that the nerve is either damaged or infected. Root canal therapy involves removing the affected pulp, cleaning the inside of the tooth, and sealing it to prevent further infection. This procedure can alleviate pain and restore function to the tooth.

In your case, since you have already experienced significant numbness and discomfort, it may be prudent to consider the following steps:
1. Return to Your Dentist: Schedule an appointment with your dentist as soon as possible. Explain your symptoms in detail, including the numbness, any pain, and how it affects your daily life.

2. Diagnostic Imaging: Your dentist may recommend X-rays to assess the condition of the tooth and surrounding bone. This can help determine if there is an infection or if the nerve is compromised.

3. Consider Root Canal Treatment: If the diagnosis indicates that the nerve is damaged or infected, proceeding with root canal treatment may be necessary to prevent further complications.


Conclusion
In summary, while it may be tempting to wait and see if the numbness resolves on its own, given the history of dental work and the current symptoms, it is advisable to seek further evaluation from your dentist. Early intervention can prevent more severe complications and help maintain your dental health. If you experience any worsening of symptoms or new symptoms arise, do not hesitate to seek immediate dental care. Your oral health is crucial, and addressing these issues promptly can lead to better outcomes.

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