Tooth Fractures: Pain Management and Treatment Options

Q: Tooth Fractures: Pain Management and Treatment Options

Hello： The dental pulp (commonly known as the dental nerve) is located at the center of the tooth, approximately 2-3 millimeters from the surface. <br>If tooth decay reaches the nerve, it can cause pain when drinking cold water, spontaneous pain, pain during biting, and even lead

Tooth fracture

Hello Doctor,
I have a small chip in my tooth (but it doesn't hurt).
I use dental floss after every meal to prevent cavities from worsening and for easier cleaning.
Recently, I decided to visit a nearby clinic for a filling.
However, when the dentist used dental instruments, it caused pain.
The dentist mentioned that I might need a root canal but could first do a temporary filling.
If it hurts after the filling, I would need to have the nerve extracted; if it doesn't hurt, we could do a second reinforcement filling in a month.

I asked the dentist why the tooth doesn't hurt before the filling but hurts afterward.
The dentist responded that it's like a pressure cooker: if you don't put the lid on, there are no problems, but once you cover it, issues arise.
However, I still don't understand.
I've often heard that you only need a root canal when there's pain, and if it doesn't hurt, a filling should suffice to prevent further deterioration.
Here are my questions:
1.
After a root canal, does that tooth become non-functional?
2.
Since my tooth is currently not painful and still functional, if the tooth becomes non-functional after a root canal, can the filling be removed to avoid unnecessary pain and prevent losing the tooth prematurely?
3.
There are some other teeth with a slight coffee-colored stain in the middle of the biting surface.
I previously asked a dentist if it was a cavity that needed filling, and they said it wasn't.
However, today the dentist said it is a cavity that needs to be filled.
(Currently, those teeth occasionally feel sensitive but not often.) Should I get them filled?
I would greatly appreciate your response!
Thank you very much.
Sincerely,
Mary

mary, 30~39 year old female. Ask Date: 2005/09/26

Dr. Liu Tiancai reply Dentistry

Hello: The dental pulp (commonly known as the dental nerve) is located at the center of the tooth, approximately 2-3 millimeters from the surface.
If tooth decay reaches the nerve, it can cause pain when drinking cold water, spontaneous pain, pain during biting, and even lead to bacterial infection and pus formation after nerve necrosis.
Root canal treatment involves removing the damaged nerve, disinfecting and reshaping the canal, and finally filling the canal.
Your questions: 1.
After a root canal, the tooth can still function as before.
2.
Cavities should be filled to prevent further decay.
3.
Brown spots are not necessarily cavities; if a sharp probe can be inserted into the spot, it indicates a "cavity," and filling is required.
Sincerely, Dr.
Liu Tian-Cai, Dentistry.

Reply Date: 2005/09/26

More Info

Hello Mary,
Thank you for your detailed inquiry regarding your dental concerns. It’s understandable to feel apprehensive about dental procedures, especially when it comes to managing pain and understanding the implications of treatments like root canals. Let’s address your questions and concerns systematically.

Understanding Tooth Fractures and Pain Management
1. Why Pain Occurs After Filling: The analogy your dentist used about the "covered pot" is quite insightful. When a tooth is fractured, it may not cause pain because the nerve endings are not exposed or irritated. However, once a filling is placed, it can create pressure on the tooth structure and potentially irritate the nerve, leading to pain. This is especially true if there is underlying inflammation or if the fracture extends close to the pulp (the innermost part of the tooth containing nerves and blood vessels).
2. Root Canal Treatment: If a tooth requires a root canal, it means that the pulp is either infected or at risk of infection. After a root canal, the tooth can still function normally, but it will be more brittle and may require a crown for protection. The tooth will no longer have the same sensory function since the nerve is removed, but it can still be used for chewing and other functions.

3. Deciding on Treatment: If your tooth is currently not causing pain and is functional, it may be worth discussing with your dentist the possibility of monitoring the situation rather than rushing into a root canal. If the filling causes pain, it may indicate that the nerve is compromised, and a root canal could be necessary to prevent further complications.

Addressing Your Specific Questions
1. Functionality After Root Canal: After a root canal, the tooth can still serve its purpose in chewing and biting. However, it will be devoid of nerve sensation, which means you won’t feel temperature changes or pain in that tooth. It’s crucial to protect the tooth with a crown to prevent fractures.

2. Removing the Filling: If the filling is causing pain and the tooth is still functional, you can discuss with your dentist the option of removing the filling to alleviate discomfort. This can help you avoid unnecessary procedures like a root canal if the tooth can remain healthy without the filling.

3. Cavities and Treatment: The discoloration you mentioned could indeed indicate the presence of a cavity, especially if it occasionally causes sensitivity. It’s essential to address cavities promptly to prevent them from worsening. If your dentist has recommended treatment, it’s usually in your best interest to follow through, as untreated cavities can lead to more severe issues, including infections or tooth loss.

Prevention and Maintenance
To maintain your dental health and prevent future issues, consider the following:
- Regular Dental Check-ups: Regular visits to your dentist can help catch issues early before they become more serious.

- Good Oral Hygiene: Continue to practice good oral hygiene by brushing twice a day and flossing daily. This will help prevent cavities and gum disease.

- Dietary Choices: Limit sugary foods and drinks, as they can contribute to tooth decay.

Conclusion
It’s important to have open communication with your dentist about your concerns and treatment options. If you feel uncertain about a recommended procedure, don’t hesitate to seek a second opinion. Your dental health is vital, and understanding your treatment options can help you make informed decisions.
If you have further questions or need clarification on any points, feel free to reach out. Wishing you the best in your dental journey!
Best regards.

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