Pain in filled molar tooth, and now need root canal - was it dentist's fault?

Porkpie

Back in November I decided to try a new dentist (who has a good reputation). After an initial checkup I was advised that I'd need a filling on a molar tooth. I got the filling done but it was quite a difficult, complex filling, and the procedure lasted much longer than expected. For a few weeks after I experienced occasional pain on that tooth but only if I chewed on something hard, such as seeds/nuts.

I returned in December and the dentist filed down the filling in the hope that it would alleviate the pain, but it didn’t work.

I visited the dentist again a few days ago and she removed the filling to inspect the tooth. She said that the nerve underneath was infected and that this is what was causing the pain. She advised that I would need root canal treatment and a crown, which would cost a total of €1,400 (or an implant, which would be over €2,000). She placed a temporary filling on the tooth and I have an appointment scheduled in a couple of weeks for the root canal treatment.

I feel disappointed now, because I never had any pain in that tooth until the filling was inserted. Two questions come to mind:

- Was it actually the filling that caused the subsequent pain?
- If the nerve was already infected why wasn’t this identified when I had my initial check-up?

I’m left questioning the wisdom of filling in a tooth that wasn't causing me any pain to begin with.

My question is, does the dentist seem competent or not? Should I give her the benefit of the doubt and just believe that the nerve was already damaged before I got the filling? (though surely she should have picked that up on the initial check-up?). I'm panicking at the thoughts of having to spend €1,400 on one tooth and wonder if it's really necessary.

Funnily enough, the temporary filling actually feels perfect now and unlike before, I don’t have any pain at all if I bite down on that tooth, though I think she said she applied some kind of dressing underneath the tooth, maybe that's what's working.

Fishorsealant

When a tooth has decay it doesn’t always cause pain.
If you don’t remove the decay it will eventually reach the nerve and cause pain.
On occasion teeth become sore after fillings even when they weren’t sore to begin with. This is especially the case when fillings are deep. The removal of decay and tooth preparation can insult the the nerve. The nerve can become inflamed and sometimes it settles, other times it doesn’t. When the nerve becomes inflamed in an irreversible way root canal treatment is often needed.

This is a risk of all fillings including repair and replacement of old fillings

Often when teeth die or become irreversibly inflamed it takes time for these changes to manifest in radiographic changes and symptoms often don’t develop for some time..

If the sedative filling is working then it can be reviewed after an appropriate time and if the tooth is “settled” a definite restoration can be placed.

To suggest this is the fault of the dentist or that it is due to their incompetence is ridiculous.

btkm8unsl0w5r4

https://www.boards.ie/vbulletin/showthread.php?t=2057273551

Porkpie

Fishorsealant wrote: »

When a tooth has decay it doesn’t always cause pain.
If you don’t remove the decay it will eventually reach the nerve and cause pain.
On occasion teeth become sore after fillings even when they weren’t sore to begin with. This is especially the case when fillings are deep. The removal of decay and tooth preparation can insult the the nerve. The nerve can become inflamed and sometimes it settles, other times it doesn’t. When the nerve becomes inflamed in an irreversible way root canal treatment is often needed.

This is a risk of all fillings including repair and replacement of old fillings

Often when teeth die or become irreversibly inflamed it takes time for these changes to manifest in radiographic changes and symptoms often don’t develop for some time..

If the sedative filling is working then it can be reviewed after an appropriate time and if the tooth is “settled” a definite restoration can be placed.

To suggest this is the fault of the dentist or that it is due to their incompetence is ridiculous.

Fishorsealant, thanks for the advice, although I don't appreciate your word choice of "ridiculous", that's a bit rude. I'm not a dentist, and don't have a clue about dentistry, I thought maybe she made a mistake, as the tooth wasn't causing any pain to begin with. What you said makes sense anyway.

DublinWriter

I'm in the exact same situation, in a lot of pain over the weekend.

Usual dentist is on holiday so went to an emergency clinic where I was advised it was either root canal + crown or extraction.

My usual dentist is one of the best guys around (I'm 50, and I've been to a LOT of dentists over the years) and he put a big composite (white) filling in the tooth back in November.

Not his fault at all as the abscess is at the tip of the root and would probably not have been obvious on the x-ray he took at the time.

Sadly, an implant isn't an option (I've already got three) as the roots are too close to a major facial nerve to risk an operation.

btkm8unsl0w5r4

DublinWriter wrote: »

Sadly, an implant isn't an option (I've already got three) as the roots are too close to a major facial nerve to risk an operation.

Thats simply untrue, if you have a tooth there at the moment you can have an implant in 99% of cases. Whoever told you this maybe doesnt do many implants. The site is preserved or lost depending on how the extraction is done.

DublinWriter

Rhea Calm Molar wrote: »

Thats simply untrue

Extracted tooth was the lower right 2nd molor. Regular guy was really careful with extraction and told me that an implant wouldn't be feasible because of the close proximity of the inferior alveolar nerve.

My three implants were previously done by Anne O'Donoghue (fantastic clinician) many years ago. I'll get her second-opinion based on what you said.

Many thanks again Fitzgeme!

btkm8unsl0w5r4

DublinWriter wrote: »

Extracted tooth was the lower right 2nd molor. Regular guy was really careful with extraction and told me that an implant wouldn't be feasible because of the close proximity of the inferior alveolar nerve.

My three implants were previously done by Anne O'Donoghue (fantastic clinician) many years ago. I'll get her second-opinion based on what you said.

Many thanks again Fitzgeme!

She is retired now....how did the the tooth fit in there but an implant cannot? You can get very short implants also. If you still have the tooth you can likely have an implant. Sometimes it can be more risky, but its not impossible. I do hundreds of implants every year, I am a bona fida implant specialist and work in a specialist team doing complex implant jobs.