Dentistry - can someone please help advise me?
Discussion
For a bit of context my teeth are generally fine. Have been for a checkup and nothing flagged up - but the issue is with a lower molar.
I had a filling in it about 30 years ago (drilled and filled in one sitting). The filling was replaced a smidge over 20 years ago where because of its size (I guess) the dentist drilled out and packed with the compound that tastes of cloves and then removed and filled subsequently (silver).
Every time a dentist has been near that tooth the injections have been fairly ineffective at blocking the pain experienced - even though the tongue etc does go numb. Because of this I have been reluctant to address it further.
Recently though it has been sensitive on biting and enough was enough. I went for a checkup / consultation and it would appear the filling is in need of replacement (pitted around the edges etc). However, the X ray showed the filling is so close to the horn of the nerve you'd need a feeler guage to measure the gap.
I did voice my concern to the dentist that i could still feel that plenty was going on with previous injections, but he was, while not dismissive, not really going for anything other than injections again (though their website says they do offer IV and in fact I picked that dentist partly because of that)
He did also say that he wouldnt know for sure what he was looking at until he got the old filling out (fair) and there was potential that it could turn into a root canal. I completely understand this.
So my question is, given that fillings do go and we could end up here again - do I just say skip the filling and do the canal? Is that a request that patients can make? At least then it would be 'done' so to speak? (I think?) Presumably then also there would be more option for IV sedation?
Or do I recontact and see if there is movement on the sedation for the filling? Or should I just get over myself and understand that's just the way it is?
Or - am I overthinking this and should just respect the dentist's judgement on what is thier field of expertise? I mean, he came across as though the proposed solution of laying a kind of bed in the hole, onto which the filling would be laid was a reasonable solution was very much run of the mill. Not arrogant - but rather quite confident in his ability to do the work and that it would be a good solution? I have an issue with this though as previous treatments on that tooth have been excruciating.
I dont know if it is relevant but it's a private practice. I have just noticed that the price list has an entry for a 'root canal re canal' so perhaps the permanence isnt what I thought.....
I guess ultimately I just don't know enough about how any of this normally works. So I feel a little lost. AM I overthinking it? I think the trouble is that its been 15 - 20 years since I last had any dental work which doesnt help...
I had a filling in it about 30 years ago (drilled and filled in one sitting). The filling was replaced a smidge over 20 years ago where because of its size (I guess) the dentist drilled out and packed with the compound that tastes of cloves and then removed and filled subsequently (silver).
Every time a dentist has been near that tooth the injections have been fairly ineffective at blocking the pain experienced - even though the tongue etc does go numb. Because of this I have been reluctant to address it further.
Recently though it has been sensitive on biting and enough was enough. I went for a checkup / consultation and it would appear the filling is in need of replacement (pitted around the edges etc). However, the X ray showed the filling is so close to the horn of the nerve you'd need a feeler guage to measure the gap.
I did voice my concern to the dentist that i could still feel that plenty was going on with previous injections, but he was, while not dismissive, not really going for anything other than injections again (though their website says they do offer IV and in fact I picked that dentist partly because of that)
He did also say that he wouldnt know for sure what he was looking at until he got the old filling out (fair) and there was potential that it could turn into a root canal. I completely understand this.
So my question is, given that fillings do go and we could end up here again - do I just say skip the filling and do the canal? Is that a request that patients can make? At least then it would be 'done' so to speak? (I think?) Presumably then also there would be more option for IV sedation?
Or do I recontact and see if there is movement on the sedation for the filling? Or should I just get over myself and understand that's just the way it is?
Or - am I overthinking this and should just respect the dentist's judgement on what is thier field of expertise? I mean, he came across as though the proposed solution of laying a kind of bed in the hole, onto which the filling would be laid was a reasonable solution was very much run of the mill. Not arrogant - but rather quite confident in his ability to do the work and that it would be a good solution? I have an issue with this though as previous treatments on that tooth have been excruciating.
I dont know if it is relevant but it's a private practice. I have just noticed that the price list has an entry for a 'root canal re canal' so perhaps the permanence isnt what I thought.....
I guess ultimately I just don't know enough about how any of this normally works. So I feel a little lost. AM I overthinking it? I think the trouble is that its been 15 - 20 years since I last had any dental work which doesnt help...
I had a similar issue some years ago. A molar that needed a crown but many attempts at numbing it over several visits failed. In the end they just put a filling in, saying it would probably not last long due to part of side tooth missing.
They were correct so I just kept on having it refilled every time it came out. I changed dentists due to relocating, explained the history and the new dentist said she'd give it a go anyway. She got it numb first time.
So if your current dentist hasn't had a go at it with his needle yet, give him a shot. Then, personally, (if the anesthetic works) let him decide what the best course of action would be once the old filling is out. He may even give you options to choose from.
They were correct so I just kept on having it refilled every time it came out. I changed dentists due to relocating, explained the history and the new dentist said she'd give it a go anyway. She got it numb first time.
So if your current dentist hasn't had a go at it with his needle yet, give him a shot. Then, personally, (if the anesthetic works) let him decide what the best course of action would be once the old filling is out. He may even give you options to choose from.
The way you describe the depth of the filling there could be a risk they won't be able to do a root canal on the tooth. It's something to do with the depth of filling, gum line and proximity to the nerve. If they can then its worthwhile as you're still saving the tooth and RCT teeth can last for years without issue.
I have a very deep filling on a back molar which if it fails will mean an extraction, as a root canal is apparently not an option because of its depth. I've been told this by two (UK) dentists so have no reason to doubt their reasoning?
I have a very deep filling on a back molar which if it fails will mean an extraction, as a root canal is apparently not an option because of its depth. I've been told this by two (UK) dentists so have no reason to doubt their reasoning?
Don't post much, but just had very similar, went private (couldn't get a NHS dentist), marginal for a root canal(s), several fillings. Decay under existing fillings.
Previous (edit: NHS) dentist drilled anyway even if anaesthetic wasn't working.
There shouldn't be any pain, it was much better than 20+ years ago. (but still hate the drilling).
Teeth will probably need r/c at some point, but I might just go for implant instead. But has bought a few years for the teeth possibly. Feels much better now the pain of decay has been removed.
Was expensive though.
(EDIT: To make context a bit clearer)
Previous (edit: NHS) dentist drilled anyway even if anaesthetic wasn't working.
There shouldn't be any pain, it was much better than 20+ years ago. (but still hate the drilling).
Teeth will probably need r/c at some point, but I might just go for implant instead. But has bought a few years for the teeth possibly. Feels much better now the pain of decay has been removed.
Was expensive though.
(EDIT: To make context a bit clearer)
Edited by u6dw4 on Thursday 31st August 17:31
I have a dentist phobia, but IV is excessive for fillings so can understand why they are reluctant.
If you previously had work done on the NHS 20-30 years ago, and are now going private, whilst not much fun, it won't hurt, unless you have infections. Even the injections don't hurt much (although you can still feel them).
My decay was on or near the nerve. Did hurt a bit for a few days after but no worse than before treatment.
Worse part for me is the vaccum thing (I have sensitive teeth/gums) which dries the teeth out for filling.
If you previously had work done on the NHS 20-30 years ago, and are now going private, whilst not much fun, it won't hurt, unless you have infections. Even the injections don't hurt much (although you can still feel them).
My decay was on or near the nerve. Did hurt a bit for a few days after but no worse than before treatment.
Worse part for me is the vaccum thing (I have sensitive teeth/gums) which dries the teeth out for filling.
Pain on biting is usually a cracked tooth. This eventually cause a dead nerve. Root canal treatment and a crown at cost of roughly £1k may cure this for a while, but ultimately the tooth will need to be extracted. Unless you like complex restorative treatment with variable chance of success I think you are better off having the tooth extracted and save the money towards an implant. Dentistry treatment recommendations are all on a percentage likelihood of it working. Cracked teeth generally always fail unless you die first.
Thanks so much everyone - some really interesting views:
xx9xx - fair points - thank you! Having read the thread I am leaning this way far more now.
AS - a worriesome update - and you have my total sympathy - but useful to know.
u6dw4 - sounds similar to where I am - decay potentially under the filling. I am interested in the implant angle but know from PH searches that horribly, these are not without issue themselves. I did mention an implant to my dentist but he dismissed it immediately - hopefully his confidence is not misplaced.
Red9 - to be honest if a dentist said "mate it'll be a grand but you wont feel it and it will be fixed forever" I would be pulling my card out before he had even finished. I really get that dentistry is expensive - I guess its just the horrible experiences previously that have left me where I currently am (at least to a degree). It really did hurt THAT much the last time.
u6DW4 - thats really useful and sounds similar. fair points re the overkill angle - and i can see that. To a degree i am torn between 'am i being a wuss' and 'the anasthetic didnt work!' but thats a really useful upate and echoes xx9xx above.
Fourfold - I did actually think this was the problem but the (actually quite impressive array of) checks show that the tooth is healthy - just, well, apart from the humungous and failing filling. The dentist was (for a layman) very interested in ascertaining the overall health of the tooth and seemed happy with what they saw.
I was actually shopping for rolls in Sainsburys yesterday and had to dismiss the crusty ones - despite being my preference because of all this which I guess fired my posting of this thread. It really is time to deal with this head on - so thank you all for taking the time to comment.
Pending any new commentary to the contrary I am going to go for the filling replacement - which does chill me writing this - but this can't go on as it is - and let's face it - it wont improve. It's been really useful for me having these viewpoints - so thank you all!
xx9xx - fair points - thank you! Having read the thread I am leaning this way far more now.
AS - a worriesome update - and you have my total sympathy - but useful to know.
u6dw4 - sounds similar to where I am - decay potentially under the filling. I am interested in the implant angle but know from PH searches that horribly, these are not without issue themselves. I did mention an implant to my dentist but he dismissed it immediately - hopefully his confidence is not misplaced.
Red9 - to be honest if a dentist said "mate it'll be a grand but you wont feel it and it will be fixed forever" I would be pulling my card out before he had even finished. I really get that dentistry is expensive - I guess its just the horrible experiences previously that have left me where I currently am (at least to a degree). It really did hurt THAT much the last time.
u6DW4 - thats really useful and sounds similar. fair points re the overkill angle - and i can see that. To a degree i am torn between 'am i being a wuss' and 'the anasthetic didnt work!' but thats a really useful upate and echoes xx9xx above.
Fourfold - I did actually think this was the problem but the (actually quite impressive array of) checks show that the tooth is healthy - just, well, apart from the humungous and failing filling. The dentist was (for a layman) very interested in ascertaining the overall health of the tooth and seemed happy with what they saw.
I was actually shopping for rolls in Sainsburys yesterday and had to dismiss the crusty ones - despite being my preference because of all this which I guess fired my posting of this thread. It really is time to deal with this head on - so thank you all for taking the time to comment.
Pending any new commentary to the contrary I am going to go for the filling replacement - which does chill me writing this - but this can't go on as it is - and let's face it - it wont improve. It's been really useful for me having these viewpoints - so thank you all!
I had a dentist who failed to numb a tooth properly and carried on drilling even though I indicated it was hurting.
I changed practice, was very clear with my new dentist that I wanted pain-free dentistry and she's been brilliant.
My understanding is that it can be tricky to 'place' injections for the lower jaw - something to do with the bone density but if they get the needle in the right place it will numb the tooth.
I changed practice, was very clear with my new dentist that I wanted pain-free dentistry and she's been brilliant.
My understanding is that it can be tricky to 'place' injections for the lower jaw - something to do with the bone density but if they get the needle in the right place it will numb the tooth.
Only your dentist can give you a definite answer, but if it hurts go somewhere else.
Numbing then injection. Can feel but no worse than into your skin like a covid injection, probably not even that.
Drilling, you feel the vibration in your head...but it's actually not very long. 30-40 seconds max. I had two drills, the initial small/sharp drill then the grinding drill which was actually worse.
I found the polishing of the filling to the worst part.
I paid 1.2K for initial consultant (180 of x-ray) and 4 fillings.
I will need a crown ats on at least one, and further work but it saved the teeth (probably) for a few years. Some of my fillings are (were) 20 years old.
Only concern is, have had the deep fillings done (and can't have any more) , I might not be able to have R/C later, and need implants...but that is a problem for later. one problem at a time, each tooth is individual, and your dentist will advise.
Don't delay it, the filings were causing me pain (not a huge amount, I got used to it). Any later it would be R/C. Decay is only going one way.
Numbing then injection. Can feel but no worse than into your skin like a covid injection, probably not even that.
Drilling, you feel the vibration in your head...but it's actually not very long. 30-40 seconds max. I had two drills, the initial small/sharp drill then the grinding drill which was actually worse.
I found the polishing of the filling to the worst part.
I paid 1.2K for initial consultant (180 of x-ray) and 4 fillings.
I will need a crown ats on at least one, and further work but it saved the teeth (probably) for a few years. Some of my fillings are (were) 20 years old.
Only concern is, have had the deep fillings done (and can't have any more) , I might not be able to have R/C later, and need implants...but that is a problem for later. one problem at a time, each tooth is individual, and your dentist will advise.
Don't delay it, the filings were causing me pain (not a huge amount, I got used to it). Any later it would be R/C. Decay is only going one way.
Edited by u6dw4 on Friday 1st September 19:07
Thanks chaps - and also yes - its a fair point re 'its not going to get better on its own'.
I had also heard that the lower jaw structure can make the placing of the injection tricky. One prior dentist did comment I had an 'unusual jaw' - I mean - it looks like any other to me - but that might offer some explanation?
If it could be just the vibration etc I would honestly be so relieved / happy - but of course the prior experiences fill me with dread. I am going to try it and see how we go - I mean there doesnt seem to be another option having talked it through. I mean - I could just leave it - but its just painfully deaying the inevitable.
FFS - TEETH!
I had also heard that the lower jaw structure can make the placing of the injection tricky. One prior dentist did comment I had an 'unusual jaw' - I mean - it looks like any other to me - but that might offer some explanation?
If it could be just the vibration etc I would honestly be so relieved / happy - but of course the prior experiences fill me with dread. I am going to try it and see how we go - I mean there doesnt seem to be another option having talked it through. I mean - I could just leave it - but its just painfully deaying the inevitable.
FFS - TEETH!
For me, everything changed when I found a dentist I was comfortable with and didn't get in the chair until I'd made my expectations clear: no pain, stop if I ask her to.
We agreed that she wouldn't proceed until the tooth was completely numb, even if it took several injections.
I felt a lot better, not just because the procedure was pain free, but also because I felt in control of things.
I'm so glad I changed practice. The previous guy said all the right things, but he was pretty off-hand about it all.
We agreed that she wouldn't proceed until the tooth was completely numb, even if it took several injections.
I felt a lot better, not just because the procedure was pain free, but also because I felt in control of things.
I'm so glad I changed practice. The previous guy said all the right things, but he was pretty off-hand about it all.
- update **
We went for the 'dig it out and see what we have option' - which to be fair was the only realistic solution. I am a person who absolutely doesnt visibly hide my feelings so they were written all over my face - but I did apologise to the dentist and nurse that I was only being very cautious because of past experience.
I had three injections in the gum that were pain free. What surprised me was that they then cracked on immediately. Previously i have then been dismissed to sit and wait for a while - presumably to take the full effect.
At this point I had sweat all over me (I dont mind admitting it) and they started.
What then followed was absolutely the best dentistry I have ever experienced. Not even the slightest 'twinge'. Literally did not feel a thing while removing the old filling. So much so that i was able to focus on keeping my mouth open and not moving etc so as to give him the best chance to fix the damn tooth.
They laid the bed and built up the filling in layers because of the depth. 7 separate cycles? There was no discomfort - I did my best to 'help' by not moving etc.
Suddenly it was done. The tooth was shaped and I was on my way. I had work 4 hours later and was envisaging aches etc as my jaw 'came alive'. Nothing ever happened. For want of a better expression it was just 'fixed'.
I lost count of the times - but i must have said thank you to both the dentist and the nurse at least 4-5 times.
Its obviously only a few days later but thanks so much to those that posted and encouraged me to finally get over myself and get it fixed. Obviously nothing is forever - but I dont know if its just that 'things have improved' or that this dentist really knows his stuff (or both) - but if anyone has been similary delaying treatment - give it a go - you might be surprised....
Well done. I had a filling done that in a sense was similar to yours as when he drilled it out the decay underneath was worse than expected and was close or down to the nerve (I think). He cleaned it up and packed it out with some stuff and did the filling but told me there was a risk that I might have pain / it be uncomfortable due to the nerve. But worth doing as if ok meant no root canal.
It has been fine since and feels completely normal so I guess got lucky as still have original nerve. Until the next time!
It has been fine since and feels completely normal so I guess got lucky as still have original nerve. Until the next time!
Just curious after reading the thread, does anyone else have fillings with no injections?
I've got a root canal on a molar coming up and will proceed with no injections unless it gets too painful, but should be ok as I had the same treatment on another molar and that was fine with no injections.
I'm not immune to pain, I've found the worse pain was an abscess which had me on the floor head in hands, feeling like your skull is being crushed in a vice, had that twice now before each root filling.
So, what percentage of us have no injections I wonder?
I've got a root canal on a molar coming up and will proceed with no injections unless it gets too painful, but should be ok as I had the same treatment on another molar and that was fine with no injections.
I'm not immune to pain, I've found the worse pain was an abscess which had me on the floor head in hands, feeling like your skull is being crushed in a vice, had that twice now before each root filling.
So, what percentage of us have no injections I wonder?
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