Previously asymptomatic tooth now at risk of loss through a simple shallow filling replacement


Joined
May 7, 2021
Messages
3
With apologies for the length of this message, I would be grateful for any insight into a dental nightmare I’m currently going through. During the course of root canal treatment/retreatment on two upper back molars commencing last November (at least one of which has now failed two months after completion, and potentially also the other, but that’s another depressing story) with a private endodontist to whom my own dentist referred me, the endodontist brought my attention to what he said were ‘very concerning areas of ‘decay’ that he’d spotted on the scan in the UR5 & 6 (adjacent to one of the back molars he’d worked on), and said I should see my dentist as a matter of urgency to have them refilled ‘before things got any worse’. I had experienced no pain whatsoever in either of these teeth, but as he was so emphatic that I shouldn’t wait, I rang my dentist who fitted me in immediately before Christmas. After examination, she said the UR6 was fine, that there was only a tiny area of demineralisation, not decay, and she was not prepared to disturb the amalgam filling in that tooth for no reason. However, she agreed to replace the very shallow filling in the UR5, despite there only being a tiny speck of decay and it being ‘nowhere near the nerve’ (the endodontist had said that it was quite close to the nerve). I had never had problems with fillings she’d carried out over three decades previously, even deep ones, but after that shallow filling replacement, I was no longer able to bite down on the tooth without an electric shock pain. She checked to ensure the bite was okay; it was, though she still smoothed the filling a little just in case, but it made no difference. As she then said it could sometimes take up to six weeks for a filling to settle if the nerve was aggravated, though, I was prepared to wait it out. The endodontist, when I later mentioned this tooth having become a problem since the re-filling, said he always told patients that there was a chance with every filling procedure that previously enclosed bacteria can be driven further into the tooth and root, and sometimes, this can result in a root canal being necessary. He hadn’t mentioned this to me previously and, as I’d only followed his advice to have an emergency re-filling in this pain-free tooth to avoid a root canal, you can imagine that I wasn’t overly-happy to hear that.

Over several weeks, the electric shock pain in the tooth itself gradually decreased to a milder feeling of discomfort on biting down, though I was now experiencing recurrent deep aching in the jaw around the root area. This continued into April, until one day, the pain in the UR5 tooth and root suddenly became so excruciating that I had to return to my dentist as an emergency, and she removed the nerve to prepare for a root canal, as it was clear that this previously trouble-free tooth was now beyond saving with an ordinary filling. She began root treatment via the NHS (RCs now again being permitted on the NHS under Covid regulations) but the pain in the tooth root area remained severe and wouldn’t settle after the dressing phase, so the only option was to return yet again to the private endodontist, for a third private root canal with more sophisticated equipment. However, as I write this, the endodontist has so far carried out two separate cleaning/dressing sessions on the UR5 tooth, with 2-3 week gaps between, but to no avail, and a persistent, painful, hard lump/abscess in the gum in the UR5 root region that had formed during the period of severe pain, and recurrent jaw pain on that side is still present. (When it hadn’t settled after the first attempt, he said he would use a different disinfectant for the second try, as possibly the first wasn’t appropriate for whatever strain of bacteria is causing the infection, but it clearly hasn’t worked). I’m due to return next Weds to reassess. However, everything is now pointing towards having to book a private apicoectomy, to see if that will work. If not, I will face losing a visible tooth that was previously asymptomatic, then waiting three months before having an implant. With savings rapidly dwindling (treatments for the three teeth, scans and consultations so far have totalled over £7,000, with a lot more still to pay) and things becoming worse with the UR5 with each successive form of treatment from the time the original filling was replaced, I can’t possibly see how the outcome could have been any worse if the tooth had just been left alone.

Although I appreciate that it’s tricky for anyone to comment in detail on my specific situation, and I am not in possession of the cone beam scans to post, I wondered if anyone – dental professional or patient - had ever seen or experienced a case where things have deteriorated so drastically in a shallow-filled tooth that had caused no issue previously, purely through being re-filled, and why that may be. Is it really a case of bacteria being driven further into the tooth and causing problems which weren’t previously there, and, if so, is this always unavoidable? Also, why an attempted root canal on that same tooth could be failing to clear infection, leaving the procedure unable to be completed. With no consumer protection with UK private dentistry (the understanding that ‘sometimes things fail’ being the caveat that the patient is bidden to accept, regardless of the cause of that failure) I feel as though I’ll just continue to haemorrhage funds into the private clinic with no resultant benefit at all, and I’m really depressed that I may lose a previously asymptomatic tooth and, for the first time in my life, am very fearful of ever undergoing any preventative or remedial dental procedures again in the future, not in terms of while I’m in the chair but that the outcome could leave me in a worse position, as it has done this time. Very many thanks in advance for any insight or advice anyone can offer.
 
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Joined
May 7, 2021
Messages
3
Hi again. As a follow-up to my previous post (this one being a lot shorter, so am hoping someone may respond!) I have now seen the original endodontist, who has referred me to a peer practitioner at another clinic, who he feels may have more expertise to resolve the problem with the abscess not clearing from the UR5 root. However, the new practitioner is, unfortunately, unwell at the moment, so I have been given an appointment on the 6th June. While I can probably tolerate the pain in the area, unless it gets much worse, I am a little worried that the canals on that tooth have now been open for over 7 weeks (albeit with a small temporary filling sealing the tooth). If the infection spreads further within the root/jaw and/or further infection gets in through the temp filling, would the chance of ultimately saving the tooth be tangibly reduced? Also, is there anything I can do to try and reduce this risk as much as possible (salt water rinses etc) in the interim?
 
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Joined
May 4, 2019
Messages
5
Is there a definite infection and are you taking an antibiotic? I had a problem with a molar when a shallow filling fell out and the tooth cracked after it was drilled again. I don’t allow dentists to talk me into filling shallow areas of demineralization that aren’t really cavities anymore. These areas can be followed.
 
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Joined
May 7, 2021
Messages
3
Hi, many thanks for your reply. When the endodontist made an issue of it, back in December, I only had his word to go on that there was an infection (I was sitting with him in front of the x-ray, as we'd originally been looking at UR7 tooth he'd root-filled) and tbh, it was tricky to discern one area of shading from another on the image (and that apart, as even the original UR7 abscess was totally invisible on the original x-ray taken by my dentist last August, with a cone beam scan subsequently showing it to be huge, I now have very little faith in the efficacy of basic dental x-rays in any event. I ended up having to pay to see a private oral maxillary specialist re. the UR7, as with nothing at all showing on the x-ray, my dentist thought it couldn't be tooth-related and advised I see a further opinion in case it was some other facial issue. The OM specialist's cone beam scan confirmed the abscess and that it therefore was a dental issue. That was the first £700 in total that started the meter running!). When the UR5 really flared up several months after my dentist refilled it, she did put me on a strong course of antibiotics for a week (after she'd removed the nerve) as she said she'd need to do that to be able to get in to RC it (of course, in the end, it didn't settle after her cleaning it, hence my returning to the endo, though he had no more luck). I'm still perplexed, though, as to how a simple shallow filling replacement with very, very little decay in the tooth could have upset the nerve so much from the get-go that I could no longer bite down on the tooth, with the nerve eventually flaring up so badly that it had to go, and now, even all attempts at cleaning the roots to place a RC filling have so far failed and there is still a hard, painful lump on the gum. Fillings don't last forever - I have several other amalgam ones in my mouth that I know are all old, as I haven't had a silver filling in many years, but I'm beyond nervous at ever having to have any of them replaced, though I've never had an issue like this before! As I write, I'm still waiting my June 8th appt with the new endo, with a vulnerable temp-filled (at least, I hope the temp filling is still whole and in situ) nerveless UR5 with open canals, and hoping like hell that I'm not going to lose it. One of the original two back molar RCs that the endo did, in January (the UL7) which was a retreatment has also failed and it needs to come out, and I accept that (even though it means taking out £1500 of dental work/crown), as there is never any guarantee, I know, but what has happened with the UR5 is beyond surreal, and if I could go back in time, I would have never agreed to the refilling.
 

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