Strange Tooth Problems

[toothgirl39]

About nine months ago I had a deep cavity filled in tooth 15. For about a week after the filling, I felt a numbness or pressure in my cheek. I just assumed it was from the filling. A few months later the same pressure came back in my cheek and went away a few days later. Then last month, the same thing happened again. I went to my dentist and she said the filling may be a little high so she filed it down. She also took an X-ray and didn't see anything. She did a cold test and said my tooth did not respond as it should. I didn't feel any pain. So she referred me to an endodontist for a root canal. He did the same tests as her and said while my tooth didn't respond as it should he wasn't sure if I need a root canal, I have no sensitivity to hot or cold and no pain in the tooth, just this weird pressure in my cheek that comes and goes. The endodontist did a 3D cone X-ray and found that the root of the molar is basically touching my sinus bone. I just don't know what to do. He said I may eventually need a root canal but he just wasn't sure. It's not been a month and the pressure is back in my cheek and it radiates into my eye. I don't know if it's my tooth, my sinus or something else. I am attaching the X-ray from the dentist.

 

[honestdoc]

The filling does look very close to the root canal. Was the tooth sensitive to percussion or tapping? Do you have more pronounced pressure when you bend forward and walk up & downstairs?

 

[toothgirl39]

It was not sensitive to tapping. It no pressure when I bend or go up and downstairs.

 

[MattKW]

It was not sensitive to tapping. It no pressure when I bend or go up and downstairs.

Then it's probably not sinusitis. And sinusitis will often make several teeth ache, not just one. You will also sometimes get a stuffy nose. That tooth should react normally to cold compared to adjacent teeth and teeth on opposite side of face. Given the depth of the filling, then it might be heading towards an RCT, but if you're not in pain and can eat with it, there's no real danger in waiting. "Que sera, sera."

 

[honestdoc]

Tooth #15 has 4 canals (Mesial Buccal 2nd canal can join to Mesial Buccal 1 canal ~ 50% of the time in Upper 2nd molars) and since the tooth did not respond to cold test, some or all of the nerves may have died. Since you don't feel percussions sensitive, it has not reached the point for apical periodontitis (not painful yet). Like Dr. MattKW mentioned, it might be heading towards an RCT.

 

[Sonia Salamuri]

Tooth #15 has 4 canals (Mesial Buccal 2nd canal can join to Mesial Buccal 1 canal ~ 50% of the time in Upper 2nd molars) and since the tooth did not respond to cold test, some or all of the nerves may have died. Since you don't feel percussions sensitive, it has not reached the point for apical periodontitis (not painful yet). Like Dr. MattKW mentioned, it might be heading towards an RCT.

Based on the post by Dr. Honestdoc, I would like to question if it is possible the nerve death by himself in a first molar tooth, since it could have 3 or 4 roots. I've heard about something similar, and I am analyzing a 26 that as lost most of the crown by decay, and the cavity is very deep, but the owner of this tooth doesn´t complain at all about cold, heat or food that get stuck inside. Is he just lucky or this may lead to serious damage or periodontitis?

 

[honestdoc]

I'm not sure I fully understand your question. Nerve death usually happens in response to trauma or cavities. Drilling on teeth for fillings after a deep cavity or crowns are a source of trauma. If a tooth does not feel cold, then the nerve is not responding or may be necrotic. Necrotic tooth may not feel pain but is a source for infection. A person may have necrotic tooth for many years without pain but infection may happen anytime.

 

[Sonia Salamuri]

Thanks for your explanation. I think that it could be the answer, the nerve it's probably necrotic. I am going to read more about that issue. Endodontic treatment should be done in those situations or a possible infection requires that extraction of the tooth, in case it has a large cavity?

Thank you very much for your fine answers!