Unusual filling concerns - HELP

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Aug 10, 2018
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I had an NHS filling two days ago that gave me concerns regarding the manner it was executed. The proceedure was to a lower molar which is fairly loose due to gum disease and the decay was on the gum line. The filling was done without the removal of any of the existing decay, by merely cleaning out the cavity and then filling straight away with a paste. No anaesthetic was used and the whole procedure took around 5 minutes. I am still in pain nearly 48 hours later.
Is it accepted practise to fill a cavity without removing the decay. I am puzzled, please advise.
 

MattKW

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It depends. If the tooth is doomed from perio problems, then a simple filling might be useful as a short term measure. Really, treatment depends on why you are having pain, and then determining the best way to treat it. In your case, the main aim is to relieve pain and if this was not achievable, then it should've been explained to you, and you should've been given options. Sometimes I'll do a simple filling without anaesthetic if the tooth is going to be lost anyway, or if the full treatment is too costly for the patient - they have to understand why, and agree. An example might be a front tooth and the patient wants to hold onto the dodgy tooth until they can get an immediate denture arranged.
 

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Joined
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It depends. If the tooth is doomed from perio problems, then a simple filling might be useful as a short term measure. Really, treatment depends on why you are having pain, and then determining the best way to treat it. In your case, the main aim is to relieve pain and if this was not achievable, then it should've been explained to you, and you should've been given options. Sometimes I'll do a simple filling without anaesthetic if the tooth is going to be lost anyway, or if the full treatment is too costly for the patient - they have to understand why, and agree. An example might be a front tooth and the patient wants to hold onto the dodgy tooth until they can get an immediate denture arranged.
Thanks, that does help clarify the situation. As I said, the tooth is loose and so I assume doomed. My main concern is that the decay remains present under the filling and I imagine will continue to cause pain?
 

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MattKW

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Decay in of itself won't cause pain. It's mostly a case of preventing fluids from getting down deep. If the bacteria are starved of nutrients, then decay can be halted, and it is a recognised technique where the bulk of decay is removed, the tooth sealed well, then reopened months later when the tooth has had chance of repair. I think it more likely your pain comes from the loosening of the tooth (gum disease) allowing exposure of root surfaces than the decay itself. Just an educated guess without benefit of Xrays etc.
 

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Decay in of itself won't cause pain. It's mostly a case of preventing fluids from getting down deep. If the bacteria are starved of nutrients, then decay can be halted, and it is a recognised technique where the bulk of decay is removed, the tooth sealed well, then reopened months later when the tooth has had chance of repair. I think it more likely your pain comes from the loosening of the tooth (gum disease) allowing exposure of root surfaces than the decay itself. Just an educated guess without benefit of Xrays etc.
Hi MattKW, Thanks again for taking the time to explain, that is very reassuring. I would have appreciated that from my dentist, who by the way, was working without the benefit of Xrays too.
 

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