Who do I believe?

[Moonchilde@2714]

I was having pain on the lower left side of my mouth where there were three teeth #18, #19 and #20 with large silver fillings in them that are 50 years old. A dentist looked and said there are two cracks on #19, I can cut out one of the cracks and replace the filling and the other is a craze line. She said there was decay under the filling that was deep that she removed. That night I felt the edges of my tooth and I felt a crack diagonally across the lingual groove where the craze line was that I could stick my fingernail into. I went back to the original dentist and she said its not a crack its a natural depression in your tooth. I then went to an emergency clinic of a dental school and showed them and they told me, yes there is a crack in your tooth there, we can’t fix other people’s work, we can only take out and replace the entire filling. I went back to the other dentist and requested she bond the crack shut. She did so, but she didn’t fill the area entirely and there is still a tiny almost microscopic crack there but I can feel it with my fingernail. I went to an endodontist who took a CBCT scan and did all the testing, biting, ice, tapping, and told me she doesn’t see any bonding there on #19, it’s a natural depression in my tooth. She said tooth #18 has a crack in it and an enlarged periodontal ligament and to put a crown on it, #19 is having referred pain and has nothing wrong with it. Both teeth are alive and no infection or inflammation. I went to another general dentist to have the crown placed and he said he’s not sure if #18 has a crack in it, he only sees a shadow, he wants me to get another endodontist opinion. The second endodontist did not take a CBCT scan or review the one I had. He only took regular xrays. He told me there’s no crack on #18. He said he thinks #19 needs root canal based on prior history and pain mostly in that tooth and he thinks the nerve is dying. He saw the bonded area and the little crack but when I asked him about whether it could be fixed with more bonding, he said it's not on the root. (I never said it was and what kind of answer is that?) But both teeth test alive with ice. When he did the percussion and biting on both teeth, I did not react right away. I got severe pain about an hour later which lasted for ten hours. I feel it mostly in #19 but it hurts if I press on #18 or #20 too. I have now been in pain for at least six weeks since the filling was first replaced and I was having mild intermittent pain even before that in that area. Today the pain is diminished but it is still there intermittently. I don’t know who to believe or what to do now.

(I personally believe that there is a microcrack in the bonded area on #19 and that #18 has decay under the filling. #18 might also have a crack as well. I do not want to do unnecessary root canals).

 

[Moonchilde@2714]

PS at the dental school they told me the bite is high on the tooth itself (not the filling) and no one has done any occlusal adjustment to that either.

 

[Moonchilde@2714]

Thank you so much for your detailed answer and your time. I just wanted to clarify that the second endodontist said she did not see any evidence of bonding or any microcrack. Most anyone who sees this current microcrack in #19 tells me it's not a crack, just a natural depression in my tooth. They don't believe what I tell them happened. One said some weird thing like it's just there because the filling isn't level with the edge of the tooth but its not a crack and not the cause of any pain. Unfortunately, I am going to have to go get root canal on Monday on #19 because my pain is breaking through Vicodin and I cannot stand it anymore. I pray that will solve the problem and I won't still be in this pain but who knows, if the problem is originating in #18 I am going to have to get root canal on that tooth too because I can't stand the pain. And I did not mention that I am also having pain in the upper left and lower right side where there are two very old onlays although I'm not sure where that pain is originating either.

 

[Moonchilde@2714]

I meant the first endodontist, sorry.

 

[Moonchilde@2714]

I realize I misread what you wrote, sorry. I did not need to clarify.

 

[Moonchilde@2714]

I decided not to get the root canal today. I would like to have my scans reviewed as you told me. However, I cannot find any endodontist that uses transillumination or dye staining. I live in NYC. Could you recommend how I could find someone ? Would a prosthodontist possibly do that?