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Advanced cosmetic and general dentistry

Archives for February 2021

Pain after my white filling is getting worse

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Last October my dentist placed a filling in my left front tooth. In January, I returned to the dentist to correct a notch between my tooth that interfered with flossing. The dentist smoothed out the notch. But a few days later, I felt a shock in the tooth while I was eating. In two weeks, I returned to the dentist, and she took an x-ray. She said the tooth is fine but sensitive to the filling, and she advised me to take Advil. My tooth is still sensitive, and the pain is intense. What should I expect to get this resolved – another filling? Or might I need a root canal? This is delaying my teeth whitening treatment that I wanted to complete before my wedding in mid-April. Thank you. Avril from NH

 

Avril,

Your intense pain means that you should see an endodontist—or root canal specialist. Your dentist should be able to test your tooth and look at the x-ray for internal damage, but an endodontist will give you an accurate diagnosis.

Is Intense Pain After a Filling Just Irritation?

Intense pain months after a dental filling is more than just irritation. An irritated tooth improves, even though it may be gradually. Progressive pain that gets worse is a symptom of an infection.

Although your dentist may have done something wrong when placing the filling, it is more likely that decay under the old filling caused bacteria to get into the tooth pulp. Bacteria trapped beneath your new filling will cause a painful infection.

Root Canal Filling on a Front Tooth

Photo of teeth whitening trays in a case, for information on DIY teeth whitening from Lowell, MA dentist Dr. Michael Szarek.

Teeth whitening can irritate unhealthy teeth

Advanced cosmetic dentists understand that when performing a root canal on a front tooth, they must ensure no root canal filling is left inside the crown. Trimming the filling below the tooth attachment prevents the tooth from discoloring and turning dark.

If your dentist is not willing to refer you to an endodontist, check with your dental insurance company to see if self-referral is allowed. Otherwise, you might need to get a second opinion from a cosmetic dentist who can either resolve the issue or give you a referral.

After your tooth pain is resolved, you can begin the teeth whitening process.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.

How long can I delay a root canal?

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I was supposed to get my teeth whitened in March, but after my last dental exam, my new dentist said that I need a root canal first. This dentist won’t do the whitening unless I get a root canal. I am thinking about getting teeth whitening elsewhere and worrying about a root canal later. I’ve had a recent dental cleaning, and I think I can find someone to whiten my teeth. How long can I delay the root canal? Thank you. Abena from CT

Abena,

Our upfront response is that it is not worth it to compromise your oral health for white teeth. Without Dr. Szarek examining your tooth, surrounding gum tissue, and x-ray, we cannot give an accurate diagnosis. But we can give you a few facts.

How Long Can You Delay Root Canal Treatment?

If your tooth is not hurting and has not hurt for a long time, you may be able to delay root canal treatment—but not without risks.

Signs and symptoms to watch for

Although it may not be an emergency, these issues need root canal treatment to prevent a tooth infection from spreading.

  • Pain – An active infection is getting worse
  • Drainage in your mouth – Fluid from the infection can affect other areas
  • Pimple in your gums near the root tip – The infection has spread to the tooth and can affect your jawbone

Risks of Delaying Root Canal Treatment

Risks of delaying root canal treatment include an abscess, external resorption, and an infection that spreads to other parts of your body.

  • Abscess – A pus sac can form at the tip of the tooth roots, become painful, and provoke a dental emergency
  • External resorption – The infection will slowly eat away at your tooth roots and destroy the tooth. You will need an extraction and a dental implant.
  • Infection spreads – Your jawbone, neck, head, and bloodstream may become targets of the infection as it spreads. And the infection can become life threatening.

What You Should Know About Root Canal Treatment

Most people delay root canal treatment due to anxiety or fear of a painful procedure. But a skilled dentist makes the treatment painless and comfortable by numbing your tooth before the procedure and helping you relax with dental sedation.

What About Bleaching Your Teeth?

Photo of teeth whitening trays in a case, for information on DIY teeth whitening from Lowell, MA dentist Dr. Michael Szarek.

Avoid whitening irritated teeth

Depending on the condition of the tooth that needs root canal treatment, bleaching gel can irritate it. It is best not to take the risk. Although root canal treatment might not be an emergency now, it can become one if the teeth whitening process irritates your tooth.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.