Teeth whitening Archives - Page 3 of 13 - Lowell Cosmetic Dentistry Blog

Pain after my white filling is getting worse

Posted on February 28, 2021 by AllSmiles.

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?

Posted on February 19, 2021 by AllSmiles.

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?

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.

My dentist is violating my tooth-extraction rights

Posted on January 31, 2021 by AllSmiles.

I asked my dentist for teeth whitening, but he doesn’t want to do it because he recommends a root canal and crown on a second molar. My point is that teeth whitening is much cheaper. If I can’t afford a root canal and crown, why should I do it? I have dental insurance, but it will only cover half of the cost. And then if the root canal doesn’t work, my dentist will have to extract the tooth anyway? Why not just get rid of the tooth, eliminate the future problems, and whiten my teeth? I’m thinking about switching dentists. – London

London,

Thank you for your question. We understand your concerns about your budget and want to improve your smile without creating debt.

Extracting a second molar tooth

Extracting a second molar tooth causes the least complications. A second molar does not have a tooth behind it that will drift after the extraction.

Some facts to consider:

Lower second molar – The upper molar opposite to the tooth you want your dentist to extract will have no tooth to meet it. It will begin to drift, bite into your gum, and eventually require extraction.
Chewing efficiency – If you have your premolars and front teeth, you can chew adequately without your upper and lower second molars.
First molar – If you later lose a first molar, it will disrupt your bit on that side of your mouth and reduce your chewing efficiency.

It’s Still Best to Save Your Teeth

But we understand your budget is limited. If your dentist is skilled with root canal treatment and crowns, the risk of it failing is minimal.

We recommend that you have another discussion with your dentist about the pros and cons of keeping the tooth or removing it. Ask about the urgency of root canal treatment and determine if you have a little time to save money. Some dentists offer no-interest financing that allows you to pay for care over time.

Resolve dental issues before whitening your teeth

If you and your dentist cannot reach an agreement, you can get a second opinion on your second molar and teeth whitening options. Some dentists offer free or discounted whitening to patients who keep regular dental cleaning and exam appointments.

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

My composite filling is still sensitive

Posted on December 31, 2020 by AllSmiles.

My upper right first molar is sensitive after my dentist placed a small composite filling. He did the filling so that I could get teeth whitening without sensitivity in the small cavity. I’ve been back to my dentist several times. He checked for a crack, adjusted by bite, and said he still thinks my bite is off. He recommends a root canal and a crown if the pain persists. I asked my dentist to redo the filling before doing a root canal. He says that the filling is not the problem because composite forms an excellent bond with the tooth. I’m in my second year with this dentist, but if I need to switch to someone who will replace the filling, I will. Is it likely that I need a root canal? Is there information I can give my dentist to convince him to replace the filling? I just want to keep things moving so I can complete teeth whitening. Thank you. Kamrin

Kamrin,

No, it isn’t likely that you need a root canal. What is more likely is that your dentist does not want to replace the filling. Root canal and a crown will cost nearly $2000, but your dentist must replace it at no cost if the filling is the problem. Unfortunately, it makes us wonder if the dentist is concerned about your oral health.

Correcting a Sensitive Small Composite Filling

Although we do not think you will be able to persuade your dentist, you can mention online research on this website and an article on mynewsmile.com about tooth sensitivity after a filling. There are two ways to correct the situation:

Ask your dentist to replace the filling – Your dentist can remove the existing filling and cover the dentin with a glass ionomer base before etching your tooth and applying the new filling. The glass ionomer eliminates sensitivity.
Go to an experienced cosmetic dentist – A skilled cosmetic dentist will use the same approach to solve the problem and prove that your dentist was wrong. Afterward, you can request a refund and explain that you will report the issue to the state dental board if you do not receive a refund. You can also publish negative online reviews on Yelp, your dentist’s Google My Business page, and social media.

Resolve dental issues before whitening your teeth

Please let us know what happens. We hope it won’t be long before you can start teeth whitening treatment.

Michael Szarek, DMD, of Lowell, MA, sponsors this post.

Tooth sensitivity after a filling – mynewsmile.com

My dentist can’t figure out why my new white filling is sensitive

Posted on November 26, 2020 by AllSmiles.

I’ve been waiting almost a month to get my teeth whitened because my dentist replaced silver fillings with composite in four teeth, and one bottom molar tooth is super sensitive. My dentist wants me to wait because he says the bleaching gel might make the sensitivity worse.

The is sensitive to cold, and I feel a little pain when I chew. And I feel mild discomfort around my jaw and tonsil and slight tingling in my lower jaw and chin. After dinner, the pain is continuous, but I take ibuprofen for it. In the morning, I don’t have any pain.

Should I ask my dentist to replace the filling or wait to see what he recommends? Thanks. Charlie from CT

Charlie,

Although you thoroughly described your symptoms, Dr. Szarek would need additional information for an accurate diagnosis, including:

The size of your filling
The depth of the filling
What an x-ray shows

But we can provide some insight into what may be causing your discomfort.

What Causes Pain and Sensitivity in White Fillings?

Some factors that cause pain and

Moderate pain when chewing. Moderate pain and sensitivity are common if you have a large filling that has changed your bite. Another cause for mild pain is trauma to the ligament that attaches your tooth to the jawbone. In either case, mild pain should gradually decrease
Minimal sensitivity to cold. When a dentist gets close to the tooth pulp to remove decay before placing a large or deep filling, it can irritate the tooth. Mild sensitivity to cold is common for amalgam (silver) fillings, but it can occur with deep composite fillings. If the sensitivity gradually improves, you don’t need additional treatment.
Evening moderate, but continuous pain. Spontaneous, lingering pain can occur with pulpitis. Pain increases when you lie down. Although a deep filling can cause sudden pain, bacteria might have infected the pulp. But this doesn’t mean that your dentist is at fault. As decay is removed, some bacteria enter the tooth’s dentinal tubules. A tooth can recover from minimal bacteria. But if your discomfort is not improving, you need further treatment.
Pain in your jaw and tonsil. Although jaw and tonsil pain are not related to your filling, the procedure might have stressed your muscles and tissue.
Lower jaw tingling and numbness. While numbing your lower left jaw, your dentist probably directly hit a nerve or even nicked it. The nerve runs on the side of your tooth, jaw, and chin, and the sensation will go away in time.

Resolve dental issues before whitening your teeth

Allow some time for the sensitivity to go away before you get teeth whitening. If your discomfort doesn’t improve, you can get a second opinion from a dentist with advanced training in root canal treatment or an endodontist (root canal specialist). If the root tip has a wide periodontal ligament space, you may need root canal treatment. Get it done before your pain and discomfort get worse—and before getting your teeth whitened.

Michael Szarek, DMD, of Lowell, MA, sponsors this post.