Pulpitis: What’s the Difference Between Reversible Pulpitis and Irreversible Pulpitis?

thank you for the informative article
I had to fill a cavity in my teeth, the Dr filled it first with temporary one and gave me an appointment 6 days later for the permanent one, following the filling I had constant agonizing pain for about 2 days, relieved temporarily by taking Paracetamol,the pain is so severe that interrupting my daily activities

I guess I have to check with the Dr again to see what is wrong ..

hi,
I have pain, (reading your blog above – pain that is unstimulated in my top 2nd back molar) i am currently in africa, and can’t get to a good dentist for 4 weeks. I have been to the doctor here who has given me antibiotics.. if i keep taking these antibiotics for 4 weeks, should that help prevent anything really bad happening in the interim of being in angola, and being able to get to a dentist in 4 weeks time?

or could the situation become lifethreatening and should i look at leaving now??, what is your opinion from a dentists point of view?

.. i have been given pencillen and ibuproen for the pain..

thanks
lorraine

Today I had a root canal. My tooth broke off below the gumline and I had crown lengthening procedure done, then saw my dentist who began work on the tooth and placed a temporary crown on it. The temporary crown was very sensitive and pain was continuous for about a week, after which it subsided, with only temperature change and pressure aggravating it. This morning I had my root canal. Am now wondering if I had reversible pulpitis vs. irreversible?… your thoughts?…

Hi there,

I have had pulpitis going on eight weeks now. It is on a veneered tooth (done 1.5 years ago), but there is absolutely nothing wrong with the tooth. I have had the dentist check it out and he has done x-rays, and all the tests, and there’s nothing wrong with it. It happened after I chewed on dried fruit using the veneered tooth for three nights in a row.

It definitely has gotten better, but I’m still can’t breath in a lot of cold air, and I can’t drink cold drinks through a straw. Everything else has gotten better though – I used to not be able to eat sweet or hot things, but that went away.

Now I’m left with the slightest pain, only on contact with very cold air or drinks. Since it is going on eight weeks and has gotten better in that time period, should I continue to wait for it to go away?

Thanks!
Taya

hi tom,i have edge to edge bite,as a result i m suffering from attrition,what will be my treatment
choice,orthodontics or light cure filling,i m a1st year dental student

Hi,
1 month ago I had a cavity filled in one of my wisdom teeth. It seemed to go well until a couple of days ago when I started to get a serious pain in my tooth. I think it was set off by me grinding my teeth which I occasionally, sub-consciously do. I was told by a dental nurse that I have textbook Pulpitis. My symptoms are excruciating pain which comes and goes when I drink hot and cold drinks, eat hot or cold food or even go into a hot room in my house. The hot causing far more pain than the cold.

She told me that I need to see the dentist and make sure the dental surgeon doesn’t prescribe me antibiotics for it as they won’t work.

Anyway, I went to the dentist and he insisted on trying antibiotics before his other option of removing the tooth. I’m 24 hours into my treatment of antibiotics and so far the pain has not subsided. I can sometimes go for two or three hours with just a little throb but sooner or later it flares up again and hurts lots.

I was wondering if trying antibiotics is pointless or do I leave it for a little longer to see if kick in and start working?

I was so happy to find this site. It has helped me to understand so much about irreversible pulpitis and answered my questions.

I have a back molar that has been crowned for years. Recently, I started to feel mild sensitivity to cold. Weeks past and it became much worse. Now, highly sensitive to hot, cold and sweet. The pain lingers and it is becoming worse.

I’ve never heard of a toothache with a crown, but I’m guessing if a root canal was not performed, then it can result in irreversible pulpitis, since the root is still there.

I have an appt with my dentist this week. I just wonder if it’s reversible? or irreversible? With the amount of lingering pain, I’m guessing irreversible pulpitis. OUCH! I hope doing a root canal with a crown does not create more problems for that tooth.

Thank you again for your very helpful information.

QUESTIONS…..I do have questions about reversible / irreversible pulpitis.

:: Should’nt a crowned tooth have a root canal prior to the crown?
:: Is it common for this to happen to a crowned tooth?
:: Is a root canal on a crown tooth possible without removing the crown?
:: Or – will the crown have to be replaced with a new one?
:: Is Pulpitis the same as an abcess tooth?
:: Can irreversible pulpitis cause you to feel ill? fever, fatique? nauseated?

Thank you – Thank you – Thank you for any help you can provide.

This is such a helpful site!

I had my 2nd upper right molar extracted mid December. On January 7th my dentist began work on my bridge, did the shaving, and put in the temporary crowns. During the whole 2 weeks that I had the temp crowns, there was a gum pain that was bothersome, but it wasn’t sharp pain, or hot/cold sensitive. When I went back on January 21st to have the permanent bridge installed, and told her about the pain from the temp crowns she noticed a redness, and said that I may have been allergic to the cement or the acrylic from the temp crowns. Well, unfortunately the bridge didn’t fit and she had to take new impressions and send out for a new bridge. This meant that I would need the temp crowns again! The plan was to put the same white temp crown on the one closer to the front, and use the silver cap crown on the back tooth. Once she put on the white temp crown it was clear that I am definitely allergic to some part of it because I experienced immediate pain. She ended up putting the silver temp crowns on both teeth.

Soooo…. here is my issue/question. Right after the anesthetic wore off after I left the dentist I felt very substantial pain in the back molar. I had to take 800 mil of Ibuprofen. I didn’t think much of it, since they had just done so much work. The next day I started to have some sinus issues, and a twitch in my eye (both of which have not stopped since). I don’t necessarily think that the sinus issue is related, just bad timing. It’s been over a week now and I still feel intermittent pain in my back molar that has the temp. The pain is enough that I need to take Ibuprofen, which always helps. Last Monday I went in because she was supposed to install the new bridge. After I told her about the pain, and she saw I was dealing with really bad sinus issues, she said that the pain could be caused from the sinus. We decided to wait the put the bridge on until my sinus is cleared up to see if the pain is resolved. My problem is that my sinus is sort of cleared up now, but I still feel the pain intermittently. It’s not sharp, just bothersome, and I do usually end up taking Ibuprofen which always helps. I am supposed to have the new bridge installed on Monday, but I just don’t know what to do! I would really like to avoid a root canal if at all possible. However, if I end up having pulpitis, wouldn’t it be better to do a root canal BEFORE the bridge is put on? What do you think? If the pain is intermittent do you think it’s possible that the tooth is still just recovering from A. having been shaved down, B. having been allergic to the temp crown for 2 weeks, and C. the sinus issue?

Hi,

I just switched to a different dentist recently and have been having some cavities filled.

On Tuesday, I had a cavity filled on back of tooth #7 with a composite filling. While he was drilling, I felt pain a couple of times that made me flinch and groan in the chair. As soon as the numbness wore off, I now have EXTREME temperature sensitivity in that tooth. Anything hot or cold sends a flash of pain instantly through the tooth, even just breathing indoor air gives me pain. It feels as if the inside of the tooth is exposed. The pain only lasts a couple of seconds and the tooth does not ache otherwise without a stimulus. I don’t have any pressure sensitivity either.

I had no pain or sensitivity at all in this tooth before the cavity was filled. I called the dentist today and he said I should give it a few more days to see if it gets better. If this is pulpitis, how long does it take to calm down? I have only been 2 days with this and the pain seems the same, no better or worse. This is causing me large amounts of anxiety.

Thanks for your time.

I had a crown put on the far back molar on left side right in front of my wisdom tooth on Nov. 30. No root canal done. The first couple weeks I had a lot of pain in my jaw and sensitivity to hot and cold. The pain even caused an earache but that went away after a couple hours. Now, I am less sensitive to hot but still sensitive to cold, but it goes away after a couple seconds. The pain in my ear is gone, but there is still a slight pressure in my ear and a feeling of tightness in my jaw. I do have a history of clenching my teeth. It is driving me crazy wondering if my face and tooth will get back to normal. It feels better when I sleep and when I get up in the morning it feels almost normal, but after being up and awake the pressure and tightness returns. I went back three times for a bite adjustment that helped a little. Although at one appointment the tooth on top of the crowned one was grinded a bit for the bite adjustment. That tooth has a little sensitivity now too. The dentist told me that with the crack I had in my tooth and the work that she did on it preparing it for the crown it could take a couple of months to heal. Any thoughts? Thanks.

Hi Leigh – It sounds like it’s getting better!

Sometimes the grinding can affect your bite especially now that you have a crown since the crowned tooth will now wear away at a different rate than the rest of your teeth.

My guess is that your tooth is still recovering from the trauma of being cut down for a crown. The fact that you’re grinding on it probably isn’t helping much. Have you asked your dentist about getting a “night guard” or “occlusal guard”? That could help with the grinding symptoms and might even help your tooth start to feel better faster.

I hope that helps – Thanks for your question, Leigh!

2 weeks ago I felt something near or around my front tooth (not pain or sensitivity) just kinda of aware of it. Several days later I had a cup of hot tea and my front tooth was extremely sensitive, even to warm, but not cold. Two days after that I noticed that my tooth looked slightly darker.

I went to the dentist and an x-ray showed nothing and they asked about trauma to the tooth, which I haven’t had. They told me the tooth may be dying and a root canal may need to be done, but not to rush as I didn’t have enough symptoms (no aches, or pain when I bite). I was so upset because I take excellent care of my teeth. I haven’t had a cavity in over 10 years.

I went to another dentist for a 2nd opinion. They took a digital x-ray and again I was told there was nothing. The Dr. said it was a virgin tooth with no decay and asked about trauma. Since neither was a factor he said if may be from braces.

I had invisalign done. They were on for 11 months and have been off for just over a year and I wear a retainer nightly. Could this be the cause? If so would it take a year to die or have symptoms? Can this happen to other teeth?

The 2nd dentist did a sensitivity test with cold on the two adjacent teeth, which I felt and I didn’t feel it when applied to my front tooth in question. I was told it was irreversible pulpitis & am scheduled to have a root canal Friday. The plan is root canal, internal bleaching and build up with white filling since tooth is in good shape (best case scenario).

However, to add to my confusion, the next night I had ice cream and I felt sensitive to the cold. Should I go back and get additional testing on the nerve, perhaps electrical? Could the nerve heal or is it irreversible? Any insight to my situation would be appreciated. I just want to know I am doing the right thing as root canal is permanent. Thank you

Tom,
First off, thanks for being so dedicated to answering all these questions!

After reading through this and other websites, I seem to have all the symptoms of irreversible pulpitis, except for one thing… It’s getting better.

I had a very large filling in one of my lower molars (#19 I believe) that my current dentist didn’t like the look of. Neither did I, I don’t recall the whole tooth looking so gray. He suggested the size of the filling didn’t leave much structure and I should replace it with a crown. I said OK, as the tooth was starting to bother me at times. I had the crown buildup done mid-February and had a temporary crown for a couple of weeks.

After about a week with the temporary crown, my tooth would start hurting without any reason until one day I woke up and could hardly even think straight. I took 4 advil and an hour later started to feel better. My jaw was even sore for a day after that pain. I started taking about 2-3 advil every 12 hours to keep up with the pain, and over the next week, I needed less and less advil to calm the pain. By the time I got my permanent crown put on (I now realize I probably should have used temporary cement) I was down to maybe 3 advil a day.

Now that I’ve had my permanent crown for a little over a week, I still need maybe 1-2 advil a day to keep the annoying pain down, but I’m still a long way off from actually using the tooth to chew. Every time I use the tooth I get a dull ache for a 2-3 minutes, depending on what I’ve chewed. I also have a history of grinding and I sleep with a mouth guard. Some heavy-griding nights seem to set me back in the recovery a bit though, where the annoying pain turns into actual pain. At this point, no matter how much pain I’m in, one advil takes care of it in about 20 minutes, and lasts half the day. As advil is an anti-inflamatory, besides helping with the pain, would taking it help prevent reversible pulpitis turning irreversible?

I’m going to go back tomorrow to talk to my dentist, but I wanted a second opinion of sorts. I see some people need to wait months for the nerve to ‘calm down’, and I’m fine doing that. However, if it is irreversible pulpitis, I don’t see the point in waiting. I trust my dentist’s dental skill but I’m not so sure I trust his communication skills.

Thanks in advance,
Jesse

Hi Tom,

I actually have a similar situation as Jesse, with a minor difference…The pain

I had my tooth prepared for a crown 3.5 days ago (saturday morning).

My dentist shaved down the molar and placed a temporary crown. As soon as the numbness wore off that day, I felt a throbbing pain which went away after a couple of hours. Later on when I ate, I chewed with the temporary crown and a few minutes later it was throbbing again for about an hour then went away.

A similar but less severe pain has been sporadically present since the day of the preparation. The pain seems to come back when I either chew with it or bite down on it but does not go away right away – it stays for a little while. It’s has never been excruciating, just dull and annoying but sustaining during its flare-ups.

Should I too be worried about irriversable pulpitis?

Thanks,
Mike

I had a very large filling done two days ago. I was given two shots of local anesthetic, left alone for about 10 minutes (to give the anesthetic time to kick in), and then the dentist started drilling. I thought I was numb, but after a few seconds my tooth felt hot and very painful. The dentist stopped drilling and gave me two more shots (lord, how I wish he would have offered me nitrous oxide too!… but no suck luck). Not surprisingly, I was very very anxious and tense as he started drilling again.

Fortunately, I did not feel anything the second time, but the dentist said I made him nervous and he wasn’t able to concentrate as well as normal while he was doing the filling. 🙁 Unfortunately, he created a large gap between my molars, and the edge of my tooth around the filling is very sharp. I’m worried about getting food caught in the gap and about cutting my tongue on the tooth.

The first two days, my jaw hurt and I had quite a bit of sensitivity to cold air, drinks, and pressure. Thankfully, the sensitivity to cold has gone away almost completely today, but I still have a sharp pain when I bite down on anything crunchy (I’ve had problems with cereal). Soft foods and gum seem okay, and the pain with biting on harder things is intermittent. It is very sharp and goes away completely within a second.

Should I be concerned about the pain I’m still having? I’ve read that reversible pulpitis pain should not last longer than two days and that it usually involves cold sensitivity. Since I’m no longer experiencing cold sensitivity, does this mean the pain with biting must be caused by something more serious than post-op sensitivity, such as a cracked tooth? Is there a possibility that, given a few more days, the biting pain may still go away, or is pain with biting not associated with reversible pulpitis at all?

If it might still be something reversible, is there anything that can help heal the tooth? I’m currently using ACT fluoride rinse twice a day (I’ve been using it a couple time per week regularly for several years) along with MI Paste. Would ibuprofen help? What about a prescription strength fluoride? If you have any other suggestions, they would be much appreciated! I don’t want a root canal (this is the only tooth I’ve had filled in my 30 years… so, even though I know a root canal is not the end of the world, it does seem like a major procedure to me). I’m really really scared, though, that it may have to be extracted if it is broken. Am I worrying too much?

Thank you so much for this site, it’s wonderful how well you answer all the questions.
About 10 days ago, I went into get a filling done because I had had headaches for a week an thought maybe it was related to a cavity I never had filled. He said there was a lot of decay under 2 amalgam fillings, he repaired them. Now one tooth hurt when I bite on anything crispy so I’ve been using the other side to eat. An hour ago I had some toast and purposely tested it and I still feel a lingering soreness. I had no pain before the cavity was replaced. I went to my dentist today and he didn’t see anything, I did bite paper and bit down on a plastic thing but nothing really hurt. Right now as I type it’s sore when I let my top and bottom molars touch. Do you think these symptoms could be irreversible pulpitis, I’m not too sensitive to cold or air. Or a cracked tooth even though I had no pain prior to the filling 10 days ago?
Thank you,
Karen

Hello 🙂

Thank-you for all of the information you posted~ You’ve given me a clearer picture of what might be going on with me.

I have crowns on my upper four front teeth that are about 4 years old. Last week I suddenly felt pain in one of the teeth (never had a root canal in that one), when eating hot or cold foods. I was worried because after years of dental issues, (I was bulimic for years and have had several cavities and root canals over the years), I tend to know when things are about to get bad with my teeth :(.

The pain existed only when exposed to hot and cold until three days ago when I woke up in the morning with constant, severe, throbbing pain. I had extreme pain if I accidently bit into food using that tooth. Even running my tounge or lips over it made me wince.

I’ve been taking Advil and using Anbesol to numb the pain but until last night, it was still hurting constantly. The pain seems to have subsided somewhat today. I’m still taking Advil but the pain feels more manageable. I’m going to assume that I have irreversible pulpitis and the pulp is dying, hense the pain is calming down.

I moved to a different city and don’t have a dentist right now. I am also not prepared financially to have a root canal done, (if it’s needed). I am also worried that the fact that I have a crown on the particular tooth might make the procedure more expensive.

I am wondering if it’s safe for me to put off a dental visit for a week safely so I can better-afford my dental treatment and find a dentist or am I risking my health by waiting.(?)

I realize that the pain might still come back and I might end up desperately searching for a dentist again but I’d really like to be able to wait a few more days to take care of it 🙁

Thank-you so much for your time and information.

Hello,

I experienced extreme tooth sensitivity to cold with lingering pain on one of my back molar since last week. Went to my dentist earlier this week and he referred me to an Endodontist for RCT next Tuesday.

Problem is, since yesterday, I’ve started to have slight sore throat and a bit of chills. However, no sign of fever. I’ve also noticed mild pain on the right of my neck near lumph node if I press on it. Should I call my dentist for assistance?

I’ve started to rinse with saltine water this morning to ease the symptoms.

I think I have Irreversible Pulpitis but I’m not really sure. I don’t experience any constant sharp or mild pain on my tooth, but it is very sensitive to cold. Also a bit if discomfort with hot and biting.

Thanks for your informative article and any further suggestions would help.

Regards,
Patrick

hi tom its me maria
i am having pain on hot drinks only that i cant drink coffee at all, went to the dentist he did a cold test on the affected tooth was negative, no pain on percussion no swelling also, it has filling in it but that was done long time, the dentist did a first session of root canal after that the pain was gone i started having coffee.. so my question is that was my tooth nonvital , that it didnt respond to cold test, but how come i am having pain on hot only! thank u

I am a retired doc (but dentistry was not part of our curriculum LOL !)
I had a temporary crown put on my back upper molar for a superficial fracture adjacent to an old large filling. Xray was negative. The dentist said procedure went just fine, but , as I expected, I had pain immediately on that molar but ONLY when I chewed on it.. This has persisted for over 3 wks..
I have absolutely no throbbing pain, no sensitivity to cold/hot.. only pain on one ridge of the temp crown when i bite down on food. Two days ago ( the day I was to have my permanent crown placed) the dentist decided to adjust the temp, and grinded down one part.. and told me to continue to use the other side of my mouth when I eat and return in one week.
In my professional opinion ( Obviously your opinion is better than mine ).. I have no signs of irreversible pulpitis. rather.. inflammation of the periodontal ligament. That is what the dentist is telling me.. and that grinding at night may exacerbate things. Woulndt a root canal be worthless ? How long can this healing of the inflammed ligament go on? How about the dentist place the permanent crown , but with temporary cement instead? Your thoughts?

hi Tom!
This is one of the most useful sites I have been to. It helped me a lot in understanding a whole bunch of stuff.
Anyway, my problem started approximately 3 months ago. I got this “discomfort” (i wouldn’t say “pain”) or this feeling of “increased awareness” of my upper left 2nd and 3rd molars. it was very difficult to locate where this discomfort was coming from exactly. It would come spontaneously in bouts. it would last for several minutes until i forgot all about it.
The feeling slowly and gradually started to become worse and started to get provoked by chewing gum or anything sticky plus cold stimuli, but not to heat. i also started to feel some pressure on my cheek from the outside in the same area as my affected teeth.
you see, i have three things going on in that area. i have an overerupted wisdom tooth that is decayed. (its bottom counterpart was removed app. 3 years ago because it was impacted) so it is not opposed by any teeth.
as for my 2nd molar, it was filled with amalgam app. 5 years ago and now i’m starting to feel the edge of the filling like it moved a bit or something. Also, my dentist way back accidentally drilled through the outer side of the 1st molar and so needed to do some more drilling to reshape the tooth and so now one of the cusps has become sharp and thinner than the other ones. Since that time, I have noticed that food accumulates much more in this area than before (which ie between the 1st and 2nd molar on the outside especially).
I’ve never had any fever or chills and the pain has never been severe.
So… I went to a new dentist coz we moved to a new city and according to him he can’t see anything clear in the Xray. He said there are some dark shadows around both molars (2nd and 3rd) but he cant be sure if it is really something or not. The tooth structure itself seemed to be fairly intact with no tranlucencies all through the tooth structure. He advises to remove my wisdom teeth (rt. and lft.) and then check my 2nd left molar for secondary caries.
i just want to check if removing my wisdom teeth is the only answer coz i have already removed all of my second premolars for braces as well both bottom wisdom teeth, which were impacted. my dentist at the time advised me to remove the upper ones as well and get it over with because according to him they will only cause me trouble.
but me being me, i told him they are not bothering me right now, i’ll just leave them alone.
my questions are:
what do u think is the cause of this pain? pulpitis due to secondary caries or maybe pressure on the second molar exerted by the wisdom tooth? (remember that they are over erupted slightly and decayed)
my problem with removing my wisdom tooth is that i have heard that teeth can be used to be implanted in place of another missing tooth. (also useful for taking stem cells in case it is needed down the road) so what if i have a deep cavity in the second molar, assuming it does have secondary caries, i know this sounds stupid but thats why i am asking you. could a carious tooth that needs a root canal be extracted and the neighboring teeth be pushed together? don’t laugh if this sounds VERY stupid. deal? coz i was thinking, the wisdom tooth is carious but not extensively so maybe it can be filled and placed in place of the 2nd heavily carious molar ?!?!?!
or is there no other way but to extract and just stick to the 2nd molar no matter what it might need (root canal or not)
what about the thinned cusp? can something be done to it?
and lastly, the other (right) upper wisdom tooth is also carious but has not been a headache so far. do you think i should remove it or leave it alone or treat it restoratively?
i know my questions seem silly but i had to ask! thanx for being patient and sorry my message is so long :S!

i need your opinion a.s.a.p. coz i have an appointment tomorrow with my dentist and i would like to have made up my mind when i go to see him. thx!

Hello! Such a helpful site. I had a lower left molar extracted last year. On 3/29 I went in to begin work on a bridge. As soon as the numbing agent wore off, I noticed it was sensitive to bite. I went back the next day to have the bite adusted, but it really didn’t help. By Thursday, the tooth began to ache, and my dentist got me a script for 800mg ibuprofen and also vicoden, thinking it needed some time to calm down. By Monday, the pain was rather continuous, as soon as the meds wear off it’s almost unbearable. I went back Tuesday and the dentist recemented the temp with a medicated cement. I had two shots of numbing agent, and I could still feel the whole procedure. My tooth was in excruciating pain, I almost cried ( and I am no baby about the dentist). Since then, my whole left side of my face hurts unless I keep a steady stream of ibprofen in my system. My cheek seems a bit swollen. Sometimes it feels like the pain is from the injection site, sometimes it feels like the top teeth hurt, sometimes the jaw. It’s almost like this phantom traveling pain…..not always seeming to be from the offending tooth. I still cannot chew on the tooth at all. It does not seem sensitive to hot/cold from normal eating/ drinking, but if I hold cold water on that side the pain lingers. I am scheduled to go back tuesday for the perm. What is a reasonable amount of time for a tooth to “calm down” from the prep? If it does feel better, how do I know if it is because it healed vs. The nerve dying therefore the pain is gone? At this point it’s been over a week. Thanks!

And some backstory: a few years ago, I had some jaw pain on that side where I could barely open my mouth. My jaw is definitely sore so it is hard to tell what degree of pain is from the jaw vs. Tooth. I have been doing some research and it seems some people get relief once the perm is on because it is a more precise fit. The past few nights the pain is worst in the morning, sometimes I have to get up in the middle of the night and take more ibprofen.

Hello, I recently had a lower wisdom tooth pulled about 2 weeks ago and ever since then the tooth next to it feels strange. I was wondering if the tooth next to it might have just been irritated by the extraction or was the pulp permanently damaged. The tooth was fine prior to the extraction but now it has this weird like throbbing feeling every now and then but its not a painfull throb. It also feels funny when I cough. I’m hoping that the tooth was just midly irritated from the extraction but im wondering if this is a sign of the pulp of the Tooth starting to die and should i make an appointment for a Root Canal.

Follow up on my case ( see above).. I was referred to an Endodontist to see why I was still having bite pain and now sensitivty ( not bad but there) after my permanemt crown was placed on my upper rear molar , but with temporary cement. As you may recall, my crown was done because dentist found a surface fracture during routine cleaning. Endodontist tested me and said that I definitely had reversible pulpitis..and, after doing a bite test, indicated that I most likely had a small residual extension of the fracture that was causing my symptoms ( xrays always negative, and of course fractures not often seen on the films)…. What he told me next was interesting—- he said one of two things would happen.. either my pulp was capable of walling itself off from the fracture and my symptoms would subside OR… it would get worse, that I would know it. with increasing aching of the tooth and major sensitivity .There was no middle ground … If that occurred, then a root canal was indicated. I am sure you have studied this in dental school. what are your feelings about this? I was not aware that pulp could wall itself off and thing could settle down. You have any idea what period of time we are talking about .. for either resolution or progression to needing the root canal? Also, he said that with the root canal , I would no longer have any aching of the tooth nor have any sensitivity issues. He would not rule out some residual bite pain due to periodontal ligament irritation. How on earth could I have persistent periodontal ligament inflammation that does not subside, especially considering I have had no issues with caries, gum disease or abscess? Thanks … the retired doctor!

Hey Tom,

First, like everyone else, let me say THANK YOU for providing this source of insight!
So here it goes:
I had a 20 yr old metal filling that developed a crack in it. 10 days ago it was drilled out and replaced with a new white filling. After the numbness wore off, I was in some pain – random throbbing in that tooth and some surrounding it.
I got sick that night with a sinus infection.

The pain seemed to dissipate somewhat over the next week, but because periodic throbbing and sensitivity to cold was still present, I went back in to the dentist today.

He adjusted the height of the filling (It was just slightly high in spots).
When I left, my tooth and jaw were throbbing and still sensitive to cold. It did not bother me most of the day. Then on my drive home from work the pain was constant and very uncomfortable. I took a few Advil when I got home and things seem to be ok.

Question is – because the throbbing is not related to eating or drinking, can this still be temporary inflammation from the dental procedure done a week and a half ago? The filling was rather large.
How long should I give my tooth to heal before I consider that I might need a root canal?

THANKS SO MUCH!

Thanks Tom.
The throbbing came back strongly in the middle of the night. When I woke up this morning – my sinus infection is in bad shape. The pain moved to other teeth and then went away after I used a netti pot twice.

Until I brushed. Now the tooth that had the filling put in is horribly painful – unless there is water on it, which soothes it.

At this point, I can’t tell whether it is a combo of sinus infection and temporary pain from the dental work or a root canal needed.
If the pain doesn’t subside within the next few hours, I will call my dentist to schedule the procedure.

Thanks again.

Emergency root canal scheduled for tomorrow morning. Would’ve done it tonight if my dentist wasn’t at a dental conference. A rush of excruciating pain hit in the mid day and never let up. I am now on Vicodin wishing I had recognized this when I was at the office yesterday!

Reason to repost… If anyone is in serious pain and can’t get to the dentist right away – GET TO WALGREENS and buy DenTek’s TOOTHACHE PAIN KIT. There is a numbing agent in there that is stellar. Only $7 and totally worth it!

That’s it… though it is only 7.99 at Walgreens. A really good option to have on hand JUST IN CASE.
Root canal was fine – it was actually in a tooth in front of the one I had refilled last week. One that was showing no signs of decay until all the pain kicked in… Anyway, glad to have it over and be pain free today!

Hello….

Thanks…

Hi Tom!

You are actually the 9th dentist that I’m asking regarding this problem over the last 3 months.

I have a pain in the top right part of my mounth. According to German classification (I’m not quite sure if this is a universal one) it’s teeth 1.6 and 1.7. The pain is rather deep. Until recently it came for a few days only to dissapear for a day or two. Usually it intesified in the afternoon. But since my last treatment two days ago it is more or less constant and I have to take more and more painkillers to keep it at bay.

Having read everything that I could find online I decided it must be pulpitis. I keep saying that to each and every dentist that I visit but for some reason they ignore it. Probably because they can’t find anything on the X-Ray picture (which as far as I know is rather normal in the case of pulpitis). Last Friday a dentist found a small hole in the tooth 1.7. Since then the pain has got more constant. I would assume that the reason is, that the bacteria causing pulpitis have no way to escape. That would actually be a good news, because then I would at least know which tooth is causing the problem. Until now I actually thought it was the tooth 1.6. But in the case of this tooth the nerve was already partly removed (but since the nerve seems to be rather long and twisted, the dentist told me he has to use special equipment to fully remove it which would cost a lot of money) and there is a medicine in it.

Now I have two questions:

1. Is it possible that a tooth, in which large part of the nerve has been removed and a medicine put into is still suffering from pulpitis?
2. At which stage can you actually see pulpitis on the X-Ray picture? The tooth 1.7 was X-rayed two weeks ago for the last time and nothing could be found.
3. Is my theory, that a stuck hole in the tooth 1.7 is causing the more constant pain viable?

P.S. As probably everyone else in this forum who has suffered from tooth ache I think you are doing a great job by answering the numerous comments and questions in a very simple and understandable way!!!! This is something that very few of the previous 8 dentists that I visited so far are able (or willing) to do.

Greetings from Berlin, Germany

Andrew

.

Hi Tom!

Here I am again… My case is getting at least fascinating as it is annoying. After around 12 visits by a dentist I do still have pains at the back right top side of my mouth. Now I’m actually sure it’s the 1.7 (first molar). The interesting thing is that I had the tooth killed and the nerve removed 5 days ago. And in fact it was ok for the first three days. It was aching a little bit especially in the afternoon, but much less than before. But yesterday I have decided to eat a pineapple: a terrible decision. The pain that usually started to grow around noon, this time became much stronger and it is with me until now, around 25 hours later. It is not a strong pain and its subsides after a few painkillers. But I finally want to get rid of it.

So here are some questions:
1. How is it possible that a dead tooth is still aching?
2. Is there anything else around the tooth that can react to cold drinks or fruit acids? Why doesn’t the pain subside after the irritant is gone?
3. Is there anything else I can do apart from removing this tooth to get rid of the pain?

Many thanks!

Andrew

Hi again!

I think I have the answer. After playing Sherlock Holmes and following all traces I come to the conclusion that the problem lies not with the nerves, but the tooth enamel. It explains the role of the pineapple and other fruits which cause the pain. In addition to that, since the pain started I tried to get rid of it by brushing my teeth immediately after eating, which made the problem even worse. The only questions that I’m now asking myself is: why is tooth still aching, after the nerve was removed?

Best,

Andrew

Hi Tom!

Many thanks for answering again!

Regarding the causes:

1. It is highly possible that the nerve wasn’t completely removed. In the second molar (1.6) it was removed only partly because it is situated really deep. I will have it removed completely next week. In the case of the 1.7, I had the nerve removed by a dentist who was taking care of two or three patients at the same time, so he didn’t really take care of my tooth (a kind of McDentist). I will have this one checked as well next week

2. Regarding occlusion: there is no pain whatsoever when I bite. It appears mainly AFTER I have eaten something – 10-15 minutes later.

3. I have just read about sinus infection. But apart from the tooth ache I have no other symptoms. I do a lot of sports and feel very well. That is as long as the pain killers work. By the way: sports (i.e.jogging) seem to have no influence on the pain. I think that would exclude some options.

4. Nerve disorder sounds interesting. I actually sometimes happen to have pains on exactly the opposite side which is also hard to localize. It seems to be situated around 2.6 or 2.7. (top left at the back). It has already been checked, but not as thoroughly as the right side. I wonder if it’s possible, that the main reason for my pain is actually situated somewhere else and its simply the wrong nerves that are sending the signals…

To sum up:

What I know now is that the pain appears after I have eaten something. No matter what it is and no matter if it’s hard or not. Since the pain appears with some delay it must be a problem that lies deeper than the enamel. On the other hand since the nerve is (at least partly) removed it must be something in between. What I’m left with is dentin. The question is: can dentin actually hurt?

My course of action at the moment is to keep taking Calcium and to brush my teeth very carefully. At the end of the next week I will visit a dentist, that has very good references online. I hope that will be the end of the story. I will keep you and your readers updated hoping that this will help others suffering from some mysterious pains. But if you have any suggestions I would be very grateful to hear them.

Greetings from sunny Berlin, Germany

Andrew

Hi Tom,

I recently had two crowns placed, about two weeks ago. Both were fine while I had the temporaries. Three days after having the placement, one of the teeth became sensitive to bite. It was a sharp pain, only while chewing. I was referred by my dentist to an endo for a root canal. The endo tested the tooth, and all we could find was the pain on biting – she felt that wasn’t enough of a reason to go ahead with the root canal. The dentist has checked the bite and it is fine. I’m taking an anti-inflammatory and it seems to be helping somewhat, however there is still a strange pressure feeling when chewing. Today I noticed that the other crowned tooth has begun having the same sensitivity to chewing as the other tooth. What could this be from? Do they both just need to “calm down” after having all the work done? If they do need to “calm down”, how long should I give it before pursuing endo treatment? Are these somehow both potentially cracked teeth? Both look fine on x-ray and the dentist says he did not notice any cracks when preparing crowns.

I’ve been having pain in my second to back bottom molar for nearly 6 months. The pain is pretty constant and gets worse when i put pressure on the front left of the tooth. Chewing on the left side of my mouth has become unbearable. Now here’s my background story:

Last January I finished up braces, I had them on for 2 and a half years, I got them when i was 23 years old. As far as I can remember, the pain in my molar began around then. Just recently it has become worse and when going to the dentist, I told her about my pain. She noticed a crack in the old filling, and decided I need a crown. I also need one on the opposing top tooth. Its been two weeks now since my crown prep, and my back molar bottom seems worse. I woke up tonight in horrible pain and cannot get back to sleep. I can’t wear my retainer at all, since it seems to intensify the pain.

Now, I am getting my crowns put on on Monday, and this is perhaps the last time I can see my dentist before I turn 26 and lose my insurance. Should I ask for a root canal? Would this put an end to this horrible pain? Will this mess up the crown? I need to fix this, and fear if I don’t act now I’m going to be forced to deal with ongoing pain, or a large hit to my wallet. Let me know what you think, any help is appreciated. After reading some of your stuff I think it may be irreversible pulpitis caused by my braces. All I know is I haven’t been able to eat on the left side of my mouth for a long time now, and it is no fun waking up at 4 am from a toothache.

Hi Tom. Your blog has given me some insight on my current situation. Let me give you a brief history of my teeth. About 2.5 yrs ago, I started invisalign treatment. Everything appeared to be working accordingly until the last 4 weeks. I normally experienced pain whenever I changed my retainer however this pain was different. Whenever I put on my braces, my front tooth (on the right side) began to ache. I experienced a lot of discomfort so I decided to take off the braces to relieve the pain. That was working out for me. I barely ever experienced pain thereafter, but take in consideration, I was not wearing my invisalign trays as frequently because of the discomfort. Two weeks ago, I noticed the same tooth is darker than all the others. The gum line looks semi-gray and the tooth itself is darker. Its not very noticeable, but if you stare at my teeth, the color difference is visible. I visited my dentist within a few days. He took x-rays and discovered that the blood vessels were inflamed. He prescribed sensitive flouride to put into my invisalign trays at night and to take motrin to reduce the inflammation. Yesterday, I saw another dentist who simply said that my tooth is dying and I need a root canal. My dentist which is his colleague said to hold off on doing further tests (such as electric pulpitis test..something like that to check the sensitivity of the tooth) since the discoloration has not worsened and the pain is rare, but present when I tap on the tooth or eat something rough like steak. I never had a cavity on that tooth. Also, I do not recall any trauma to my teeth besides the invisalign treatment. Does it sound like reversible pulpitis to you? Thanks a mil!

Hi, I’ve just had a deep amalgam filling on one of my back bottom teeth about 8 days ago by a dentist in Glasgow.
Since having the filling, the side of the gum next to the tooth was inflamed and the side of my face a bit numb.
The tooth hurt (a lot) when I drive from vibration and also hurts from hot drinks (not cold)
The tooth has raised up a bit from the other teeth by 2mm
Another thing that sometimes caused pain was going to bed, but if I got out of bed and sat and watched TV the pain would go after 5 mins, so its like lying down causes the pain.

I guess i have pulpitis, and after 8 days I think it getting better (but hot drinks are still a problem)
Do I need to see my dentist again? if the nerve dies and the pain goes can I just leave it?
I’ve had root canal on another back tooth years ago, but the tooth sort of raised up about 5 mm above the other teeth and had to be taken out, so i’m not keen to have this done again.

PS just to correct my previous post,looking in the mirror the tooth has not raised by 2mm, but moved to the side by 1 or 2 mm , i.e. it is no longer in line with the other teeth

my name is sairum i am having pulpitis from 2 yrz now.and every time i go for the root canal treatment the dentist gives me anesthesia first but unfortunetly every time i feel throbbing pain when the dentist proceeds with grinding.plz tell mr what should i do to get rid of this problem.ill be thankful to you

Hi Tom,
you are really doing a great job…i have to ask you few questions,as i have my presentation on this topic next week..
my questions are…

1.histologically,how can we differentiate between reversible and irreversible pulpitus,if in both cases pulp remains vital?

2.what can be the complications of both? in case of reversible…if untreated,it will lead to irreversible pulpitis(that’s what i understand)and in case of irreversible?(in one of your replies i have read about pericronitis..i will be obliged if you mention some other too in sequence, before RCT.

3.what are the roles of pulp caping(direct and indirect) in reversible and irreversible pulpitis seperately?

4.please elaborate the term apexification in context of reversible and irreversible pulpitis?

5.indications for RCT and when will we go for extraction?

i will be very thakfull to you if you tell me the answers.

Ushna

Hi Tom,

Wonder if you can help me. I’ve been diagnosed with irreverible pupitis caused from a deep filling which I’ve had for a while and then a bit broke off. Originally tried stick on filing rather than doing the full filling, but this failed a number of times. So the dentist said re-do the filling. In waiting a week my tooth inflamed with great pain and was then told that the only way forward was specialist root canal (nerve is thin and curved) and crown, or extraction (and imlplant later is wanted). The filling is very deep and like a quarter of the tooth missing. Was prescribed antibiotics which seemed get rid of the pain, but not totally. I can function on the current sensations without painkillers at the moment, but it feels far from right, a bit achy, stuill swollen and I’m not eating on that size. I cannot get the canal treatment done at the moment due to my wife expecting a baby which can come in the next five weeks 37-42, plus paternity at least one week as I can’t just leave my wife to it all (3rd kid). The first root canal availability is is not for 2 weeks and even if I get it done now there may be problems. I can’t get into the chair and then receive a call to get home. If I can put up with the discomfort in the mean time do you think I will be ok if I wait another 7-8 weeks. I still do not know if the root canal and crown root is the best anyway as its it very expensive and apparently tooth is below gumline, so maybe the extraction and implant root is better which is the same price anyway here. Look forward to you comments on my complicated life! Nick..

About a year ago, I had to replace my invisaligner trays that I’ve worn for years as retainers. The new trays were really tight even though they were made to use only as retainers. For several months, the only way I managed to remove the upper trays was to jerk really hard in the area of my two front top teeth. Beginning last winter, I began to notice uncomfortable aching in these 2 top front teeth after coming in from walking in the cold which I would treat with ibuprofen. I had never had this type of sensitivity before. I discussed with my dentist at my last checkup a couple of months ago and he concluded it was simply sensitivity to the abrupt change in temperature. Unfortunately, these same 2 teeth have continued to ache even though it’s summertime. It happens about twice a week and sometimes there seems to be no precipitating factor. The aching is very uncomfortable and will last for about 5 minutes. I’m going back to my dentist tomorrow, but I afraid that I may have irreversible pulpitis and I’m wondering if I caused it by not removing my trays more gently. Fortunately, a few months ago my top tray finally became easier to remove so I am no longer jerking it off.

Hi Tom,

I had one of the molars on my lower jaw filled on Tuesday. In the couple of days before the filling, that area had been aching intermittently, but I never had any real sensitivity to hot, cold, or biting. After the filling, my dentist told me that the cavity had been deep, and that the tooth might need a root canal–we just have to wait and see while I monitor it closely. The day after the filling that area ached a lot, and I took a painkiller to stave off the pain, hoping that the work that was done to fill the tooth had simply irritated the nerve/pulp. The next day, there was no pain, and I hoped that I was in the clear. This morning, it’s aching again. The ache is not excruciating, just bothersome, and is not exacerbated by hot, cold, biting down, or touching the tooth. It’s only been two days since my filling–do I wait for this to get worse/better? I’m going to Colorado for the weekend, from tomorrow until Sunday, and my worst fear is that the pain will suddenly intensify while I’m on vacation. I’m also very scared of the root canal procedure in general. I’d really appreciate your opinion.

Best,
Mel

hi tom
. in june this year i had a fair bit of dental work done in thailand. this inclued a bridge between molars for a missing tooth (no root canals done) and removal of 7 large amalgam filiings and replaced with white ones. the bridge was installed about 7 weeks ago. i have had pain at the back molar ever since. i think it is gradually decreasing( gradually ). i have been in email contact with the dentist who says ,( excuse the english)
“we are sure that the tooth preparation during the procedure of the bridge work was done completely, with NO deep damage to the teeth. Anyway, the type of the cementation to insert this bridge is called the resin cement (Panavia-F), which is the strongest cementaiton, but this is the mild acid, and this may cause the reversible pulpitis. However, as our natural teeth are alive, it takes time for the healing, and the tooth can be turned to normal. We would like to ask you that the pain from then has be constant , more or less. Do you feel the pain during sleeping at night too?”

what do you think???

yours painfully
mark

Hi Tom,

I had a filling for a deep cavity about 5 weeks ago. Following this, I experienced a small amount of pain when biting down on the tooth in question, particularly when eating hard foods, but it was only when it hit one small sensitive part of the tooth. I went back to see the dentist 4 weeks later, as this didn’t go away and was worried there was an underlying problem. He did an adjustment to the tooth, right on the sensitive spot which hurt a lot. Ever since then I have not been able to bite down on the tooth at all, or even brush it properly. There’s no real hot and cold sensitivity, or lasting pain, but quite severe pain when I bite on it. Today I also noticed a bit of tingling in the tooth/gum.

Do you think this could be reversible (or irreversible) pulpitis, or is it more likely to be a result of a tooth fracture or something else? Should I try and wait it out for a few weeks or go back to the dentist?

It might also be worth mentioning that I am half way though a course of antibiotics to treat a bad cold.

Thanks,
Sarina

Dear Tom,

I am in my mid fifties with a mouth full of large fillings and crowns.
In the past 3 months I have had irreversible pulpitis in two molars, in teeth with existing crowns. I am coming to the end of a root canal treatment in the second tooth (first one done about a month ago). I now appear to be developing irreversible pulpitis in yet another tooth.
Is this unusual? Anything to be worried about (besides the cost in money, pain and time)?

Thanks for taking the time to answer my question.

Hi Tom,
Thank you for this wonderful site. I usually do not have sensitive teeth. However, I guess for a while, I don’t really know how long, there has been some bite sensitivity (not even pain) on a section of my crowned molar 19. For the first time, I felt heat and cold sensitivity when eating. I felt more heat than cold sensitivity. I went to the dentist to check it out. I didn’t take advil or anything to see if the temperature sensitivity would go away by using advil. I forgot to tell the dentist that I had some bite sensitivity (only sometimes and only in a certain section of the tooth) and was more focused on the heat sensitivity. He took an xray and said that there was a slightly darkened section of the root on that tooth that looked suspicious. However, I’m pretty sure he said that he didn’t see signs of an infection. He said that when there’s heat sensitivity, that’s a sign that the nerve is dying. He wanted to get me to an endodontist which I did. I have no pain in this tooth. The endodontist did some sort of cold test which did not make me uncomfortable at all. He also took xrays and said that the dark section of the xray indicated that the tooth nerve was dying. He said the heat I felt was from methane gas releasing from the dying nerve. He recommends a root canal. Could the dark part of the xray simply be reversible pulpitis or can he tell from the xray that it is irreversible? I thought he didn’t see infection either. He would recommend antibiotics if he did, right? I thought he said the root looked a little narrower to him at the bottom. The other root is healthy in the tooth. The plastic bite test where the sensitivity is shows the area near the nerve he’s talking about. Root canals are permanent so I don’t know if I should wait to see if I can get better. The heat sensitivity has gone away. I think it happened after a night of clenching my teeth. I’ve been eating on the other side to try to rest that tooth. Is there an advantage to having the root canal right now? It just seems strange to have a root canal when I’m not in pain.

Just adding, I believe the part of the xray shows inflammation, correct? Wouldn’t a nerve on an xray appear inflamed whether it’s reversible or irreversible pulpitis?

Hi, Tom –

Thanks for this site … I’ve been learning more just reading through it!

Lately I’ve been experiencing some pain that I can’t quite figure out what the origin is. Are you ready for the saga? =)

In the spring I had a root canal performed on my #2 molar, and a crown placed over it as well my #3 and #4 molars. The cavity in my #3 molar was only 1mm away from the pulp, so I was aware that a root canal might be required, but we were hoping to avoid it. Earlier in the spring I also had three somewhat large fillings placed in my #29-31 molars. (Yes … it’s payback time for not having visited the dentist while I was a poor college student!)

Everything was healing nicely. My #3 nerve/ligament was sensitive while chewing (hard/tough foods especially) but it was getting a little better daily. Encouraged, after a couple months I began to wear my bottom retainer again at night, just to keep my teeth in place.

After a couple weeks of wearing the retainer at night, my bottom teeth (specifically the two teeth that the bracket clips onto) began hurting. When the normal dull ache of moving teeth escalated into pain on the whole right side of my lower/upper jaw, I stopped wearing the retainer. The pain in the lower jaw mostly subsided, but the pain in the upper jaw did not.

Currently, I can go several days with nothing hurting and it never hurts to chew (I’m still a bit sensitive on the right side, compared to the left, though). However, inexplicably, the pain will come in my upper jaw (and sometimes my lower jaw) in the form of a throbbing, aching, intense pain. Sometimes it lasts only 5 min. and sometimes it lasts hours. This has happened several times at night, thought not every night; several times after eating, though not every time; once while driving from elevation into the valley; and once after eating ice cream. Ibuprofen takes care of the pain. When I wake up in the morning, my bite often feels a little off on the right side, then adjusts throughout the day to feel normal again.

Unfortunately, I can’t decipher which tooth is causing the problem. Of course, I’m very suspicious of #3 but it doesn’t hurt at all when I tap/wiggle it (none of my teeth do). My gums aren’t red/swollen and I definitely don’t have any externally visible abscesses.

Any thoughts? I appreciate your input – I live in a rural, isolated area, so there’s no such thing as a “quick trip to the dentist”! I already have an appt. on October 26, so I’m trying to figure out if I can wait until then or if there’s something serious going on that I need to see him about before then.

THANK YOU!

Hi, Tom

I think I have irrevesable pulpitus now. I am travelling for work and am in Japan. I saw a dentist here and they want to give me two days of antibiotics and I think grind down a tooth. The antibiotics are strong enough that I will need a stomach calmer (prevent vomiting i think)…

I would do the antibiotics, but Im not keen on getting a root canal here. Do you have to do a root canal right away, or will the antibiotics help kill the infection, and I can wait a week till im back in Canada (home).

The pain is severe, and the flight here 3 days ago was insane for pain. Constant cold water flushing helped. THe dentist here found a cavity on the tooth with the problem. The cavity was from at least 3 years ago if not more… I am currently using a oral gel pain killer that numbs the area, and it is working really great… a phamacist in Tokyo gave it to me, and it is for tooth pain specifically.

My hope is to not have surgery here, With all my options and the up coming plane ride in two weeks back, what should I do?

Thanks
Rob

Hello

Just over a month ago part of my filling in my upper second premolar fell out. I had it replaced by an emergency dentist. However, three weeks later I was still experiencing pain when biting, sensitivity to cold as well as occasional mild ache at night.

Last Tuesday I saw my regular dentist who after a thorough examination and an x-ray couldn’t find anything wrong with it. He replaced the filling, putting in a lot more insulation. He concluded that liquid might have got into the tooth when the emergency dentist placed the filling.

The tooth is no longer sensitive to cold and it doesn’t hurt at night. However, I still cannot bite on it. Even if I apply pressure with my finger to one particular spot on the tooth, I feel pain.

Is it something that will go away on its own? The dentist mentioned that if the pain persists I might need a root canal treatment. What are your thought as to the cause of this pain? Is it pulpitis (reversible?)? Or could it be a crack (I’m told the walls of the tooth are very thin)?

Thank you very much in anticipation of your assistance.

Kind Regards

Joanne

For years now I have had a lot of pain around tooth #3/#2. Just spontaneously happened one day sitting at my desk at work. A year before I had some dental work done on #2 so I thought that there might have been repercussions from that(amalgam removal). Also a week before the pain started I just got over a bad head cold. Have had many bad head colds through my life but never any dental pain resulting. I could not precisely localize the pain, but it was certainly #3/#2 region. Throbbing and cold sensitivity….but constant pain. No heat sensitivity…never has been, even at the endo office with heat test. Tooth #2 had a history of multiple fillings and #3 has no history of dental work. So about 8 months after the pain started I had a root canal on #2 which did not resolve my problem. The cold sensitivity went away for one week but came back. I got some second opinions. One dentist that I saw did a nerve block(to block throbbing sensation) in the upper right and it actually exacerbated the throbbing immensely. I had a cone beam ct scan which showed no issues with the teeth, but some sinus thickening and small air fluid level. Had ENT visit and sinus CT showed thickening and small fluid level as well, but ENT doc said it would be unusual for the intense pain I have to be caused by somewhat milder thickening and fluid level. Another ENT doctor agreed. I went for a second opinion with another endodontist probably eight months after the root canal. He said I did have irreversible pulpitis at #3 because of the exacerbation of the pain after cold was applied. Negative on percussion. Negative on x-ray. He said the root canal on #2 was well done and no retreatment was needed. No crown was ever put on #2 however. I ended up having tooth #2 extracted because many months after the root canal it started to hurt when I bit on it as well as pushed on it. Some of the dentists noted pocketing as well on that tooth. The extraction did not help, but the oral surgeon said there was some infection above the tooth that he cleaned to the bone. I have neither biting pain on #3 nor pain when I push on it. I have had extreme sensitivity to cold at that tooth. The pain can be spontaneous as well. Food hitting the gingiva at the extraction site can also trigger throbbing. Throughout this ordeal the quality or type of pain has been the same.

It is very worrisome and a bit depressing because I think I had the wrong tooth(#2) root canalled and extracted. I have had some dentists tell me that even cold sensitivity is not definitive for a root canal issue(on #3). I am scared that if I root canal #3 and the root canal “goes south” so to speak, I would have to extract that one and that leaves me with no upper molars on the upper right side, so my chewing and smile would go out the window. I really don’t know what to do. The dentists seem to be stumped but it seems the cold sensitivity is enough to be definitive in my layperson opinion. I even have seen an oral pain dentist (and still consult with him) and he said that unless it is radiographically evident of a problem at #3, I should not proceed with anymore work. He also said the cold sensitivity would not be definitive as well, even though it is a trigger. I certainly want to have this taken care of but chasing pain also has me cautious. I think my issue has become much clouded. I feel that if I had not extracted #2, I would feel much more comfortable root canalling #3. Recently I had #2 exposed root surface covered with composite and cold sensitivity is almost gone, but pain remains. This has been over 3 years now. It is looking like it is neuropathic but I am still skeptical.

Hi Tom,

I have a question for you.

Last week I had an appt with my dentist because a white filling came out, no pain or anything. It was a large filling, well to me, in that from my vantage point it covered the whole left side of my tooth (bottom left, far back molar, the molar before the last one, no wisdom teeth present), so it covered the whole left side and the the side of the tooth that meets the tooth in front of it. He put in an amalgam filling. The appt took literally 15 minutes for him. 5 minutes to numb, 10 minutes to refill the filling. He made it seem no big deal. Although he did say that the filling required an amalgam.

For that day after the numbness wore off, and the next day, I had a painful gum, sort of like the gum was being pinched. Tyenol immediately helped. The gum pain then went away. Everything was fine.

So now my head is WAY below my body and when I do that the tooth beings to hurt, within minutes. But when I sit up the pain is gone within several minutes, maybe 15 or so, no medicine needed. I mentioned this to the dentist this morning, at my cleaning and asked if the bite was off and his exact words were “there is no occlusion there”. I don’t know what that means, but he basically said it is not applicable here and he said my gums look fine and there’s no problem with the tooth.

So to reiterate, I have no pain at all during the day, nor in the evening, nor when I eat or drink anything, nor when I bite or chew, it’s only when my head is lower than my body. As my comedic father would say, well, then don’t lower your head lower than your body, but that is beside the point, I want to know WHY it hurts. What is it about the blood getting to that tooth that hurts so much? It does NOT hurt if I lay like normal with my head on my pillow, only when the pillow is removed and I am flat on my back with a pillow underneath my lower half. I cannot bring myself to say this to my dentist, even though I adore him, because I am too embarrassed. Can you offer any insight? Well, as much insight as can be gleaned over the internet without seeing someone.

Thank you so much! Kindest regards, Ann

I am so happy to find this. I’ll be as brief as possible. I visited a high end dentist. She replaced all of my fillings (for several reasons). All teeth are virgin otherwise. After replacing them, some large, she said I could wear my Essix retainer. My teeth felt like someone had a pair of pliers and squeezing them. Additionally, the Essix retainer I received was so painful to put in my mouth it felt like my teeth were going to burst PRIOR to the fillings. The ortho didn’t seem concerned. My dentist said that ALL OF MY TEETH have some form of cracking (craze lines – some legitimate cracks). I never had them prior to the ill-fitting retainer. That’s when I sought the cause of my pain. The essix is a C-plus btw. Back to the DDS who replaced the fillings. She said my pain was because of tooth movement not that the teeth expanded with the new fillings which was what I thought. In any case. The retainer “eventually fit” meaning, the tightness went away. Now, the retainer is very hard and has not cracked. However, when the retainer is out of my mouth – now I have pain – all day and hurts to breathe, eat or drink anything. I require percocet. My incisal edges as can be seen on the models I have, are splitting on the incisors. I DON’T clench and I wear nightguard and take flexeril. I’m very scared because I’m noticing more cracks in my teeth – lingual sides of laterals and incisors and canines and bicuspids. Is it possible to have irreversible pulpitis? Is the ill-fitting retainer what caused the cracks. It’s been 2 years since the fillings. My DDS dismissed me because she thinks it’s in my head. It’s not. I would like your feedback. Thank you. PS. I have clinical photos to share if interested.

Hi!

I am so glad i found this website as I have been suffering from tooth pain for 2.5 weeks now and i finally feel like i have a bit of understanding as to what is going on. I had what the dentist called a small filling done on my bottom right side (fourth tooth from the front) A couple of days after the filling i noticed that it was uncomfortable at times when i would chew food on that side, it would make me jump but it wasn’t all that painful. As the days went on it started to become sensitive to hot and cold, and usually after supper my tooth would ache for 10 minutes or so. the pain from drinking something hot would linger for 10-20 minutes but pain from drinking something cold would only last 1 or 2 seconds. During the night the pain was awful and i had to take Advil to stop the pain which worked well. I saw my dentist 10 days after the filling and he shaved down my filling and told me that it will probably still be sensitve for awhile. So i am now at 8 days after he corrected the high filling. The pain is slowly getting better as yesterday was the first day i didn’t have to take Advil in the evening or during the night. The tooth remains sensitive to hot and cold and usually hurts during the night however there are starting to be long periods where the tooth is quiet and i feel no pain at all. it is still uncomfortable at times when i chew but everything seems to be slowing improving. I’m not sure if I should see my dentist about the lingering pain or if i should give it more time to improve. I read on one of the earlier posts that with pulpitis the pain can actually improve because the pulp dies. I’m not sure if i have reversible pulpitis that is finally improving or if it’s irreversible and because my tooth to going to need further treatment. I have an appointment in a week for another filling so i’m not sure if i should wait until then or address this issue sooner. Please help!!!! Thanking you in advance!

Hi Tom,

Thank you for you help. I got a filling done a few days ago. The tooth that had the filling done experienced sensitivity to sugar, hot, and cold, resulting in a 5-10 second sharp pain. I went back to the dentist today and she “polished” the tooth. However, I am still experiencing a sharp pain when exposed to hot or cold temperatures and sweets. Additionally, I’ve been experiencing a dull pain on the tooth that had the filling done. Could this be a sign of irreversible pulpitus?

Thank you,
Wade

Hi Tom,

I had a right, back lower 2nd molar removed 6 months ago, which after healing, has resulted in a wisdom tooth trying to come through in that area.

The wisdom tooth is slightly impacted, and this led to a v.painful bout of pericoronitis, which has fortunately subsided after 4 days on penicillin 500mg (3 x day).

It doesn’t appear to be so close to the adjacent 2nd molar, as I have seen in pictures, and there doesn’t appear to be any obvious caries, but I have pulpitis in the 2nd molar which is painful, especially at night and is causing problems sleeping.

The 2nd molar hurts when I tap it with the percussion test, and feels slightly loose and painful when I try to rock it side to side.

I have a dental appointment in 2 days time, to check on the pericoronitis infection, but I’m in the UK and the dentisit won’t do another X-ray, as I had one recently.

I’m hoping (!) the pain in the 2nd adjacent molar is a result of pressure from the emerging wisdom tooth, but am thinking I could have an abscess under the 2nd molar, needing a root canal, however surely the antibiotics over the last 4-5 days would have controlled an abscess?

I would be very grateful to any advice you can offer,

Many thanks and best regards,

Chris

PS. Thanks for such a great & informative blog, and by the way, I’m taking painkillers in the form of Ibuprofen (aka. Advil) and paracetamol – mainly Ibuprofen every 4 hours as that’s the most effective out of the two, but once or twice a day taking paracetamol instead of an Ibuprofen dose.

Thanks again

As an update today: the pulpitis kept on getting more and more painful until last night, when I took some Co-codamol, which enabled me to sleep, and now this morning the pulpitis is apparently subsiding, but the jaw around it is swollen (a symptom I’ve not had before in this area).

I think it may be an abscess which has spread from the pericoronitis, though I have felt around the jaw and tooth, but can’t feel any bumps (at this stage) ??

Thanks

Hi Tom,

Firstly, thanks for providing such useful info. I hope you might be able to offer me a few words of advice too.

I have just got back from a visit to a dentist after experiencing some discomfort for the last three days or so when I bite. I’m a Brit currently in Indonesia so would welcome a 2nd opinion from you because I’m a long way from home.

It’s not a constant pain but I feel it momentarily when the top set of teeth come down on the lower set and I’ve been chewing food carefully on the other side of my mouth. The dentist said that the problem tooth (bottom right, one from the back) only had a temporary filling and yet I’m not aware of being told this filling was only temporary when I last had treatment. I did experience some tooth sensitivity in the area a couple of years ago, but switching to a brand of toothpaste for sensitive teeth resolved the problem.

An X-ray was taken today and the dentist said that my filling was deep and right down to the pulp. She diagnosed my problem as pulpitis, She drilled in and said she was inserting a type of medicine that would kill the nerve, then gave me a quick filling. She told me to return in a week when she would remove the nerve. This was all discussed in the local language, but I guess that means a root canal.

I should add that the gum under the innerside of the affected tooth and surrounding teeth feels ‘fatter’ than on the other side of the mouth but is not at all sensitive to the touch.

So, my first question is does this sound like pulpitis to you? From reading this Web site it seems that if the pain is only momentary then reversible pulpitis is suspected. If this is the case, would it really be necessary to conduct a root canal? Thanks in advance.

Hello Tom!

It is very comforting to see other people with similar problems and read your thoughtful replies. I have what I hope isn’t a major problem, but internet research has turned on the neurotic worry switch.

Eleven days ago I got 4 fillings on the top of my mouth, two on each side. The first few days after were fine, with only mild sensitivity, but after 3 days I started having pain when chewing food (not when simply closing my teeth together). Exactly a week after the procedure, I went back to the dentist to make doubly sure the fillings weren’t high, and she did some slight adjustments, but claimed it didn’t really seem to be much off. The chewing pain continued, and I resolved to eat only very soft foods. Now, I wake up in the morning with very little pain, though I am aware of some sensation in my teeth. As the night progresses, however, my top right fillings begin to ache, and the pain seems to refer to my bottom right teeth as well. I do feel minor sensitivity to cold, but not hot. The top left fillings seem to be doing fine.

The pain at night varies, and is never sharp and jolting, but simply persistent. I would say it varies between a 1 and a 3. The teeth do not feel any particular pain from direct contact or pressure other than that created by chewing.

During the adjustment, the dentist also filed between two of my top right teeth that had a little extra composite between them because it was interfering with my flossing. I can now floss, but still detect a noticeable little ridge of extra composite in the between space. I don’t know if this could possibly be a contributor to the pain.

My big fear is that I might have irreversible pulpitis, as a root canal would pretty much bankrupt me. Angst!

Do you have any insight into this pain?

Hi Tom, I am hoping you can help with this issue. It concerns my 19 year old daughter. Three years ago she had orthodontic bands applied and orthodontist said 18 months should be sufficient as her problems were not complicated. They remained on for 2 1/2 years. No definite explanation for this duration was given. Towards the last few months of treatment she was experiencing quite a considerable degree of discomfort on the right hand side of her mouth , but being a little toughie she endured it , but did of course mention it to ortho. Bands were removed March this year. In April she was still experiencing pain mainly now focused on the upper right area so she revisited ortho and he and dental hygienist ( who did a lot of the treatment) said it was probably her wisdom teeth erupting. No tests were done. The pain continued so she visited a general dentist in May and explained the pain was causing her great discomfort and time off work and university. He performed no thermal tests, or xrays and suggested the use of a sensodyne tooth paste. Again believing there could be nothing seriously wrong she went away still experiencing bouts of quite severe pain. Late September she made another appointment with the same clinic and saw another dentist who immediately asked her had she had a trauma to the right side of her face or orthodontic treatment, and noted the class 1 filling in the upper left 6 , but said it could not have caused the death of this tooth. He took a digital radiograph and did a thermal test. Tooth of course is dead and abscessed. Open drain performed one week later by first dentist and antibiotics prescribed. At end of appointment he suggests she sees an endontologist as I believe he , by then. realised he had failed to diagnose correctly in May. Just over a week later she sees endo and he cannot begin RCT as tooth still very infected ( sinus tract fistula etc), so he performs another open drain. Unfortunately even though we live in Australia and have private health cover there is only one endontologist in the island state we live in. He is booked solid until Decmeber. She is however on cancellation list but I am so worried that this could become more serious. The ortho and the first dentist have contacted each other and then called me and have ‘blamed’ the class 1 composite filling as the cause of this problem. As a qualified dental assistant I find this very hard to believe and think 2 and 1/2 years of orthodontic work is more likely to be the cause. However regardless of the cause my concern is her health and the chronic abscess which has probably been festering away for over 8 months, and the risk of any of her other teeth which may present one day with resorption. I have read that resorption usually occurs within the first 6 to 9 months of ortho work but have also read that ‘trauma’ to a tooth can take up to 10 years for the pulp to react and die. No one here is giving my daughter or myself any answers , so I am hoping you can advise me. I love you blog by the way and commend you on the friendly helpful advice you’re giving to so many.!

Hi Tom-

I had a rear upper molar prepped for a crown on Wednesday 10/19. Since then, I have been taking Advil and with that usage I don’t really have any problems. My issue is that when I wake up the past two days I have pain in the tooth that requires more Advil. I know they did some sort of work on my gums and told me to get the peroxide rinse to help with discomfort.

Is still having pain five days later typcial. Do you think this could be reversable pulpitis or do you think it’s more likely irreversable?

Thanks.

Kevin

HELP!! I have had a root canal x 2 and a crown on a molar for 2 years. The tooth has remained sensitive throughout– no serious pain. Is it possible to get irreversible pulpitis after a root canal at the top of the roots since the nerve canal has already been filled?? Is extraction the only answer?

Hi Tom,

Thanks for the information. I had a accident two days back and I have visible horizontal crack on my front teeth. I have no regular pain but i have a sense of broken teeth. I can also feel a pain when I put some pressure on the that teeth. Yesterday when I put pushed my that teeth I saw little bit of blood came out but now I am not seeing any sign of blood. I drunk hot tea and had a hot juice also but did not feel any pain. Due to weekend I can not visit the doctor and will visit the doctor as soon as possible on Monday. By reading your article i am feeling positive that I might save my teeth but I am not sure. I am right now taking antibiotics three times a day. What do you think by my explanation? Is it a reversible pulpitis or irreversible?

Thanks once again for helpful information!!!

-Sid

Hi Tom,

Thanks for the information. I had a accident two days back and I have visible horizontal crack on my front teeth. I have no regular pain but i have a sense of broken teeth. I can also feel a pain when I put some pressure on the teeth. Yesterday when I pushed my that teeth I saw little bit of blood came out but now I am not seeing any sign of blood. I drunk hot tea and had a hot juice also but did not feel any pain. Due to weekend I can not visit the doctor and will visit the doctor as soon as possible on Monday. By reading your article i am feeling positive that I might save my teeth but I am not sure. I am right now taking antibiotics three times a day. What do you think by my explanation? Is it a reversible pulpitis or irreversible?

Thanks once again for helpful information!!!

-Sid

Hi Tom,

I have horrible teeth! Three abscesses in my back molars – 2 root canal treatments and 1 extraction. Needless to say, I get a bit nervous when my I start to feel tooth pain/irritation. I take care of my teeth very well and yet still seem to have teeth problems, which I find extremely embarrassing. The past few days my front tooth has been very sensitive to hot/cold and air from outside. I finally went to the dentist today and she preformed a pulp test and took x-rays. Based on all the results – which were fairly inconclusive – but with my dental history and the fact that my front tooth ligament (or artery) is a bit swollen, she thinks a possible explanation could be irreversible pulpitis. She gave me anti-inflammatories and antibiotics, but I’m wondering if we are simply delaying the inevitable? Should I be expecting another trip to the dentist for yet another root canal in the near futur?

Thanks for your help!

Dear Tom,
I am quite concerned by the incorrect information you have provided people with on this page:

“Some common causes of reversible pulpitis are:
Cavities that are just starting in the outer tooth structure – this is a white spot lesion – it would not cause pain and definitely not reversible pulpitits
Drilling done by a dentist when doing a filling or crown preparation on the tooth – the caries would have initiated dental pain beforehand, unless the operator was extremely and un-necessarily invasive
A fracture of the enamel layer of the tooth which can expose the dentin – this is dentine hypersensitivity, NOT reversible pulpitits
Getting your teeth cleaned (scraped!) by a dental hygienist, especially when they clean the roots if you have periodontal disease. – are you serious? cementum should not be removed nowadays, so even dentine hypersensitivity should not occur in root surface debridement, LET ALONE pulpitis!!!

I think you need to work on your pain diagnosing skills. Absolutely shocking!

Jenny.

Hi Tom– I had a temporary crown put my second back molar last Thursday. Hours after the Novocaine wore off- I tried eating something. There was a very sharp pain when I chewed. Now many days later, I am still in pain when I chew on that tooth. My jaw has been periodically throbbing as well I went back to the dentist and they don’t see anything wrong. They tried readjusting the bite and took xrays. The nerve and crown both look normal. Do you think this pain will go away? Or do you think I will need a root canal? Would love to hear your thoughts. Thank you!

Hi,

I had 2 fillings that hurt when I bite. A week ago I had them grinded down a bit. One side was fine, but the tooth on the other side needed a lot more drilling at it. The bite was fine after this but the tooth that was drilled for a while has hurt ever since. It started the next day with throbbing and over the past 7 days it has got slightly better each day and it’s now just a small, more niggling sort of pain.

Is this normal and how long will it take to go away completely? Could my tooth be bruised? As the dentist didn’t drill through my tooth, I am wondering if that rules out the possibility of needing a root canal.

What I am worried about is that I’ve already had 3 root canals in my life. The first two were fine, but the third one was the rearmost upper tooth which was difficult for the dentist & they said they only found 2 roots in it & may have to take my tooth out which made me panic. I caught an infection in it and I was very stressed and upset that my tooth wouldn’t be saved. Eventually, it all settled but I am dreading if I would have to go through all that stress and upset again. The sore tooth is a premolar.

Please help. With this and the recent problematic root canal I had, I’ve had a month of problems and I can’t get on with my life.

Maureen.

I had a couple of crowns done on two adjacent molars. The teeth were basically being held together by old fillings and required a fair bit of drilling.

I immediately started experiencing pain with the temps which I attributed to the bite being too high and too much pressure. Got the permanent ones in and same pain so I went back to have them buffed down but then left the city.

I work out of town (geologist on oil rigs) and haven’t been back for 45 days. I’m taking 1200 mg of Motrin/day just to get by. As soon as it wears off my jaw aches to the point that the back of my head hurts! I need this addressed before my liver fails from Motrin overdose.

I have deduced that the bite is probably OK now but the pain when eating is brutal if I put any pressure on the new crown(s). I chew on the other side of my mouth but even then I have to be careful not to close too tightly.

I think the pulp was damaged during the process of preparing the crown which is apparently an inherent risk with getting crowns. The dentist did mention a small chance of needing a root canal but I don’t recall the reasoning.

Presuming the pulp was damaged and is now encased in a shiny new crown, am I looking at having to get a root canal and yet another crown?

Hi Tom,

Thank you very much for the information.

I’d like to have your opinion on my problem:

About one month ago I went to a dentist because I had a black shadow between two incisors. He drilled deeply into one to remove caries on its inner face. He filled the cavity with a glass ionomer. One week later the tooth started to be sensitive and its ‘architecture’ was very uncomfortable. He then put a composite on the glass ionomer.

One week later… I came to undergo a complete examination of my teeth. The dentist asked me if the tooth was OK. I told him it was fine but the filling was blocking the dental floss. He insisted on filing it down and, in this process, removed the filling by accident (and it was painful!). He replaced it with either a composite or a hybrid glass ionomer (I’m not sure—it doesn’t seem to be a normal composite because it has a distinct, quite unpleasant, metallic taste). Then, because the filling wasn’t even, he polished it, and he polished also a part of the previously untouched crown of the tooth…

This happened two weeks ago. Now, the tooth is sensible to heat and cold, and I also feel pain when I chew into something hard. A feeling of slight pain remains for minutes, and, sometimes, even hours, but without being excruciating. I’m taking ibuprofen hoping it will relieve the possible inflammation.

I’m afraid this could be pulpitis, caused either by the repeated trauma or by the filling itself… Do you think this could be reversible? And in such case, what can/should I do? I’m nervous about losing the vitality of an incisor…

Kind regards.

(Please excuse my English: I am not a native speaker.)

Hi Tom:

I hope you are doing fine.
I had a crown preparation last Monday and the temporary crown was left high but I did not experience any pain until the third noght that Inwoke up in pai. I took a couple of tylenol and the pain subsided. I am a grinder so I think taht being the provisional mdid not hav

I am sorry! I hit the wring button on the message above.
I was telling you that being the provisional molar high I thught that was irritatin the nerve more so the molar was adjusted yesterday morning but last night I had pain again. Not as much but still had pain. My questions are:
How do I know if I have irreversible pulpitis?

Can it be a good sign that there is no pain at all while standing up and it only appears after 40 minutes approx after lying down?

How ling does it take for the inflamation or the pulpitis to calm down?

Thank you very much for your help

hi, i just had a crown put in a week ago. Yesterday, i started to experience a throbbing pain that has persisted. if i tap on it with my finger i feel a sharp pain. would you advise me to wait a few more days and see if it goes away or call my dentist right away?

thanks,
ash

I wonder if you can advise please; I had a deep filling in one of my molars about 7 days ago. Initially my dentist didn’t think the filling would be a problem – however, as he began to drill he discovered that a previous dentist had ‘patched’ the tooth, leaving decay below the patch. He began to look a bit worried and explained that as the filling was now so deep, it may not work and a root canal may be required. As I had the filling on 21st Dec, I was happy to leave things as they were over the festive period, hoping that it wouldn’t be too sore and would settle down. How wrong I was!! I have been in unbearable pain since the anaesthetic wore off, and sledged through Christmas (and now more than likely new year) on a cocktail of ibuprofen, paracetamol and voltarol. Not very nice. I am still hoping that things will settle down – am I being unrealistic? I am on annual leave for the next week, but the prospect of returning to work if this pain continues is bringing me out in a cold sweat. I have been reading about reversible and irreversible pulpitis, and also about fillings taking between 8 and 12 weeks to settle down. Should I sit and wait (the pain isn’t getting any worse) or go back to the dentist?

dear tom how r u? i am very thankful about your job, i would like to have your opinion in my problem

i have bachelor degree in dental science(BDSc) it is three years program but my title is Mr not Doctor but i work as a dentist is it possible to called by my patients as Mr?and is my degree is internationally accepted? i am worried i practice dentistry for five years in some governmental hospital some were Africa. i want your answer badly,thank you for your help

Hi Tom,

I had crown preparation a week ago. The temporary crown is cold but not hot sensitive. The sensitivity goes away in a few seconds. I have been getting intermittent mild toothaches here and there, but they aren’t bad. The permanent crown isn’t scheduled to be placed for another 2 weeks.

The cold sensitivity I expected. Just wondering if the occasional mild ache is normal a week after the crown prep.

Thanks.

Ed

Hi Tom,

In Oct. 2011 my adult braces were removed, I had braces as a teen so this was my second time. My teeth got loose and moved due to Graves Disease and my front space came back. I have my teeth beside my upper front teeth grew in as tiny pegs so after my teen braces crowns were placed and I never felt I had an issue with them. I went to a new dentist in November and she prepped my four top front teeth to replace the two crowns and put veneers on the upper two front teeth. It has not been a pleasant experience. I had three sets of plastic type, temps that she removed and I felt like she was ripping my mouth apart each time, her assistants did a poor job of helping and chunks went flying all over my mouth and down my throat. The next step was temp porcelain that was supposed to be final but the lab she sent them to did a horrible job. She glued them in with temp glue and vaseline. My next appt was rescheduled twice because the lab messed up again. When I finally went in she said we have to start all over doing molds again and everything since the lab broke all the molds too. I begged them to shape the porcelains that were glued with the temp glue vaseline mix. They did shape them for me I’m still not thrilled with how they look but I can’t sit in the chair and go through more, I’ve always had a fear of dentists and now I’m petrified. My problem is pain, when I floss one of the crowns on one side I feel horrible pain when the floss hits the top of the gums. Do I have pulpitis? What should I do?

Hi Tom,

I forgot to mention one more thing, since the cosmetic work began I now have a terrible crackling sound on inhaling while breathing that I’ve never had in my life. My family doctor has ran several tests on me including sending me to an ENT doc. The results of all the tests have been normal. I told him this all started with the awful cosmetic prep and numerous temps being ripped out of my mouth. We wonder if all those flying particles affected my lungs? Also I had a mirror and looked at my poor teeth after each removal and the gums surrounding the crowned tooth that hurts on flossing was horribly red and inflammed.

Hi Tom,

Hope all is well. I had two adjacent molars crowned recently and had to wear temps for 3 weeks on one and 4 on the other. I had bite sensitivity which finally went away with the temps, but the temperature sensitivity was there the whole time. I still have temperature sensitivity which is diminishing, but still there. I even have a strange sensation (not pain), but something different and not comfortable with room temp water sometimes. I can eat most nuts, but almonds sometimes make the tooth feel tender. I am trying to see if the teeth will calm down. I’ve had the permanent crown on one for almost a month and the other for two and a half weeks. I had thought the dentist took an xray before crowning, but it turns out the xray he took was for the contacts and I’m not sure if he saw the root of the teethin a bitewing. I know I might ultimately need a root canal(s) but I’m waiting it out to see if it calms down. This dentist does not believe in going through the crowns for root canals. Other dentists say it is fine. This dentist said something like the filling material is a different composition so it can settle in a way over time that can leave a slight gap or something. In any event, what is the opinion in dental school about the best result for root canals on crowned teeth. Is it just as good to go through the crown or is a new crown a better procedure? I would think there might also be risks with a new crown so I’m not sure what is better.

Hi Tom,

Thank you for all you are doing here!!

About three weeks ago I got four temorary crowns on my front teeth. After maybe four or five days I felt something, I would’t call it pain, just an awareness that something was going on on one of my front teeth. After 8 days into my temp. crowns I felt a sharp pain everytime I ate something “cold” or breathing cold air from outside. I was unbearable but it went away after a couple of seconds … each time. I did not wanted to talk anymore. So I contacted my dentist and she told me that I most likely had an inflammation going on and that I should take some Advil or inflammatory, use toothpaste for sensitive teeth but without whitening and see how it goes. She did tell me that my tooth could have a trauma and I might need a root canal done. So over the course of two days, which was the weekend, I took Ibuprofen three times a day and the pain was still there but maybe a little less. On Monday I called them to be seen. My dentist took a look at the cement, nothing was lose though, and decided to put a little bit more cement on, because she thought something might have gotten lose. Right after she was done, no anesthesia used, it felt much much better, I would even say the pain was gone. Because I did bleach my teeth before I got my temp. crowns she gave me a relief gel and special tooth paste to use. Oh and I use this special rinse so my gums would not get infected (Peridex), twice a day. When I was in pain I could not take it because of the cold factor even it was not really cold. Later on the next day the pain came back but not as bad and intense as the time before. On Thursday of that same week I went in to get my permanent crowns placed. She cemented two teeth in with permanent cement because those were the teeth without pain and had a root canal done years before that. One the other two teeth she used again, but a different kind, temporary cement. Just in case if the pain would not go away and I needed a root canal done. After she placed my four permanent crowns everything felt perfect! She also told me that is was my right big front tooth who was inflammed because she saw the inflammation and descibed it to me. After everthing was done I was totally pain free …. but only for 3 1/2 days. On Sunday morning afterI woke up I felt a sensitivity to cold again, nothing super big but it was there again. Only if I drink cold stuff and cold air again. I did feel some stuff peeling of my temp. Cement but I guess that is only the stuff what they put over the cement, right?
Remember, when I went to my dentist after I had so much pain and she put mor cement on. I did call her when the pain came a bit back and told her that a string or something like that peels or comes off. She said that is ok and I forgot how she called it. Anyway the same thing happened on my permanent crowns. I am hoping that there is only a tiny gap or losening going on that will make this cold sensitivity?
Any ideas why it comes and goes that way? Why did I have no pain at all for over three days and now it is back. It is not that bad but it came back. I did use the Peridex after I got my permanent crowns maybe three times a day so everything would stay healthy in my mouth because my gms were sore. On the night before my sensitivity came back I put my lower orthodontic retainers in because the upper once don’t fit anymore. Do you think that could have caused something! I also grind at night.
I really hope I don’t have to have a root canal done!!!

Thank you Tom in advance!

Is Tom still reponding?

Thank you so much for this site. Here is my issue:

About 10 years ago an amalgam filling that I had since childhood finally fell out of my 2nd lower right molar. I was in EXCRUCIATING PAIN!!! To the point where my entire right side of my face and body was in pain and feeling very weak. I finally went to see a dentist for an emergency visit. He quickly wanted to do a root canal and even though I was desparate, I refused and suffered. I then found a holistic dentist that said I didn’t need a root canal. He cleaned out the molar and put a temporary filing and told me to return. The agony stopped IMMEDIATELY. I never returned to him and the temp filing lasted for 10 years.

On Thanksgiving Day 2012, the filing finally called it quits and came out. It didn’t hurt at at, but food would get caught in it and I would clean it out. Well, at the end of March, the molar started hurting. And as the days went on the pain increased. In April it got really bad, but for some reason not as bad as it did 10 years ago. But it was enough to keep me awake a night crying. So I went for an emergency visit to a different dentist. He then said “root canal or pull the tooth”. I still hesitated. I asked him if he could just clean out the cavity and put a temporary filing. He didn’t clean it, but he put gauze (which I found out he did later) and covered it with temporary filing. I went home and that evening the pain was unbearable and just increased in intensity over the next few days. I ran back to him and told him to take the tooth out. He said “Are you sure, because we can do a root canal to save the tooth.” It was the gauze that was touching something in my tooth that caused it to throb really bad. The holistic dentist never put gauze and that’s why it didn’t hurt for 10 years. As he gave me novicane and started working on me, I felt pain. He had to inject me 3x with novicane. The third time, I was in such EXCRUCIATING PAIN he had to stop. All of the dental assistants ran into the room and watched me as I cried and writhed from the pain. I sure they thought something bad was going to happen. The dentist handed me a Motrin on top of the anesthesia, but I didn’t take it. I was in so much pain, I didn’t dare even open my mouth for anything at that point. I was afraid of having too much medicine in my body already. So as I waited a half hour or what seemed like it, for the pain to subside, the dentist said “I’m not going to touch it anymore. I’m sending you to the oral surgeon so he can do the root canal instead.” He gave me a referral, prescription for Ibeuprofin 800 mg, and Amoxicilin 500 mg. With an empty hold in my tooth, the pain over the course of a week has gone down to a mere pinch without the medication. I clean it out with salt water, baking soda, several drops of clove and eucalypus oils, dry it with gauze and cover the hole with dental wax. Sometimes I just use warm salty water to clean the hole. There is slight pain or discomfort if I bite down to hard on my right side, but generally it seems to be getting better. I can tell the pulp is still alive because it would throb a bit if I bite down too hard on the wax. As the days go by, I have less and less pain. I’m thinking I should find that holistic dentist since he seemed to have given me the best results. Like I said, I had not been to the dentist in 10 years and I have no cavities in any of my other teeth. The 2nd lower right molar is the only problem. At the time of this writing, I feel nothing but a pin prick of pain in the tooth and I can bite down with about 1lb of pressure without pain. Any more than that I feel a little pain. That’s my story. Oh by the way, when I looked at my chart, it did say: ‘Pulpitis’, but not sure if it’s reversible or irriversible. Maybe you can answer that for me. Thanks.

Lisa

I forgot to mention the pain got worse when the dentist drilled down into the tooth after the anethesia. That’s when I told him to “STOP IT HURTS!!!” lol

Thank you,

Lisa

Hello Tom, your website is a real service. I found it helpful to read other people’s experiences and your insightful remarks.

I visited my dentist a week ago The previous two weeks I had been experiencing persistent, intense tooth sensitivity to hot and cold in the area of my back, right upper molars, one of which had had a filling 15 years earlier. I was also experiencing discomfort on biting down in the same region. It was difficult at the time to identify exactly which tooth/teeth was/were involved. There was no pain around the gums. I avoided eating on that side. I began to wake up at night with a light throbbing pain that would last about ½ hour and disappear allowing me to return to sleep. There was no discomfort when I woke up. My dentist took x-rays, which were inconclusive, and determined that there was sensitivity. He treated the back molars conservatively (but did not explain the treatment to me). If the pain persisted after 10 days I was to contact him. Here is the situation 8 days later: I can identify the tooth responsible for my discomfort now. While the conservative treatment provided has reduced the sensitivity somewhat during the day, it is still there and I continue to wake up in the middle of the night with moderate throbbing pain when I lie on the same side as the tooth. It goes away when I lie on my other side. My dilemma is whether or not I should throw in the towel? On the basis of the evidence, I am inclined to think that I have irreversible pulpitis. I will, of course, discuss this further with my dentist, but wondered if I should give myself more time since the pain has subsided somewhat during the day, although I am still unable to chew comfortably on that side. Your thoughts on this matter would be greatly appreciated.

Hello, Thanks for providing this site. I had a tooth crowned about 5 years ago. Four days ago I began to have pain radiating through in my right ear and right jaw. I thought it was allergy related, perhaps even an ear or sinus infection. The next day that pain continued, and I also noticed sensitivity (when biting on food) in the crowned tooth.

Unsure whether the problem was dental or sinus related, I decided to go to the dentist. He took x-rays of top and bottom teeth on the right, and found no indication of any problems. He tapped on my teeth and I did have sensitivity in the tooth that has been bothering me. He said that he thought the problem might be sinuses since I have so much radiating pain in the ear and jaw. I then saw my regular family doctor, who found no infection in the ear, nose, throat, etc. He recommended motrin, sudafed, and flonase for my allergies in case the problem was sinus related. He seemed to think it was my tooth after all since I could pinpoint one tooth that was sensitive rather than just experiencing generalized tooth sensitivity.

Since following the motrin/ sudafed/ flonase routine for a day, I do notice significant relief in pain. When I accidentally bite a piece of food, however, the pain will flair to the jaw and ear. I also have a flair-up of pain if I swish with cold water. I talked to the dentist today. He didn’t offer any explanation about why my tooth would hurt if there was no abscess. He said if I was still in pain in a week, or if it got worse, he’d refer me for an endodontic evaluation of whether or not to have a root canal. What I don’t get is why he wouldn’t educate me about pulpitis.

My questions:

1. What can the endodontic specialist do that the regular dentist can’t to determine whether or not a root canal is needed?
2. If the x-ray shows no abscess or anything else abnormal, what is the justification for performing that procedure? I’m reluctant to have a root canal solely because my tooth hurts.
3. Based on my description, what are your thoughts on my tooth? Could it be sinuses?

Thanks again!!

I had a crown done about 9 months ago. I’ve never had any pain or problems with the tooth. All of a sudden, the other night, it started to throb when I breathed in cold air. Drinking cold water didn’t bother it. I took some ibuprofen before I went to bed, and the tooth felt better in the morning, and I have not had any pain in it since. Is this weird? Should I be worried about it?

HELLO
WHAT IS THE DIFFERENCE BETWEEN THE PULPITIS CAUSED BY DENTAL CARIES AND TRAUMA?

I have been experiencing throbbing pain that I now know was due to a high filling. I returned to the dentist this past Monday (a week after I had three cavities filled on the left side of my mount) to inquire about the cause of the pain. After an x-ray and an inspection, the dentist determined that everything looked fine. I was told to wait 2-3 days and to call if the pain continued. I contacted my dentist two days later as the pain did not abate. I was not able to get a hold of the dentist as he neglected to tell me that his office does not operate on a regular schedule on Wednesdays. I then visited another dentist that day since, after much researching, I had determined that the source of the problem was due to a high filling causing inflammation of my periodontal ligament. I had this dentist adjust the height of the filling after he determined that it was, in fact, too high and putting considerable amounts of stress causing pain.

I have another appointment with my original dentist for an assessment and to determine the course of action since my pain has not abated (I am not sure if I need to wait longer for the ligament to heal).

My fear is that I have irreversible pulpitis.

What is the likelihood that my pain is a result of irreversible pulpitis, and that I will need a root canal?

My symptoms & details:
– constant throbbing pain in my jaw
– awaking in middle of the night with this pain
– pain and unease felt in Masseter, jaw near ear, and temple
– It was confirmed by my original dentist (during follow-up visti) that the cavities were not deep enough to have cause nerve damage and/or infection
– (I am ) highly certain that original source of pain was due to high filling (cannot rely on dentist’s diagnosis since he did not provide one during the follow-up visit)

In January of this year,I had a cavity filled. The dentist said it was a very deep cavity close the nerve. It was the third cavity I had to have filled in this tooth. Since it has been filled it has been very sensitive. Two weeks ago I started having radiating pain in my mouth which I couldn’t tell which tooth is was coming from. I have also been having a lot of pain in ear. I also have been having extreme pressure on face that hasI went to the dentist last week and he did an Xray and he said it showed no abcess or infection. He did prescribe an antibotic just in case I was having sinus issues. He said if it continued to bother me to call back and he would refer me to an endo dentist but didn’t want to rush into it yet because the tooth looked fine. Since I was still have pain in my ear I went to my medical doctor today to see if I had an ear infection and she said no it had to be a dental issues. My question is if my tooth/nerve is dying how long will it take? Wouldn’t the xray show if the tooth was dying or had an infection. Should I see and endodontist?

Hello Tom,

Very informative article. It helped me understand a tooth lot better.
I have few doubts, which, I will be glad, if you can answer :). I recently met with an accident and two of my incisors on the upper jaw were chipped off at the edge ( Specifically, the front one and the smaller one next to it ).
I had some sensitivity on the day of accident and after that, the sensitivity is no longer present and I have not felt any pain till date.

I happened to consult two dentists, one of whom suggested only crowning and the other one suggested a root canal and then a crowning, after taking an x-ray (the dentist said the pulp has been damaged to some extent). However, the dentist mentioned that the pulp is still vital.

After reading your explanation, I now cannot determine if it is a reversible pulpitis or is my pulp dead due to which I do not feel any pain/sensitivity ? What happens after the pulp is dead?

Can you please suggest if it is good to go for a root canal in any case?

Thanks again for your suggestions !!

Hi Tom,
what a fabulous and informative site! Many thanks for taking the time to attend to so many questions. I have recently decided to restore 12 amalgam fillings and replace them with composite as the health risks related to amalgam worry me. The first two fillings were replaced yesterday. The dentist discovered some decay on the bottom of the old filling, and alerted me that the new filling was very deep and may have irritated the nerve. He put medicine underneath the new filling to calm the nerve down. I understand that in the case of irreversible pulpitis the pain could start in a week, in three months or in six months. The risk of pulpitis hadn’t occured to me earlier and I am now beginning to question my earlier decision of having all amalgam fillings replaced, as most of my old fillings are large and as such I may put myself at risk of root canals even though my teeth are healthy. Do you know what are the chances of contracting irreversible pulpitis after deep fillings? Would you consider a complete restoration of amalgam fillings reasonable given the risks of subjecting otherwise healthy teeth to potential nerve damage? I travel on business and have several long haul flights scheduled over the next few months (12 hr flights). What if i develop serious toothache while on board a plane? The thought of it terrifies me. Is there an effective painkiller that I can bring along, just in case I will be without access to any medical facilities or pharmacies? Really appreciate your thoughts! Many thanks in advance!

Hi Tom!

You seem a knowledgeable person, maybe you can give me a hand.

I have a molar that’s been acting up for about a week now, and acting up really is the right word. The tooth feels elevated whenever I try to close my mouth and during the day it feels fine, I have no pain. However, as soon as it gets around 10pm, the pain comes and it’s really bad. It spreads to my whole right cheek and it’s unbearable. I’ve been getting by with paracetamol before going to bed, but I wanted to know whether I really have to pay the dentist a visit or if it will just go away on its own.

What do you think?

P.S. I am not eating anything extremely hot or cold before bed. I have dinner early and I’ve been keeping off sweet/cold stuff lately.

Tiago

i had a filling last week and was told afterwards that it was a mm away from the nerve. So i could require a root canal if nerve is traumatised and damaged. My xrays showed a medium sized filling but dentist after the filling said xrays are 2-3 months behind. The following 4 days i experienced discomfort around surrounding teeth but the tooth filled was fine, no pain, no sensation. However, the following 2 days i experienced throbbing pain which lasted for about 4 mins over period of 2 days. Cold water gurgling set it off and due to pain i clenched my teeth whilst sleeping and biting my inner cheek. I took ibuprofen once in the morning and pain calmed. Throbbing came back in evening and took ibuprofen and had a nice sleep. The pain has gone since and its been 2 days and i dont need ibuprofen. But filled tooth still seems sensitive and slightly discomfort on bite. Dentist said he will review the situation in a week. Is my tooth getting better or has the nerve died???. Also warmth and heat feels soothing to teeth and after brushing with sensodyne, the filled tooth is not sensitive and feels normal. Please advise. Thank you.

Great article, very informative! I had a crown put on 2 months ago, a broken tooth that already had a silver filing. Dentist removed the silver filling and replaced it and prepped the tooth for a crown. I noticed when he put the crown on it was very sensitive to cold (he had to numb me to get it on), the sensitivity never went away, he took another xray and said there wasn’t any reason for my pain. This was an upper tooth. Then I went in for a cleaning and the hygienist cleaned some stray cement that was left around the tooth, two days later the pain was excruciating. It radiated from my jaw to the entire side of my head, at first I thought it was my TMD acting up and they called in predisone for me, after being on that a few days it helped tremendously, but the pain wasn’t gone. I then went to an oral surgeon thinking it may have been an impacted wisdom tooth. the surgeon did an xray and didn’t see any swelling in or around my wisdom tooth but that it was indeed impacted, so much that it was growing into the roots of the tooth in question. He suggested I wait it out and let the steroid do it’s job. I did but it was still very sensitive not to cold but to pressure now. My dentist said I needed a root canal, however I couldn’t get a root canal done because the wisdom tooth was essentially “in the way”. I’ve had the wisdom tooth removed, and not I don’t have any pain in the tooth (so far) no sensitivity to cold or pressure. could this have all been a result of my wisdom tooth compromising my other tooth? Esp after all that work was done on it?

Hello Tom, I have a question for you.

A couple of weeks ago, I started getting extreme sensitivity in one of my lower molars. It would feel icy cold even from sucking normal air over it. My dentist found a small notch in the dentine near the root of that tooth, but otherwise the X-ray showed the tooth to be totally healthy. She applied a small layer of filling material over the hole to cover it up.

Now the sensitivity issue is pretty much gone, but I am getting spontaneous pain coming and going from that tooth that does not seem to be getting better. Could that tiny notch in the dentine have caused an irreversible pulpitis?

(My dentist is currently recommending we simply monitor that tooth. But a year ago, I had pretty much the same issue with the same tooth on the other side of my mouth. That tooth eventually had to have a root canal.)

Dear Tom,

I have an obvious very large cavity in one of my teeth, insofar as about 1/6th of the tooth has fractured off and there is some darkening of the tooth inside. I have had no symptoms apart from sometimes the root of the tooth feels sensitive when brushing or if I press it from the outside. I intend to see a dentist asap but have moved and need to re-register (in the UK). I think there is a chance I have developed irreversible pulpitis but am very much hoping I have not got an abscess yet- is it possible that I have one?

Thanks,

Sagar

I wrote you one year ago regarding mild pulpitis after crown for cracked upper rear molar.. When I started having pain, I saw two endodontists, who both said there was a chance it would resolve and that , in fact, the pulp of a tooth has the ability to wall itself off from the offending insult.. Welll, they were correct, and my pain resolved, and I had the permanent crown cemented in… nice ending huh… Wellll fast forward to now. a year later… I am now having mild aching in the same area of the crowned molar.. There really is no major sensitivity to heat or cold. no major problem biting down on foods.. just a slight achy feeling which starts after eating.. no throbbing.etc.
I have had this for about 2 weeks, saw the dentist who “crowned me”. She took xrays, examined and said there was no evidence of any crack, cavity or anything visible.. Since she has to have something to do LOL.. she said the crowns bite may have to be adjusted.. so they did just that and told me to eat on the other side of my mouth for a week or two. The discomfort so far is very minimal..
My question for you is….. is it still possible the pulp to wall this off as it did before? The endodontists last year told me something that stuck.with me…. Toothaches due to pulpitis , infection, whatever…will either resolve OR get worse. requiring you eventually to get a root canal. They do NOT linger forever.. Do you agree? and what do you think is the most likely cause for my recurrent mild ache? Good news would be appreciated. Thanks..

Hello Tom
My name is Deepesh.
First of all will like to thank you for your such an help to the commom people.
I wanted to ask you that how can symptomatically reverssible & irreversible pulpitis can be detected. And another thing which i wanted to ask you is that,what are these restorative mouthwashes

Hello Tom
My name is Ricky.
First of all will like to thank you for being so informative for all of us.
I would like to ask you somethings. Tom how could one detect symptomically wheather he/she is suffering from reversible/irreversible pulpitis? And another thing which i would like to ask you is,what are these restorative mouthwashes & how-when to use them?

hi, over 2 weeks ago i had a filling done and was fine for the first week then the pain started, its comes and goes but when it comes its agonising. i went back to my dentist who said it was a very deep filling gave me antibiotics and said to come back for root canal or an extraction if the pain persists which it did for 2 days and seems to have subsided slightly. a friend recommended pro relief toothpaste which i rub on the tooth to get instant relief, weather it remains that way i will wait until i’ve finished the meds

A part of my last bottom molar cracked off. Must have been an expansion-contraction issue becuase I was eating fat free frozen yogurt at the time this happened. The tooth had a filling in it. The fracture left a sharp edge. The dentist smoothed edge and told me I needed a crown. He had done one successful crown before, so I decided to go ahead. (I think now I should have gone to a dentist with Cerac technology available.) Anyway, the temporary crown gave me round the clock pain which I treated very successfully with 400 mg of Advil every 10-12 hours. When I came for my permanant cown visit, I told the dentist I had terrible pain. He took a Panarex (spelling) xray to check for abscess and did not find one. He said he believed my pain was from pulpitis and that with installation of the permanant, better fitting crown it would let up. Just to be sure, he put the crown on with semi-permanant glue. It’s been more than 24 hours, and my pain is back. I have resisted taking Advil because I want to be able to trace what makes the pain worse. Chewing on that side definitely brings on pain. I am considering seeing a second dentist for a second opinion; the scheduler said that I would need to have a PA xray to determine if RCT was needed. Questions: 1) how long is it reasonable to wait to see if this is irreversible or reversible pulpitus? 2) should I avoid eating on the “bad side” to let the area clear up? (Nothing is wrong with the gum area.) 3) can a Cerac crown be created after my natural tooth has already been ground down for a porcelain crown? I have a call into my dentist, but probably won’t hear from him until the end of the day.

I’ve been through a case of pulpitis and still have some lingering sensitivity, not in the tooth, but in the gum over the tooth. I’m wondering if this is just a side effect that will eventually go away or if it is a sign of persistent infection of some sort.

I had a pretty hairy filling done, and my dentist prescribed me antibiotics (Penicillin VK) and some hydrocodone pain pills. Since I didn’t have much pain, I skipped the pain pills and took an aspirin that night and woke up feeling pretty good in the morning. Since there was so little pain, I figured I didn’t need the antibiotics, so I stopped taking them after the first day.

The tooth was sensitive to heat so I bought a tube of Sensodyne and felt it was gradually getting better. But after about four months it started getting worse: there was pain when I bit down on the tooth. I saw my dentist and he said I needed a root canal. I immediately regretted not finishing that antibiotic prescription.

We scheduled the root canal and he put me back on antibiotics. I immediately felt better and asked to delay the root canal while I finished my original 10-day course of antibiotics. When that ran out, I felt much better but asked for a refill and took a second 10-day course (500 mg x 3x/day).

I finished my antibiotics over a month ago and the tooth feels fine. No pain or sensitivity. The only thing I notice is some sensitivity in the outer gum above the tooth; feels kind of ticklish when I run my finger over it.

Any idea what this is? I be back at the dentist for a checkup in just a month or two, but am curious whether I should be worried in the meantime. Thanks.

I had a root canal about a week ago and the dentist said he wanted to see how the tooth settled before he finished it off. I can only say that my tooth has killed me since then and the pain was as bad as before I went to the dentist. I go to the dentist very often and get my teeth cleaned every 4 months so it isnt a case of cavities. This particular tooth is crowned. Do you think the pain is normal and will I have to have the tooth out. The dentist did tell me I had pulpitis but I hadnt heard of reversible or irreversible until I read your site!!

I have been going through my pain for about four months now. It hurts so bad I have found myself looking for the gun.no joke. But dental care I need is very costly and my children come first.I know what I’m now gonna say you probably will not agree with. But if your hurting like I am I’ve found that swishing hundred proof or more of pure vodka will take away the pain long enough to get to sleep.during the day I take the ORIGINAL Listerine (SMALL BOTTLE) AND MIX A LARGE BOTTLE OF LIQUID AMBASOL (20%) BENZOCAINE AND SWISH IT THROUGH THE DAY.LIFE ANIT BLISS BUT ITS TOLERABLE. I NEED $1500 TO GET AN ORAL SURGEON TO CUT IT OUT.BUT I DONT SEE ME HAVING THAT KIND OF DOUGH NO TIME SOON.BUT I THINK ROBBING A BANK TO GET IT WOULD BE WORTH THE JAIL TIME. IVE HAD PANCREATITSUS QNR A HIP REPLACMENT. BUT THAT PAIN NOT EVEN CLOSE TOBE AGONIZING LIKE THIS IS.THIS IS 24/7 HALF THE TIME ITS AGGRAVATING BUT THE OTHER IM LOOKING FOR A GUN.UNLESS I CAN AFFORD THE VODKA. BUT THANK YOU FOR YOUR TIME.THANK YOU FOR LISTENING. BECAUSE MOST FOLKS DONT UNDERSTAND WHAT THIS FEELS LIKE.WILLIAM

I had a deep white filling on my bottom right molar about 5 weeks ago I have been back 3 times to the dentist, fist time she checked with liquid nitrogen in cotton wool and I nearly jumped out of the chair in agony. She said the tooth was fine. I went away and it still hurt. I can’t chew on that side at all and I have a dull ache and pain in my tooth and jaw constantly. No swelling. I went back again and she said the bite was too high, adjusted it and there was temporary relief for about two days. The pain has come back more now. I am going back for 3 rd visit we’d as my bite is still too high. They seem perplexed as the tooth looks fine etc ect. But no x rays have been re- taken. Am I looking at root canal or is a bridge and extraction the better route?
Thanks for your time, I’m driven nuts with popping pain killers and trying to ignore the pain for so long.

In case anyone has noticed. the moderator has left the building LOL

Is anyone else helping with answers if the moderator has left the building/blog? Thank you.

I went to the dentist yesterday for routine cleaning/x-rays. He saw on the x-rays 2 of my lower bicuspids (#20 and #29) each have an abscess infection, they are asymptomatic.. He said root canals for each would not yield the results we would hope for. They both have been heavily filled, not much tooth left I guess. He said I have to get them extracted, and then bridge work or implants…

I wish I had had symptoms to alert me, maybe then I could have saved these teeth from irreversible pulpitis. Who knows how long I had these infections. It’s been 2 years since I had a dental xray.

Questions: Why are thse abscesses asymptomatic? Are bicuspids hard to extract? Do they have a lot of roots? Will there be a lot of blood?

Hi Tom,
I had a crown on my back and front tooth to have a bridge, this was fine for 4 years, my teeth are very sensitive to hot and cold anyway because of receding gums. In April I noticed a small ulcer between my gum and cheek right at the back next to this tooth, I ignored it thinking it would go away as apart from a little soreness I was not in pain. This week I mentioned it to my dentist and he said I needed a root canal, today he removed the crown and bridge and the smell from my tooth was very bad. He did a root canal treatment, but said I must come back every ten days to have some more stuff squirted into my tooth, until the infection goes as he says the bacteria is live but can’t survive without air.When this is done he can give me a new crowns and bridge, it is aching at the moment although I have temporary crown and bridge, I also grind my teeth at night could this have caused the problem? if so can it occur again or should I be alright now I have had root canal

Today my dentist diagnosed irreversible pulpitis in my upper left canine. The tooth has never had any work done on it, and the X-rays show no cavities or other problems. The tooth is sensitive to heat, cold, and sweet, and I just about jumped out of the chair when the dentist tapped on it. I’ve had a minor ache come and go without stimulus, but it hasn’t been keeping me awake at night.

The dentist told me that a root canal would definitely fix it, but he also said we could wait several days and see if there’s any improvement. I have a night guard I plan to start using again to try to protect it in case I have been grinding my teeth at night.

My questions are whether there might be infection, what will happen if the pulp is dying, what are the chances of this clearing up by itself, and whether I should get it X-rayed again next week to check for abscess.

Thanks.

I had routine dental work done one June 25th (cleaning, x-rays, and fillings). Most of the work was done on the right side at the top on teeth 2,3, and 4. I have been in pain since then. Most of the pain came fron tooth #2 which had a very deep, big 3 layer filling done. I had the bite adjusted several times and I had to get it extracted since I couldn’t afford a root canal. The relief was instant (it was a severe shooting pain that affect the entire right side of my head. face, and neck so the relief was felt even with the numbing injections.). I had it extracted on July 17th. Since then tooth number 3 has been bothering me. It feels big like it doesn’t belong, my jaw feels stiff and it hurts badly when I lay down on my sides.
It’s not senistive to cold/hot and when it hurts heat makes it feel instantly better. It does feel like it’s “off” when I bite down and it feel tender to pressure. I do have a bad habit of grinding/gritting my teeth when I’m stressed and when I sleep.
My problem it that I have random pain that comes and goes around that tooth/area that lasts about 5-8 minutes without stimilation. My denist doesn’t know what’s causing it since everything looks fine and dandy.
OTC pain medications work to relieve any pain I have but I’m nursing and I am afraid of taking to much medication in case it affects my baby. My question is is this normal after an extraction? If it is how long until it feels normal again? Or would I have to have a root canal to fix it?

Hi Tom,

I banged my front tooth about a week ago and chipped a little bit of the tooth. Now my tooth is sensitive to hot/cold, when I eat and also I get sudden spurts of pain that come and go for no reason. Pain lasts for a few seconds. Is it too soon to know if I will need a root canal? If it is reversible how long will pain/sensitivity generally last?

Thanks

Thanks for the helpful information. I have a couple of questions/worries about a similar situation to many of the questioners.

I had a cavity (in #14) filled 6 weeks ago that was under(?) an old filling. The dentist described the new composite filling as deep. Immediately after, I had sensitivity to cold (extreme), hot, sweet and sometimes to biting pressure. Occasionally it would ache slightly and fleetingly for no apparent reason. The dentist told me to wait a month. After a month the pain was basically the same (a bit less to hot and pressure). At week 5 the dentist checked the height of my bite (fine) and painted something to seal the tooth and told me to see if that helped it. Since it remained sensitive (only a small improvement), the dentist removed the filling today (week 6) and placed a temporary filling that I can taste has eugenol. He said he’s trying to see if the problem is with the filling or with my tooth. So if things improve with the temporary filling in 2 weeks, he’ll place a new permanent filling in the tooth. If not I suspect that means a root canal.

– Is he trying to see if the pulpitis is reversible by doing the temporary filling?
– If drilling deep in the tooth causes the pulpitis, why does this plan of action involve so much more drilling (i.e. take the filling out, put a temporary one in, take that out, put another in)? Won’t all that drilling just make it worse? What is the logic behind the temporary filling?
– Given all the drilling, should we have waited longer to see if the pain would go away before taking out the filling?
– What kinds of problems with the filling (versus my tooth) could cause this kind of sensitivity?

Many thanks,
Allison

PS: sorry that this was originally posted in the wrong place in this thread.

I am a 31 year old woman with perfect teeth until my car crash 10 years ago. I had never had a cavity or anything before then(well except for having my wisdom teeth out and celence put in my back molars because the center was too deep). Now I have a mouth full of broken teeth and my jaw pops every time I open my mouth. I am constanly in pain because of it and can hardly eat due to it. I know it can be life threatening with the possibility of getting an infection and having it go to my heart but I don’t have a job, my credit is very poor(in the toilet), and I do not have insurance because I can’t afford it. I live in Eugene/Springfield Oregon and the only free clinic we have here is White Bird and they cant do the extractions on my teeth because they are so bad. I was wondering if you knew anyone who would be willing to pull all of my teeth(or atleast the bottom ones) and will take payments?

Hey Tom. I’ve started from the top and really enjoy your interaction with the people that need help and gave me a sense of good feeling, while learning all about reversible pulpitis and the irreversible pulpitis.

So I have a top molar on my left that sparks a jolt of pain when I bite down on my teeth or softly play bite to test it’s sensitivity. The pain is just a quick jolt. Not continuous, and just fades away until I bite down again.

I’ve done several tests on ice cubes to test it’s sensitivity to coldness and warm foods on hot triggers on the tooth. The coldness and warmth doesn’t trigger pain at all. Just the biting pressure.

Also when biting food on it, it doesn’t trigger. Only when it lands on my bottom corresponding tooth.

Also this tooth have had a filling on it before on the back of the tooth. But I can sense the pain is on the tip of the crown.

I would like to repeat that it doesn’t inflict any continuous pain at all. And it ONLY triggers if I bite down on my teeth or something of exact hardness. No warmth trigger or coldness trigger.

I want to know if this is something that can possibly be fixed without a root canal since I had one already and don’t want to go through the process of affording it. I can probably sense a cavity, which involves cleaning it and putting on some filling. I’d much rather have that then facing a root canal and crown situation.

Thank you Tom!

Hi, you have some great answers on here so I’m hoping you can help! I had a White filling dome 6 moths ago and it hasn’t been ok since. It had to be filed down a few times
because it hurt when I bit anything hard. Filing didn’t help.

It was removed after x-rays showed it was ok but it was too sore to keep in. Replaced with silver filling.

The silver filling then started to throb around the tooth area. A dull ache from time to time. Again x-ray showed nothing wrong. Was too painful to have in so they removed it and put it a sedative filling to see if it would calm down the ache/low throb. This worked for around 3 weeks so it obviously did something right! Then, even with the sedative filling in the throbbing came back. Never agony again. Doesn’t keep me up at night. Just there in my mouth, sometimes every 10 mins, sometimes every few hours. Nothing to do with hot and cold as far as I’m aware, just happens. It’s my top left back tooth and so it sometimes hurts when I lie down on that side to sleep now too.

I was given antibiotics 2 weeks ago which didn’t help. Ache still here. Sometimes it’s shooting pains now too. But x-ray shows nothing and today the sedative filling was removed and replaced – cleaned tooth and looked around and all seems fine! Apparently filling not even near the nerve according to x-ray.

I’ve to wait between 1 – 3 weeks and am booked in for either rot canal or filling in 3 weeks either way.

They just seem to be guessing it is root canal though and I don’t want to get something down that isn’t even needed if the tooth looks fine?

Could it be anything else in that area that they are not picking up on? I have had sinus pain aroundtooth area in past so know it can be other things than toothache!

Do I just bite the bullet and go for root canal soon as the sedative filling was put in 11 hrs ago ad I’m still feeling a low throb (not sure if it takes days to calm the tooth?).

I have seen numerous dentists over the last 6
Months and I just feel I might get root canal and actually it is so eking else that is going on. The dentist says I don’t have typical symptoms of root canal?

Please shed some light and your opinion on this as I am running out of patience with this matter as it has been dragging on too long now!

Thankyou in advance.

Hello Tom,
This refers to a 6 year old filled back upper molar. Pain on chewing for some months, dentist could not see an external problem. A week ago I awoke with bad pain. Relieved on standing up, returning every time I reclined. Then pain continuous for a couple of days. Now completely pain free. The dentist suggested a root canal but due to my age (70) and finances, I booked myself in for an extraction in a few days time.
I reasoned that the problem would return and that it is preferable to get rid of a presumably dodgy tooth, with the concomitant risk of later more serious infection.
Do you think that I have made the right decision? Or should I wait for the next episode?
Many thanks

David

Hi Tom

Just found this QA site, reading of which has been very helpful. From what I’ve read looks like I have irreversible pulpitis. Had a fractured back molar and dentist removed old deep filling in preparation for having a crown fitted. A temporary fitting was put in place and at first there was no pain. After 3 days the pain arrived and has got steadily worse with referred pain in my upper teeth. The ache seems to come on late afternoon and is worse at night. I returned to the dentist last week who prescribed antibiotics which I knew would do nothing for the pain but thought they might be prescribed to prevent an abscess forming – is this right? Have to return to the dentist on 20 Sept and now realise there are only two courses open to me … root canal or have the tooth taken out. Am not looking forward to either treatment in all honesty!

Jan

Hi,
my back tooth cracked about 2 weeks ago, and I went to see a dentist to see if he could save the tooth. He told me I need a crown, and prepped my tooth with a temp crown. Since then I have had pain radiating from the jawline to my ear. After I week, I saw my dentist again, and asked him if the pain that I was feeling was normal? He readjusted my temp crown, but I still have pain, especially at night. I then saw another dentist (my went on vacation) after the readjustment (2 weeks later) and he took an x-ray of my tooth to see if there was anything else going on. The x-ray showed a perfectly healthy tooth, and he could not figure out what is causing me so much pain. Any thoughts on my situation?

Hello Tom!
Toothache with pins and needle (tingly) feeling on the right side of my face!
I’m in China and I can not communicate with the dentists here beacuase of the language barrier.
I had filling a few years ago in the lower molar tooth; Three days ago after eating sweets i started to feel pain in my Wisdom tooth (near the tooth with filling); I used Advil and put some powdered aspirin near the gum, it helped a bit; but now I feel tingly feeling on the same side of my face; I feel like sneezing but I cant; I also got runny nose today; the eye on the same (right) side is watery!
Is it due to the tooth ache or I got somethingelse?

Why is it that today in 2012, that we can have a problem with a deep-filled cavity?

It seems to me that perhaps we have problems with the material used for the filling.

I get pain after a filling, with hot and cold. Hot and cold should not reach the tooth nerves. If hot and cold could not get to the nerves I would have no problem (it seems).

Do we get pulpitis simply because we had a deep filling, or is it to do with inadeqate filling materials?

Hey Tom, I have a quick question. I have a upper back molar (5 teeth from the front upper tooth) that has a large amalgam filling. Ever since the filling, I have had lingering sensitivity to cold (about 5-7 seconds). About a year after the filling (about a month ago now) I had ridiculous pain in my tooth. It felt like it was going to explode, along with a huge headache, and everything else. I couldnt do anything but try and sleep. Went to the dentist the next day, and got xrays. He said there was no abcess, and said that I was really sensitive to “knocking on the tooth”. He said if it doesnt go away fully in a week, come back and do a root canal.

So everything got better, but now a month later, it started again, but about 60% less painful than the first. I can still eat (mostly on the other side of my mouth). It is only sensitive now to pressure, and when I close my mouth when my teeth rest on each other.

My questions:

1. I really dont want to get a root canal, I feel that If I do, since the tooth is basically dead, it will eventually crack and I will have to get it extracted and have a implant put in anyways. What do you think about this?

2. Do you recommend going to an endodontist for a root canal? My dentist said my roots are mostly straight and not curved much. But If I end up getting a root canal, I want it done right. Should dentists be good at root canals, or are they just able to do them?

Thanks a lot for your time.

Interesting. All my teeth are painful, are see through, have lots of scrape marks from Hygenist. Dentin on back of teeth exposed. Pain excruciating keep going to the dentist every 3 months they clean and use a laser to go around all my gum lines. I have facial disfiguration with these teeth, pain in my face, neck and nose and no one wants to treat. Oral surgeons just want to make bites and give drugs, bite I use but told I don’t grind, I can no longer eat well as cannot chew and food sticking as we’ll as painful to all surfaces. swallowing difficulties. Severe dryness in mouth and nose, teeth shifting. Lips swollen and bottom hangs; loss of jaw. Though some say I have bone. One dentist said no I could not have dentures too dry and no implants due to bone loss. Inflamation redness in face, opening mouth is harder and it hurts to speak. Pain even with air touching them. Stiff neck. Tongue has been white given nystatin to rinse.
Every cleaning is making them thinner. Food sticks to all surfaces.

Under a different side you said Vincent’s mouth I think it is osmylietis of jaw. Teeth are sharp palate high, tongue has tooth marks on side and they are just shifting. I live in 08724 area code Food tastes awful. Never had dryness or breathing difficulty till this has been going on.

How do you test for Vincent’s disease? My teeth and jaw, whole face is painful.
I looked at the photo on Wikipedia and I am worse than that. I would share with you a photo for your professional opinion. When I try to smile I am bite off and I no longer have a chin. Pain keeps me from sleeping. One dentist gave me tramadol but I vomit so narcotics don’t sit we’ll, no over the counter remedy works. Over the counter don’t work also. Thank you.

Hi Tom,
I had my bridge replaces about two years ago just because the former one was over 10 years old and reciding. I’ve been sensitive to cold ever since and usually just drink cold through a straw or have found ways around it. About three days ago my dog bumped his gigantic head against my bridge and it hurt for a second but I didn’t think anything of it. I’m still not positive this is the reason I am having issues now. The next night a weird pain showed up in my bridge but came and went just a handful of times. Each day since the pain has become increasingly worse to the point where now its there always and I can’t bite down on that side. Even if I move my lips over it it hurts or let my tongue touch it. It almost feels sore. I’m also pregnant just fyi.

Hi

I recently had a sinus infection, and was waking at night with my upper left teeth very sensitive to hot and cold. I went on a course of antibiotics and steriods which cleared the sinus infection. However my teeth are still sore, and sensitve to cold esepcially. I went to a dentist and she thought it was my very back tooth based on the x ray and it had a longering pain when she put that cold stuff on it. However, when I drink cold drinks, it is a tooth further in front which hurts.

I’m wondering if she’s got the right tooth? As I’m considering getting the back one extracted rather than a root canal, I want to be sure! She has suggested waiting and seeing if the tooth settles down, but I have been off the antibiotics for 2 weeks and no real improvement. The pain isn’t bad, it comes and goes, but occasionally it has started up with no stimulus.

Should I wait longer, or is this a false hope? I’d like to have it sorted before Xmas! Appreciate the time you put into responding to these questions – this a great site!

Thanks

Dear Dr. Tom,

This is the best thread on the Internet about reversible / irreversible pulpitis.

I have a fundamental question that I cannot find addressed anywhere on the Internet. Everyone says that a dead nerve cell can lead to infection. I have not read anyone claim that it will definitely lead to infection.

If the nerve dies and is sealed up so not exposed to daily food debris, what is the chance that nature can handle it? Common sense tells me it can, that it should be given a chance before a root canal. More than 200,000 years of human evolution has had time to come up with a solution. Warm-blooded mammals have been around 1000 times longer for 200 million years. Teeth have changed little.

My pulpitis history is as follows. I suffered a few weeks of both minor chronic tooth pain and also while chewing. It was not isolated, not even to my lower left jaw where the problem tooth number 20 is located. My guess is that was an infection throughout the jaws.

Suddenly I noticed that half of tooth number 20 was missing. There had been a filling there for 40 years from since I was about 10. A cavity developed under the filling. I immediately went to the dentist who prescribed penicillin which I have been on for about a week. The dentist wished to do root canal but did no testing of the nerve. the nerve appeared as healthy as any other tooth, but I understand x-rays are not very good at judging the health of the nerve. The x-ray showed extremely little evidence of pus ever having drained from the tooth into the jaw.

Because half of the tooth is gone rather than being a big hole, it is now much easier to clean the area. I believe most of the pain subsided due to this fact, and not from the penicillin. I have no ongoing pain or unusual sensitivity to cold.

The tooth however is sensitive to even warm tea. The dull constant pain will be 90% gone after 1 min., and 100% gone after 2 min. There can be a 10 second delay after drinking the tea for the pain to start. I intend to start measuring the tea temperature. I could later post here changes in temperature/pain thresholds. It looks like I’ll be the first to ever chart this out. Given it has less insulation, there must be a point where it is normal for it to have greater sensitivity.

I’ve heard the sensitivity can last a long time. Does continuing sensitivity indicate that the nerve is still alive? The only explanation I’ve heard for the pain is gas bubbles expanding. There must be some molecular explanation, but given the low temperature of lukewarm tea, it’s hard to see how that’s the only explanation.

In general (medical advice of course is impossible without you seeing me), is it better to somehow protect the tooth or is it impossible to cap it until the nerve decides whether it’s going to live or die? One dentist is quoted on the Internet saying there is no reason to take out the nerve until it is truly dead. Do you agree with that?

Nature is telling me to do absolutely nothing at all for now. I sense the tooth is healing itself rather than every day coming closer and closer to exposing the nerve. Is that reasonable or wishful thinking? I’m not against a cosmetic filling, but just feel I should give the tooth some time to heal on its own. But if I have indefinite heat sensitivity, I may have no choice but to leave it alone, or of course undergo root canal which obviously I’m against.

Hey~ I had two fillings done on November 16th, tooth #2 and #3. The thing is that tooth #3 had a large composite “build up” or bond, whatever you want to call it 🙂 However, it had a cavity under the bonding. Basically I had a cavity in between tooth #2 and #3 so the dentist had to completely remove my old bond on tooth #3 to do his thing. So here I am with what looks like an amalgam mixed w/composite on tooth #2 and then a composite bond on #3, but he only left like 50% of my tooth structure (if that!) on tooth #3. So him removing the old bond and leaving me with a smaller tooth is fine, but right when the numbing went away it hurt like hay to chew on it and was SO sensitive to cold. I called and they said don’t eat on it, give it a few days etc. So actually, I waited until December 2nd to go in to have him peep it out..what was happening was it throbbed like hay with cold stuff and it throbbed mildly if I chewed on it, the part that worried me was in between the two teeth feels like I have a cavity when I floss in that space, it hurts when I lightly tug the floss out. I went it and he said said a piece of filling was high (but that he didn’t think that was the prob). He put some de-sensitizer of sorts in the space and said give it time. He didn’t do an x-ray and my tooth was not hurting at that time to really point out what I was talking about. He didn’t mention root canal at all, but did say if it is sensitive later on I should get a crown. My problem is not the sensitivity, it is the cavity sensation in between the teeth when flossing..then my concern shifts to the throbbing from cold. My intuition tells me that he didn’t fill it correctly, my tooth tells me something is going on in between #2 and #3, right where he filled and drilled. Pain with cold stimuli is light throbbing inflammation about 2/10 pain, and the pain when flossing in between those teeth is more of a sharp pain with floss tugging 4/10 pain. What’s your take on it? It’s been roughly 18 days since the drilling and filling.

respected sir, i am, myself, a dental student. i want to ask u what is meant by exudative pulpitis? what is the difference between exudative pulpitis and suppurative pulpitis???
Regards

When the dentist was drilling my tooth, I had to bite down on something that sprayed water on the tooth and sucked water back out of my mouth. After the dentist had been working for some time, it started to hurt right through the novacain. The dentist said, “more water” and I realized that my bite had relaxed and the thing I was biting on had moved and wasn’t spraying right on the tooth anymore.
Two weeks later, I still have a lot of pain in that tooth. I’m afraid that the pulp overheated while my loosening bite allowed that instrument to shift and not cool the tooth properly.
Could that have happened? What is that instrument I was biting on called? It seemed to spray water and suck it back out.
What can I do to reduce the risk of the tooth dieing?

Thanks for this amazing blog!.. I think I have pulpitis. Basically, I don’t have any pain throughout the day. I do have some sensitivity to my warm salt water rinses.It is only painful when I lay down and go to sleep at night. It feels like the pain is from pressure maybe from blood flow perhaps?? because when I sit up or stand up the pain goes away. Anyway. Im scheduled to have it extracted by an oral surgeon next friday which is a week away. Ive already been experiencing this for over a week but that was the soonest I could get an appointment with him. Is it safe to wait another week to see him? I called the office the other day to see if there was any way to get me in sooner and He offered to put me on antibiotics but I dont like the damage that antibiotics can do, especially if they’re not necessary. i Have no idea if you’ll read this but I hope you can respond soon. Thank you

Josh

I’m having long periods (longer than 15 seconds) of pain in my left hand side of the mouth, upper and lower. I have had a filling recently on a molar but when I went to the dentist yesterday complaining of sporadic excruciating pain, she took some x rays, said there was no visible sign of infection and that my filling were not ‘deep’ and gave me some antibiotics ‘just incase’. I can’t locate an exact tooth where there is pain it seems to run the whole of my left hand side of the mouth, mainly at the back and the bottom. She did a sensitivity test by spraying each tooth, but none of them were particularly sensitive and she also ‘pricked’ them but I couldn’t identify particular pain in any tooth, yet the pain comes and goes and when it comes its excruciating, my eyes water spontaneously and the pain lasts for about 20-30 seconds intense or longer but not as intense.
My worry is that I need root canal but the dentist cannot locate the effected tooth and is hoping it’s something else, but I don’t want to continue with this pain.
Any thoughts would be much appreciated
Huma

Reversible pulpitis and apical periodontitis caused by high filling or irreversible pulpitis?

I went to the dentist as my lower rear molar was giving me very sharp pains whenever I ate or drank anything cold. The dentist did an xray and said it looked like one of the roots “might” be dead (he wasn’t sure). He wanted to extract the tooth and said there wasn’t enough space for a crown. He also said that if I have the tooth extracted, the tooth above it would grow longer and start cutting into my gum and that would then have to be shaved down and also have to be removed in time. Is that right? I really don’t want to lose the top tooth as well as it is a good tooth.

I’ve never had an extraction before and wanted to know if anything else could be done to save the tooth so asked for a second opinion. In the meantime, the first dentist put a temporary filling over the top of the existing filling on the tooth concerned (I’m not sure why as the pain is coming from the outside edge, not the top) but he didn’t adjust the bite and the filling was far too high.

It was painful to chew on the high filling. Initially, the second dentist asked me “if I could live with it” and said I might just have a sensitive tooth and to avoid anything very cold. She also said the tooth above it would not have to be removed as well as it would stop growing when it reached the gum line.

I returned to see her a week later, by which time I had been chewing with the high filling for about two weeks (and the highest bit had cracked under the strain the day before my appointment) and the tooth had by then become constantly painful. It was also very sensitive if I touched it with my finger and if my finger was slightly cold.

At the second appointment, the dentist removed the high filling and also drilled out the old filling beneath that. She said there wasn’t any decay but that the nerve was inflamed and she put in a temporary sedative filling. Immediately, this made a diference and the tooth seems ok when I eat or drink anything cold.

However, I do have a more or less constant dull ache from the tooth and it also aches for quite a long time after the pressure of chewing. I’m hoping I might have reversible pulpitis and also apical periodontitis caused by the high filling but it might also be irreversible pulpitis.

The dentist has asked me to come back in about a week but I’d like to give it a bit longer to see how it feels. How long should it take for the pain to subside if it is apical periodontitis from the high filling and would I expect to see an improved x-ray result soon if I have reversible pulpitis?

Dear Tom,

Congrats on your graduation and thanks for starting this blog.
It’s of great benefit to many people around the globe.
The second to last of my top left molar has been hurting on and off , over the last month.
Sometimes so severe I couldn’t sleep till five in the morning,only clove soothed the pain and allowed me to sleep. It was awful! I’ve been to the dentist about it and he can’t see anything on the x-ray. Sadly,for me because the pain keeps coming back, which tells me there must be something wrong. I’ve quite a big filling in the tooth, today is one of those days that’s it’s hurting aw…..I feel let down by the dentist. He told me it’s really difficult to do a root canal on this tooth. Why doesn’t he refer me to a specialist? I’ve already lost the molar next to it (going forward). I would hate the idea of having an other molar extracted , there would be a huge gap. It won’t leave me any teeth to chew with.Only one at the top! Surely, everything should be done to save the tooth?! Please, give me advice as to what to do. I feel so frustrated and let down by my dentist.

I forgot to mention that my wisdom tooth starts to come through on the top left.My dentist told me that possibly due to pressure the molar is hurting.But it’s only pushing the gum a little it’s not showing yet. Why would my molar hurt when I bite? If it has to do with pressure? It’s hurting me constantly today. I can also feel my “heart beating “in the molar. I’ve no clue why? The dentist said as long as the pain is bearable to leave it or it might be extracted. What about the option of having root canal treatment? Is he trying to escape to sort me out properly or what? A painful tooth is extremely frustrating. I’m looking forward to any advice. Thanks again.

Hi Tom,
My partner has been diagnosed with irreversible pulpitis. The dentist recommends extracting the tooth, something about 2 roots being dead. Are there other options?
Thanks

Hi, great info here!. My problem is that I had a filling replaced for a white one about a month ago. Its a very deep filling ive been told. For the first weeks my tooth hurt with hot foods and drinks. The pain didnt kick in right away but after 30 seconds or so. Then the pain would become less in about 2 minutes. With cold drinks the pain was felt instantly. Now after a few weeks the pain with hot drinks is getting less and less. i feel some mild pain after a minute after the very hot drink. Its the same proces with cold drinks. I still feel that my tooth is very senstive but its not like the pain before. its more of a dull ache for a few minutes. Also sometimes with eating hard food i feel a but of a discomfort. is it geting better or is the nerve just dying?

My big dillemma is whether it needs a rootcanal treatment or wait till it stops hurting. Also because i will go on a big holiday in about two weeks. So shall i have it treated before boarding a flight?

Hi, Tom.

I’ve been experiencing some “phantom tooth pain” in the two front bottom molars on my right side for a handful of months now. I had mentioned it to the dentist a couple of times, but he said the x-rays don’t show anything, that “the structure looks good”, and he doesn’t see anything otherwise. He mentioned it could be the natural shifting of teeth, but that didn’t (and still doesn’t) make much sense to me seeing as I only feel the discomfort in these two molars and it’s been pretty persistent. He said that if it still bothers me, I should come in so he can “do something about it”, but I don’t want him to do anything unnecessary. Also, because he didn’t seem to know what the problem is, I’m not sure how he can do anything in the first place. It’s not completely debilitating, but it is uncomfortable, annoying, and can occasionally border on painful–still, I do sometimes experience periods of relief where I don’t feel the discomfort for a few days.

I had never experienced this sort of discomfort until after I started seeing the dentist (before last June, I hadn’t been to a dentist in about 6 years. My teeth had never bothered me before then). He refilled three of my teeth, including the first “big” molar next to one of the molars in question. I also got fitted for an occlusal guard to help w/ my grinding (which has been an on/off issue for me).

I honestly can’t remember if I noticed the pain AFTER I started wearing the guard or AFTER I got the filling, though I think it might’ve started after the filling. Could the pain be caused by either of these things? I’ve tried to figure out if any other habits could be contributing to it, but it doesn’t seem likely. I’m at my wits’ end with this. Any suggestions would be great.

Thanks for the website. I’ve used it as a reference a few times now :).

Hi there,

Thanks for all the information you are providing; it’s very helpful!

About three months ago, I had a filling down on a back molar (told it wasn’t very deep). Immediately after the anesthetic wore off, I would feel a sharp pain when biting down (when they were curing, it didn’t feel like the light was in the right place and in fact at some point in the second curing or so, the dentist notified the hygienist that was so, but I was assured that improper curing was not a possibility with the new composite materials). Waited the week-end, and that got better but I would still experience a dull pain when chewing on it. Went back twice and the filling was grinded down/adjusted. Still felt similar pain, plus slight sensitivity to cold. Went back a fourth time and the filling was adjusted again; I was told to give it another month since removing/replacing the filling might only irritate the nerve more.

It’s now been a month since then and although pain on chewing has pretty much gone away, I am still experiencing sensitivity to cold drinks and foods, which has increased this week (usually lingers a bit but I would say no more than 10 seconds). I’m about to make another appointment but wonder what the best course of action would be. Should I give more time for it to settle down since I am worried we may further irritate the nerve and increase the likelihood of causing irreversible pulpitis or is the filling itself causing inflammation and I should have it replaced (hopefully by a temporary filling at first)…?

Your opinion would be greatly appreciated (I would very much like to avoid RCT and crown).

Thanks.

Back in early August, I noticed I had a hole in my tooth (I had previously experienced a feeling as if something had gotten stuck between my teeth that made biting uncomfortable but tolerable, but it went away…) Turns out I had a cavity that almost broke through to the pulp…. Well, the dentist I saw at the walk-in clinic drilled out the cavity, filled it with medication and sent me on my way.

For a week or so, I would get RANDOM pain surging into my tooth for a few seconds and then, suddenly, it was as if the pain never happened…. I have since stopped having such feelings of pain, but the tooth itself is very sensative— like the feeling of a high filling, old sensitive, and don’t get me started on what it feels like when I bite down on something hard (OW!!!!!!)

I saw a dentist again a few weeks ago (Now March) and he did a cold test— He put some freeze spray on a cotton swab, and introduced me to a world of hurt that lingered for nearly a whole minute….. He then dubbed that I had Irreversible Puplpitis…. The issue is— it doesn’t hurt, unless of course I bite down on something hard.

He gave me a round of Penecillan, to which I took the ENTIRE course of, and now my hope is that I can find a way to allow the nerve to become un-inflamed. Any Suggestions?

(PS – I want to leave a root canal or extraction until the last resort, I don’t have the money, or the insurance to go through with one if I can find a herbal, or less extensive or less intrusive way to heal my tooth.)

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Hello Sir, I had my first bought with pupitis. Antibiotics were prescribed but the pain continued. I went back and a root canal was performed. I hadn’t felt better in weeks. It started with a little fleeting pain then eventually it just got worse. I think I had irreversible pupitis. Constant pain with cold/hot and sweets. Took Vicodin and doubled up on aspirins. Nothing helped. I always find more info after all is well. I’m glad I stumbled unto your site. So informatative. You can publish my comment if you wish. : )

Hi Tom,
Thank you for trying to help so many people – it is a laudable endeavor!
Here’s my situation:
I chipped a tooth a few weeks ago, but didn’t do anything with it (in between jobs).
Every few days I would have pain in that area when I would lie down.
Three days ago I started to have that pain much more frequently. The pain is intense & lasts for a couple of minutes, but is instantly relieved by cold water.
Wondering if RCT is the only option, or if there is some hope that it is reversible pulpitis?
Thanks again!

Hello Tom!

Thanks for such a great article, really helped. But I just have a question.

A few days ago I went to the dentist for a filling on my last upper molar because I had a huge cavity and the enamel wore off I think because I could feel the hole. Anyway she said it was quite close to the nerve but managed to fill it and it’s giving me absolutely no problem yet. But what’s bothering me is the tooth next to it. The day after the filling I began to feel it a bit weird. When I bit down it, it gave me a small sharp pain and goes away after a few seconds. So basically every time I chew it hurts to an extent, not unbearable but quite annoying. I took a look at the area within it and it looks a little black, probably needs a cleaning or something. What I’m concerned about it, is the fact that it hadn’t hurt before the previous filling that I received. What I’d like to know is, do you think it could be pulpitis? I know I need to get it checked by the dentist again and I’m going in a few days. But I’m just really freaked out if she mentions root canal or anything because she’s seen the tooth and didn’t say anything about it before, like I need to come in for another filling or anything. Just wanted your opinion.
Thanks so much!

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Hey there, had a filling replaced two weeks ago and it is very very sore when biting, when I floss it aches to one side of newly filled tooth. I have had extream tmj can this cause sensitivity? really struggling to eat or relax the jaw/ cheeks at all, please help. Alice

Hi Dr. Chris,

I am looking for some insight. I have a unique situation that I feel like I am running in circles with and want to know what you think. About 3 months ago I got a filling done with the new white fillings. My first ones. When I got it done the dentist told me it was bigger than normal so it would be sensitive. Well it was sensitive but wasn’t too bad. I could handle it. Well, I had to travel for work via airplane and noticed not on the littler planes but the bigger planes a sharp pain occurs about 10 minutes into the flight. Approximately when you reach the 30,000 mile mark or when the stewardess hand out drinks. So, it was sharp pain running through my mouth worse I have ever felt. Lasted about 30 minutes. Not continuous just like seemed like when pressure changed occur. This happen to my destination and back home on both airplanes. So when I got back I made an appt with my dentist telling him what happen. He took more xrays, didn’t see anything wrong so he went and re did the filling thinking there might have been an air pocket in there. Well, went on another airplane for my honeymoon about 3 weeks later. Still the same pain. Went on 4 airplanes, 2 littler planes which weren’t nearly as high then the two bigger planes. Again the same thing happen where about 10 minutes into flight get sharp pain and lasted about 30 minutes. I immediately called the dentist and told him I want a referral to an endodontic. So once I got back from vacation I made the appt. which was about 3 weeks ago. Went in, the endodontic did a bunch of tests, did xrays and nothing hurt or was wrong. He filed down the filling cause he said it was a little high and also put something on it to help with seal the filling in. Not sure what it was, but said it should help. Well about a few days after I noticed slight throbbing every now and then. Nothing bad, just annoyance it seemed like. Over the past couple weeks as well since I was in the endodontic, I felt more sensitivity to my tooth when drinking hot and cold items. And the throbbing from the hot and cold items lasts minutes. Sometimes quite a few minutes then goes away. I think it is getting slightly worse for I never experienced that much sensitivity before and feel a root canal will be in order. My problem is I have been saying it ever since I had the airplane experience that I would but the dentist and endodontic said they cannot see anything. I am at a loss and just don’t know what to do. What is worse, is I am going scuba diving this upcoming weekend, and Throbbed was told that might be worse because of the pressure changes you go through as well as the cold water. What do I do? I have read an article about pulpitis or something like that http://www.dental-health-advice.com/pulpitis.html this is the website and it is almost exactly like my symptoms and experience I went through. Any help would be greatly appreciated. I already made another appt with the endodontic but want to have another opinion if you have heard this. I wish I would of gotten a root canal when I first experience my airplane ride, because now I am afraid to fly as well as scuba dive. Plus not to mention the sudden slight throbbing of that filled tooth. Please Help!

I have been complaining to my dentist for about a year about pain from 2 molars the dentist just said I had sensitive teeth and to use sensodyne toothpaste.I had a bout of more intense pain last week and the dentist took an x ray and said there was a shadow which could be infection and he could take the tooth out .I was shocked and said I would not book for an extraction but would wait and hope it settled .By friday night I was a lot worse and telephoned Nhs direct advised pain killers.They did not help and when I could no longer eat and had not slept for 3 nights I saw another dentist who said I had pulpitis.

Can you tell me how long it is possible to have pulpitis without the pulp dying and causing intense pain?

One of the teeth is not so sensive now and I am worried the pulp has died and I will have problems later.

My dentist (who refused to see me over the weekend) has not mentioned pulpitis and I am wondering why I seem to have been mis diagnosed.

Could taking the xray have cracked the tooth and made it worse? What is the difference between sensitive teeth and pulpitis ? is there a test so a dentist can make a different diagnosis?

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Hi Tom!
I had two “silver” fillings replaced 8 days ago with composite fillings. Ever since I got the new fillings, my teeth and jaw have been killing me! I have been alternating Tylenol and Advil every three hours and I am still in pain one hour out of three. I went to the dentist 2 days ago and she took x-rays and filed down two high spots on my teeth. She said that the fillings weren’t that close to the nerve, but since I clench my teeth, one of the teeth could have cracked a little bit from the drill causing me pain. She told me to wait for a few more days and call her for a root canal if I am still in this much pain. She prescribed me antibiotics and Tylenol 3. What are your thoughts about this? I don’t want a root canal but I am so tired of this constant ache. Should this clear up on it’s own within a few weeks?
Thank you!

In May I had Irreversible Pulpitis that caused me the most pain any tooth has ever caused me in my life. I got a root canal that did me wonders to treat it all.

My endodontist prescribed me 5mg Hydrocodon with 325mg of Tylenol to relieve the pain during treatment. It worked like a charm.

Now that I am suffering from migraines for the last month my Primary Care specialist is trying to tell me that Hydrocodon won’t treat nerve pain. Is this true?

I aplogize if this off topic. Please at least answer if it relieves nerve pain.

Thank you!

Hi, I had a cavity filling done on saturday, today is Tuesday and all of a sudden, i am having nerve spasm on that tooth, at least that’s how it feels, however, i am not feeling any real pain on that tooth at least today. The spasm come and go, so uncomfortable. I am worried because i might have to get a root canal. Also can one have a root canal without having a crown done?

Hello:

I was diagnosed with irreversible pulpitis two weeks ago. How I came to get it is the mystery. I went to my general dentist for a chipped molar, #15. It didn’t hurt. It was just chipped. I remember the dental assistant asking the doctor about putting in a composite filling. He said no, he wanted an amalgam filling.

While doing the work–after numbing me–he ground away at whatever and I flexed with severe pain even while numbed. Next, he gave me an anesthetic shot in my upper palate–a secondary numbing that enabled him to do the work without me complaining about it.

When he finished, he said I’d probably feel pain for a few weeks, which was true. The trouble, however, was that I never got better. It pained me more and more.

When I returned to ask what might be wrong, he gave me more pain pills and asked me to give it a couple more weeks. Still no relief.

I returned a third time–this time seeing the original dentist’s partner. She tapped on my tooth and quickly declared I needed a root canal.

So here are my questions:

1. Was the amalgam filling the right choice and might I have survived better with a composite filling?

2. When the first injection for numbing didn’t spare me pain while drilling, should this have alerted him to something that he ignored?

3. When I returned because of the unabated pain, should he have removed the filling and done something different, or was it just too late?

4. Is it possible that my initial pain of pulpitis was reversible had different measures been taken?

I’d just like to know if I was unlucky, or had a bad dentist since my chipped tooth has turned into a $1200 root canal, 1000 crown and mega pain.

Hi there,
My dentist told me the pulp is ‘dying’ in my molar. But, if it’s ‘dying’, it’s NOT dead yet, right? I had bad symptoms of pain during sleep, etc, but after taking some antibiotics it has subsided. My origianl problem was a cavity so close to the nerve the dentist said he could actually see my nerve. It just never really stopped hurting. Could this be reversible or will the pain/inflammation eventually return? I’d like to avoid a root canal if at all possible. Have you heard of a tooth coming back to life if not dead yet? Are there any nutritional supplements I could be taking? We are starting raw milk tomorrow (as per advice of the Weston A. Price Foundation) and I plan on introducing cod liver oil shortly.
Thanks!

Hello!

I’m not sure if this is the best place to post this question but… here it goes.

I broke a tooth 7 months ago (bottom molar second from the back [I don’t have wisdom teeth]). There was no pain. My dentist did a filling just to patch it until I was able to have a crown put on. The entire time there was no pain or sensitivity.

A week ago I had my tooth prepped for a crown and had a temporary crow put on. I was a bit sore the next day which I expected with what is involved in the crown prep procedure. 3 days later my jaw began to ache a day after that the ache was also at my tooth. Still no temperature sensitivity. I went to the dentist the next day. An x-ray was done and everything was fine. He tapped on the tooth and there was no pain. He did adjust the bite of the temporary. Since my jaw began to ache I have been taking ibuprofen every 4 hours to stop the aching and hoping the keep any inflammation to a minimum. The bite was adjusted 3 days ago but my jaw still aches.

I guess want I am wondering is, is this pulpitis? Does root inflammation show up on an x-ray? Is this just trauma from the crown prep? Will putting the permanent crown help? How long should it take to calm down the tooth/jaw after adjusting the bite? Could I have developed TMJ from eating on the other side of my mouth?

Argh! Sorry for all of the questions. I am just very confused since my main issue is an VERY achy jaw (the “tooth ache” is minor)

Thank you in advance.

Hi Tom,

I’ve had a throbbing pain in my tooth for the last 2 days- really painful, hard to locate where it was coming from- and looked in my mouth and saw a very small hole at the back of the tooth next to my front tooth, near the gum. The pain is sensitive to stimulants and goes away but then aches and throbs during the day. It isn’t any worse at night.

I’ve got an emergency dentist appointment for tomorrow- would they just be able to put a filling in it, do you think, or do you think it’s a full root canal job? I’m so worried!

I had a filling done and the dentist said it was a deep one. It was fine for the first couple of days but probably mainly because i avoided eating on that tooth. but on the 4th day after the filling I was eating cashew nuts and I felt a sharp pain on that tooth and since then I’ve been having slight pain on it on and off sometimes the pain is more than other times, like it’s sore. it’s not unbearable or anything or giving me problems to sleep. I know pain anywhere in the body signifies that something might be wrong and i’m worried. I felt the sharp pain three times while eating hard or dense food on that teeth, I’ve been avoiding eating on it since then which is like another 4 days. if i do eat on it, it’s softer foods and i don’t apply much pressure on it. Will it subside?
I have another appointment scheduled two days from now for another filling and i will tell her about it but i’m afraid she’ll suggest it requires a root canal and as it’s costly and i don’t have dental insurance.

Hi, I went and saw a new dentist on Feb 12. I had 2 fillings done on #3 and #29. Well the dentist said that the cavities were deep and that I might need root canals. Once he drilled into them he said he got it all out and was able to just do fillings. I was so relieved. But now it’s been almost 4 weeks and I have heat sensitivity to #3. It’s a sharp pain just for a few seconds and once the heat is off it it’s fine again. I saw my regular dentist just recently and he said he would be more worried if it was sensitive to the cold rather than the heat. He said if it’s heat then the pulp is still alive just inflammed. Is that true? I’m reading the opposite online. He looked an X-rays that were taken 2 days after and said it looks fine just thinks I’m having this sensitivity since it was such a deep cavity. What do you think? I’m worried.

Hi Tom, What an amazing site. Here is my story. 5 weeks ago I went to the dentist for a regular check up. I wasn’t experiencing any problems at all. She said I had an old amalgam filling in my lower molar that could do with being replaced as it was nearing the end of it’s life. I agreed to let her replace it. She gave me a big (and very painful) anaesthetic in my jaw joint and another in the gum of the tooth. She started drilling straight away and it hurt. She waited a minute and then started drilling again! I then asked her to stop as I was experiencing nerve pain so she squirted another dose of anaesthetic on to the nerve and started drilling again. It was slightly more numb by now but I could still feel some sensitivity. Afterwards she told me it had been a very deep filling. I went home and 3 hours later while watching TV I got a severe electric shock pain right in the centre of the tooth. It felt like a lightening bolt and lasted about 12 seconds, leaving me screaming and dripping with sweat. It then went as quick as it started. 3 hours later exactly the same thing happened, no trigger at all. I phoned her and she said that the filling was very close to the nerve and it is just irritated and it will settle down. After a couple of days and several sporadic bouts of shock it did seem to settle. I then went on holiday thinking everything was ok. I flew and once the airplane reached about 20,000 feet I got the lightening bolt in the tooth again, lasting for about 5 seconds a time every 10 minutes. I took Ibruprofen which took the edge off but I could feel it sizzling away. Once I landed the pain stopped but I was then left an ache in my other teeth and jaw (injection site) for about 3 days. Then I had 2 weeks pain free and then the same thing happened on the flight home! I went back to the dentist who told me I either need a root canal or I have trigeminal nerve damage. An xray was taken and nothing could be seen. I had heat/cold pressure test etc and only had a very slight reaction to the cold which lasted a few seconds once the stimulus was removed. I can eat drink and chew with no pain. I would be grateful if you could shed any light on what you think may be causing this sporadic sudden electric shock pain. Also are xrays safe? I have had 3 within 5 weeks and am changing my dentist this week and assume they will want to take more. Thanks in advance for any help you can give. Take care. Emma.

Hi Tom,

I’m 37 y/o , and I’ve had quite a few cavities in my lifetime due to poor eating habits as I recently realized. So, after getting a crown due to a cavity, I decided to change my routine teeth care. About 2 month ago, I started to floss and brush my teeth after each meal and before bedtime and no snacking during the day. Everything was fine until a week ago I introduced a mouthwash, so it was floss, mouthwash and brush. A few days later I developed pain in my #14 which has a filling, but never hurt before. I finally noticed that the pain was brought on after using mouthwash. So, I stopped it. A day later, #9 started to hurt which has a veneer. The pain is intermittent, a kind of slight burning sensation, both teeth feel tender when running a tongue over them, but don’t hurt when biting and no severe reaction to cold/hot stimulus. I’m beginning to think that it’s reversible pulputis ( I definitely hope so). The pain in #14 subsided greatly after I removed the irritants – mouthwash and changed toothpaste from peroxide/baking soda to just fluoride kind. However, I’m concerned what this means for both of these teeth. Does this indicate some damage in the teeth that is not visible? My most recent x-rays didn’t show any cavities in these teeth. Any thoughts would be greatly appreciated.

2 weeks ago I had a permanent crown put in. The root remains in tact and have never experienced any problems before the crown or while the temporary crown was in. I notice that when I drink hot beverages or really hot foods, the tooth feels sensitive. It’s not painful, and goes away after consuming the hot food/drink. (It seems to be less of a problem with cold foods/drinks). Is it normal to have mild sensitivity after a permanent crown?? or does this usually signal the need to have a root canal? How long after the crown should I consult a dentist if the sensitivity persists?
Thank you

hi thanks for that information i am dr. ahmed from iraq and i am a dentist i just graduated one month ago
before two month i had a filling that it was deep as my dentist claimed so he put an calcium hydroxide and everything just goes well and at first i had pain with temp stimuli cold & hot and sometimes light pain that will start and last for 10 min or less and sometimes pain during force on the distal side of the lower first molar where the exposure is and then it developed now am having paint during night but at the morning it goes and this is maybe once a week and sometimes a week passes without pain so what do u think my dear colleague ??? should i make and RCT or wait till tertiary dentin forms ??

Hi, I would like to know if I could treat my tooth with an alternative to the root canal. I went to one dentist here, and even though I had never pain, only caries, he assumed that I need a root canal and started drilling exposing the nerve of the tooth, only a small portion. But I decided not to go back to him, and find another way to treat it. I went to another dentist who checked it and said that the other dentist might have already started the root canal and it s too late now. I had some light fever and discomfort the last days after the second check up. I’ m still wondering if anything could be done, and not the root canal. If the pulp is only light my touched are there partial root canals, or removîg the infected area and have just a filling? Thanks!

Hello! So about two weeks ago I bit down really hard on a fruit pit with my front right tooth. I got a painful shock from it. It throbbed for a few days. I went to an Endo and he did the cold test (normal), tap test (normal) and a x-ray that didn’t show any fractures. He said give it a few weeks and see what happens. A week later I went for a 2nd opinion, he did the bite test (normal), blowed cold air (normal) and said to also wait and see. Could of damaged the ligaments he said. So what I’m feeling is hard to describe. It’s a little sensitive to hot or cold but the sensitivity persists for only a few seconds. My teeth have always been a little sensitive tho. Doesn’t hurt to bite down either. It just feels funny. Like a weird tingle where my gum line is above the tooth. I also feel a realy light throb/ache too but not painful, just weird. So any clue to what I have done? Could it be just ligaments? How long will that take to heal? Or is pulpitis slowly developing? Just really concerned b/c it’s my front tooth and I’m not sure how a root canal (if eventually needed) would turn out on my front tooth. Thanks for listening 🙂

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2 months ago I had an exercise bar come down on my teeth causing trauma. One front tooth broken was bonded. Other front tooth displaced was splinted. Tooth next to front tooth chipped and fractured up inside gum was temporarily bonded. After 6 weeks xray taken showed things abscesses free, no darkening of teeth however displaced tooth still feels unstable. Difficulty biting through sandwich etc. Upper lip/ space between mouth and nose, even up into my nostril feels weird yet as well. Dr wants to wait another couple months to take off splint and assessment further for possible root canal etc. I am ok with letting time heal but the nerve pain and sensitivity is so severe with hot/cold stimuli that it worries me. Is the wait and see approach appropriate considering the extent of injury or should a root canal b done sooner than later? Thank u for ur time

Tom,
I had a filling done on June 6 on my bottom right back molar. Ever since it has given me a lot of pain with chewing, hot & cold, and ESPECIALLY sweets. If I eat something soft that is sweet and it even touches near the tooth, I experience searing pain for about 30 seconds to a minute and then it is slightly achey afterwards for a few minutes. I went to the dentist yesterday and he said it was a high filling and shaved it down some, but it has still been giving me grief. I am going back on Monday for a follow up appointment. I am scared of getting a root canal! I never experienced any pain before he did the filling!

Thank you,
Ashley

My tooth that had to get a filling in it a few years back has had the filling slowly being eroded away, the first day I was running my tongue along it and it felt gritty, which I’m assuming was a temporary filling (although I wasn’t told), since then I’ve been careful about brushing my teeth regularly. Now that the filling is gone, I can feel the rest of the filling going away and a small hole where they drilled. Is this reversible or irreversible?

My dentist tells me I have irreversible and is recommending a root canal. I’ve been researching the book “cure tooth decay” which promotes the research of Dr. Weston Price. In my diagnosis case, would dietary changes cure the pulpitis? Or is there really no other cure, and extraction or root canal is it? I strongly do not want either one of those, so I am trying to do other things to naturally heal. Just wondering if there is any point if there is no cure.

I recently had three composite fillings done after cavities were diagnosed. Six weeks later, I still have the same symptom as soon after the fillings – severe, constant, throbbing pain, all day every day. This is much worse when running. Over-the-counter painkillers don’t help. I’ve been twice to the dentist. First time they said it might be sensitivity after fillings, they gave a fluoride toothpaste. No change. Second time they did an x-ray and the fillings weren’t deep, and there didn’t appear to be signs of anything wrong. They checked sensitivity to cold and tapped the teeth, which also did not appear conclusive. They then suggested it could be the type of filling, so used an amalgam rather than composite filling. No change, that was two weeks ago. I still have severe, constant, throbbing pain with all three teeth. Please help!

Hi,
A few months ago I had a filling done in a back molar. The cavity was larger under the surface than expected and the dentist said that she went close to the nerve. I have had temperature sensitivity since, and we put a plan in place to extract this tooth and the two wisdom teeth on that side, one which is impacted against the filled tooth. Extraction seemed a good choice because this tooth is in pretty bad shape and likely I will need crowns on several other teeth (thus it seems wise to save my money for those).

That said, this week I woke up with lots of mouth, face, head, and neck pain, concentrated on the side of this filling. I couldn’t sleep for most of the night, even with 4 Advil, and did not go to work the next day. It seemed like the wisdom tooth next to the filled tooth is trying to break through the gum, so I took homeopathic teething medicine. I’m not sure if this helped or not! I did notice that while the pain was on-going, with waves of more severe pain, when I brushed my teeth there was no sensitivity to the tap water, which I had become used to feeling.

Now, after the second night of less pain, I am still feeling the pain but not so bad. BUT, I am now feeling intense pressure-triggered pain. My tooth is sensitive to touch and to the gentle tap of it’s partner tooth on my bottom jaw. Still no temperature sensitivity, which seems like the weirdest change.

I have called my dentist but it is a Saturday and I won’t hear back until Monday at least. It would be great to understand a bit more about what is happening. I would appreciate any thoughts. Thanks.

My dentist just did a lot of drilling to prepare my teeth for a bridge. One of the teeth is quite tender and I mentioned it when I went back to try on the frame work before it was complete. The dentist said she did not believe my teeth needed root canals but after a week of taking ibuprofen every 12 hours to relieve the pain she said I may be heading in that direction. I now take 200 mg. of ibuprofen every 12 hours and that keeps me pain free so it is getting better but its been 12 days. I dont believe she put in any medication under the temporary filling. I really would like to try other options before jumping right to root canal. The bridge was quite costly and wiped out my funds. Thanks Kathy

Hi,
Three years ago I had my second last molar on the bottom left side of my mouth extracted. I never had any more problems in that area until March of this year. Since there is now a big gap between my last molar and the smaller eye tooth that was in front of the removed molar, when I eat food tends to go into that gap area. In March I noticed that when something hot would hit the back of the smaller tooth, I could feel it then a few hours afterwards the tooth would start to ache. It would ache for a few hours up to a day then go away. If I take Tylenol while it is aching it will help the ache. I have been to the dentist twice and I have been told that there is nothing wrong with the tooth. The xrays don’t show anything and they tested the tooth applying cold to it and I didn’t feel it. The dentist told me to start using sensodyne toothpaste as I have gum recession from having the molar removed. If I don’t let anything warmer than my mouth temperature hit the tooth, I can go on for weeks without any problems. I have been using sensodyne since August. A few days ago I was eating something that was warm and it hit that tooth. Sure enough about an hour later the tooth starting aching. I took a Tylenol and the tooth stop aching about an hour or 2 later. What could be wrong with this tooth? The tooth in question has never had a cavity or any work done to it. I just have a feeling that I damaged it by letting hot things hit the wall of the tooth where the big gap in my mouth is. It’s terrible not being able to eat like a normal person and having to constantly make sure nothing hot hits that tooth.

I have intermittent throbbing between my two upper molars. One had a root canal 2 years ago and has a crown. The other has a pretty old filing. I can’t tell which tooth is the problem. It doesn’t bother me at all during the day but at night the gum swells a bit around the back of the tooth with the filling and between them, and throbs. I’ve been dosing ibuprofen and that has reduced the swelling and pain but I still can feel it sometimes. And I don’t want to continue to take ibuprofen daily. During the day the swelling is completely gone. Occasionally, during the day, when I’m exercising it will throb for a couple seconds. My dental insurance doesn’t start for a couple months. Any suggestions?

A couple weeks ago my molar started to hurt slighty. Its been filled 16 years ago and often have me slight pain but always got better. This pain has become agonizing, I went to the dentist and the xray seems to show the tooth is ok. The pulp is a little close to the filing but other than that there’s no clear sign of infection and no damage to the filling. I have cold sensitivity, no heat sensitivity, didn’t have pressure sensitivity until today. It’s a constant ache and im taking ibuprofen for it. The dentist said I may need a root canal but I can’t afford that. Could this be simple irritation? It’s incredibly agonizing

Just had my 2 front teeth filled because of deep groves – worn enamel. My gums above the teeth and behind are very painful and one tooth the left one is extremely painful the dentist grinded some of the filling away to see if that helps but it hasn’t my teeth really hurt it was done a week ago. What could this mean? my teeth didn’t hurt before, I just had this done because I didn’t like the look of the worn enamel. What should I do?

A few weeks ago I had a bottom left molar start to feel like it had a little pressure under it and it would noticeably touch my upper molar before the rest of my teeth seated as normal. I had a root canal done on this particular molar YEARS ago. This wasn’t something new as from time to time (maybe 1x a year) I’d feel this but the “inflammation” would normally last only a day or two, But NOT this time though!… over the course of a week my gums around this molar were inflamed and the pressure/pain became massive beyond belief! I endured this 2 weeks..(lol yes, I know!) I took 500 mg of amoxicillon 3x’s a day for 10 days (and ibuprofen for inflammation) and presto!!!..All returned to normal..or SO I thought..It’s been a few weeks now and I am starting to experience that molar feeling like it is beginning to “rise” a little again and just a little bit tender. My prognosis isn’t good is it? I thought that since this had been a root canal, I had no pulp/nerves and that it was just an ordinary inflammation…appears that isn’t sooo…sigh!

Hey, Tom, I’m having a pulpitis, (not sure which) I’ve had the sensitivity long ago (about a month or two) but the pain and throbbing started a few days ago, I can’t see a dentist for at least a week. I suspect the cause is trauma on my lower left incisor. according to your opinion, would you say it is reversible or irreversible?, if it is reversible, how would I heal it? would time do it? cause again, i don’t have a cavity on my lower left incisor and is probably due to trauma. I’m 17 years old if you need to know. thanks.

I do not know how to put my question, but I am afraid my new dentist will be pulling a good tooth from an xray show dark or something at root while an xray was taken 5 yrs ago biy another dr. that says it has not changed since then. I am on meds and could be serious. It is nice to have you online.Joy

Hi,
I had my teeth cleaned at a new dentists office in May. Since that visit, I’ve had intermittent gum pain in the back top teeth. I saw the dentist in June and then again July and told them symptoms, they xrayed my teeth and said there were no problems, it was probably tooth sensitivity. In December I want for my check up. Had 3 cavities filled which was extremely odd. So had the teeth filled. waited to let it settle. Had a bit of pain, biting so the dentist adjusted the bite. But I told him I have pain in the gums still and it goes up my one nose and I get headaches time to time. I’ve had these teeth xrayed over one over and he sees nothing. What could this be? I’ve never had such constant annoying pain in my life. I have been taking naproxin or Ibuprofen at least 3x a week.

I had a filling done on my lower rear molar,this tooth had been filled three times previously!
As soon as the anesthetic wore off all hell broke loose in my mouth!!
I couldnt stop drooling / salavating, not long after my stomach became upset,bad taste in my mouth.
went back dentist and he lowered the filling but it still stayed the same.
checked on xray all ok he said !!
My symtoms got worse with a bad throat, wierd tingling tongue,head aches.
four months on,been to a specialist who xrayed and said my teeth are all in normal tollerances!!
head aches are worse and getting chest pain now!
going to insist my dentist removes my tooth!!

I had many fillings done (7) in a period of 4 weeks. This was right after a root cleaning and wisdom tooth removal. My mouth was going through a lot basically. One of the fillings (first molar, top right) started throbbing about three weeks after the filling which was very deep. This was also the tooth that went through three bite adjustments and frustrated my dentist. I think she shaved it a bit too much as when I clench my teeth don’t seem to meet like before.

Anyway, the throbbing (started 2 days after final bite adjustment) was mild with a dull ache that would last a couple of minutes and reduce intermittently. I am not sensitive to cold or hot and touching, pressing the tooth etc does not hurt. Even chewing is ok, but the throbbing was there off an on. I was also getting radiating pain in nearby teeth, even the lower jaw. Slowly the pain in the jaw started, then there was shooting pain in the ear, just below the neck and in the jaw joint. It was similar to the TMJ pain I experience every time I go through dental treatments, only worse. I went back to the dentist (the one who treated me was on a vacation so another one saw me). She banged the tooth a couple of times with the mirror, touched it with ice and took xrays. Nothing conclusive came out of it. She said filling was fine, tooth was fine and it might be that the pain is coming from the premolar next to it as when she hit that spot between the teeth, I felt a bit painful. But there was no decay or cavity so she gave me a painkiller for three days and told me that everything looks fine. The pain in the ear, jaw and neck was apparently due to the wisdom tooth surgery trauma (horizontally impacted) that happened some 6 weeks back (??)
After three days of painkillers, the tooth feels a tad better. I have not taken any pills today and it hasn’t deteriorated, but I fear it may not last. The throbbing has reduced but it still happens once in a while (unstimulated). The pain in the jaw and ear and continues, but has reduced. The pain still radiates to the nearby teeth intermittently. I am wondering now if the tooth has got better or the nerve has simply died and I am looking at developing an abscess. Or if the entire episode was a flare up of the TMJ as the application of moist heat on the jaw does give me relief. Last thing, I had worked out pretty hard just before the pain episode, so I don’t know if its connected. My dentist is not in town for another week and I don’t want things to take a turn for the worse. I will be grateful if you can give me some advice.

Hi there,
On New Years Eve I took a fall & had a wooden table fall on my face. I ended up with 14 stitches in my lower lip & my front teeth had splits in the gums above them where they were nearly knocked out. Less than two days after the accident I went in to see a dentist because I was in pain and when he did the cold test, I felt it on my left front tooth but not the right one. He immediately said I needed a root canal and the soonest I was able to schedule it was two weeks out. During those two weeks as my mouth healed, I noticed I was developing the ability to feel cold in the tooth I was told needed a root canal. The X-rays I had done didn’t show fractures although he said they can be hard to see, & I got so much sensation back in my tooth I pushed out the root canal two more weeks. By the time my appointment rolled around again I was able to use my tooth to eat things like soft sandwiches so I canceled the root canal all together. As of today, nearly 3 months after the accident, I can eat mostly anything without a problem but I still have sensitivity. My tooth hasn’t changed color at all, I can push on the back of my tooth with my tongue & not feel any discomfort at all, but if I use my tongue to pull on the front of my tooth it’s slightly painful and I feel my tooth when I talk. It’s sensitive to cold still as well, but I can eat and drink cold items without pain, I just noticeably feel the cold sensation in that tooth. Do you think my tooth with recover? Or does it sound like it’s going to slowly die? My dentist didn’t argue with me when I canceled my root canal but I feel apprehensive about asking his opinion now because he was so quick to jump to the root canal when I failed the cold test so soon after a table knocked me out. I’m only 26, and it’s my front tooth, the very last thing I want is a root canal. My primary care doctor who is obviously not a dentist did tell me that it can take a long time for a tooth to completely recover after an accident like that

It’s a good question, I’d talk about it with the dentist, and if he seems to lean toward a root canal ask a different dentist, get a second opinion. If the pulp dies you might still be able to root canal. If the tooth becomes painful take ibuprofen, it helps with the pain and inflamation. Inflamation could kill the pulp. My pulp died from an inflamed periodontal ligament, and I regret not having ibuprofen which probably would have saved it. Now it’s abscessed and has to be extracted

Back upper left molar has had sensitivity to cold and extreme hot liquid food. Every once in a while get a very dull ache brief. This tooth has a deep filling done 8 months ago and had pain and sensitivity for a few weeks but went away. No dis-colorization of tooth or gum swelling or tenderness

Went to doctor 4/7. She did x-ray. No decay, no infection, no crack visible. Inspected tooth and filling: fine. She tapped and blew air on the tooth, brief low sensitivity. She had me swish with water and hot water and again brief low sensitivity. She put endo ice on and had brief sensitivity. Which is odd because when I drink water out of a fountain or fridge I get a larger reaction. She said I may not need RCT but for now since I don’t have throbbing pain and feel fine besides sensitivity to use a mouse guard, use prevident, take motrin 800mg

After two days of mouth guard, prevident and motrin my tooth feels mostly the same. Maybe a little less sensitivity because the toothpaste. I did try swishing with hot water (saw steam) from the sink and had no sensation, but when I microwaved water (probably the temp of coffee) I felt it. I stopped taking motrin because of the high dosage and because it might be masking my symptoms. An important thing to note is the tooth has major gum recession. I told this to my dentist and asked if it could be an exposed root and she simply said “no”.

a confusing situation. I know what a tooth feels like when RCT is needed since I have had others and it’s really painful or other signs with the gums will show, but I am only really have sensitivity. The hot is ominous but it’s only with extremely hot items like fresh coffee or microwaved water. Basically I have been told by my doctor and others online to just wait and see if more symptoms developed. A stressful diagnoses and a ticking time bomb of a situation