Dead tooth?

[ToothTrouble10]

Hi,
My upper right first molar is heavily filled (had to wait for treatment during lockdown so ended up being worse). It has had periodic flare ups of mild pain since being placed 3 years ago. This has seemed to coincide with having a cold and some sinus pain.

Pain started again about 3 weeks ago, again alongside symptoms of sinus inflammation. GP gave me penicillin, 5 day course, which finished a week ago. It was also sensitive to hot and cold.

I visited my dentist for a general check up prior to starting the antibiotics. He performed a cold test on the tooth which was normal. The pain is intermittent and some days barely there. The sensitivity has reduced.

I am going on holiday in a week and panicked (very nervous patient), so booked a consult with an endodontist for an opinion. Tooth normal on x-ray, no pain on percussion. He didn’t perform any thermal tests. Said tooth would probably be ok, at least for a few weeks/months, but he could put antibiotics inside of it got worse before the holiday. He said it looked suitable for root canal treatment.

Today I’ve had no pain. I’ve just used some ice on the tooth and felt nothing, so I’m guessing it’s dead. My question is, do I go to my own dentist and ask him to put antibiotics in or do I leave it alone and go on holiday?

Had a bad experience a few years ago with an emergency dentist who put medicine into a tooth and I was in agony the next day, ended up with an abscess.

Many thanks if you’ve read this.

 

[Dr M]

If the tooth became necrotic, there is a chance that it can stay like that for a short while. Bacterial accumulation will occur and gradually you will experience symptoms again, due to abscess formation.
If the endodontist advised that it should be fine to leave for a short while, then it should be okay.
Alternatively you can have your dentist or endodontist, perform the initial emergency endo.

 

[ToothTrouble10]

Thank you for responding. Had an appointment yesterday with my regular dentist to plan some cosmetic work. He checked the tooth again. It did respond to cold but only a bit. He wasn’t concerned by this as the tooth is heavily filled.

Is that something you’d expect to find?

Many Thanks .

 

[MattKW]

Thank you for responding. Had an appointment yesterday with my regular dentist to plan some cosmetic work. He checked the tooth again. It did respond to cold but only a bit. He wasn’t concerned by this as the tooth is heavily filled.

Is that something you’d expect to find?

Many Thanks .

If it responds to hot and cold in a similar manner to adjacent teeth, then it is not "dead", and does not need an RCT. From the info you supplied, I don't know why the endodontist wants to start an RCT. Antibiotics don't prevent a tooth from dying, nor do they cure it - they may only relieve pain for a short while in an emergency situation. Your info suggests possibly a leaking filling or a crack in the tooth. Attached is my toothache list I give to students.

 

[ToothTrouble10]

Many thanks

 

[John Morgens]

It sounds like you're experiencing a complex situation with your tooth, and it's important to consult with a dental professional for personalized guidance.
From what you've described, it seems that there might be some uncertainty about the status of your tooth. While the endodontist mentioned that the tooth would probably be okay for a few weeks/months, it's always best to have a clear understanding of the situation before making any decisions.
If your tooth is indeed showing signs of infection or inflammation, your dentist might consider placing antibiotics within the tooth as a precautionary measure. However, since you've had a bad experience in the past with a similar approach, it's perfectly reasonable to be cautious.
Given that you're going on holiday in a week, it might be a good idea to consult with your own dentist again for a thorough evaluation. They can perform any necessary tests (like thermal tests) to assess the tooth's condition and give you specific advice based on your situation.
If the tooth is stable and not causing significant pain, it's possible that you could wait until after your holiday to take any further action. However, this decision should be made in consultation with your dentist, considering your dental history and the current state of the tooth.