What is wrong with this tooth?

[Dental Fear Not]

Hi all.

I've got mad pain right now, but it's near-11pm here in Germany so can't see a dentist until tomorrow. Here's a little background:

- I use 3% hydrogen-peroxide (mixed 50/50 with water) whenever toothpain comes, worked fine for many years.
- i have vices like cola, ice-cream & crunchy-müsli...not insane amounts but regular enough.
- I brush normally, but have never flossed.
- a few weeks ago a bit broke off a top-row tooth, but as there was no pain i've been putting off going to the dentist about it.
- today out of nowhere mad bad pain like i've never experienced before concentrated in the area of the half-broken tooth: sharp twangs going right up to the side of the head.
- probably overdosed a little on the 3% hydrogen-peroxide, used it 5-6 times...each time gets very foamy but the last two times the pain even got worse...which is new! normally toothpain subsides after use.
- taken 2x400mg Ibuprofen plus placed an ice pack on my cheek to at least mask the pain somewhat.
- took a couple of pictures of the culprit tooth...i'm no expert but it looks like the enamel is almost completely gone, the dentin is hugely exposed.


Attached are two pics from different angles (please forgive the saliva!)...can any of yous tell what the sharp pain might be caused by and if it's a good idea to try continue with the hydrogen-peroxide until the foam-effect calms down (i.e. until it's killed off most of the infection...if there is an infection).

I'd just like to understand better what's happening, as I'm a privately-insured patient paying only bare-minimum rates which means however much the dentist will charge I'll have to fully-pay myself, no chance to get any of it back from the insurance...I'm expecting costs of over a grand so the better I understand myself what's happening and what I need, the more I can politely decline unnecessary costly treatments...tho' i suspect the whole tooth might have to be removed...

thanks!

 

[Busybee]

I'm not a dentist but I reckon you need a crown and maybe a root canal. But you definitely need to see a dentist, give up the coke and muesli while this is being treated. Stop using hydrogen peroxide. It cannot be good for the soft tissues in your mouth. Try to see a dentist who will do good quality work. Maybe the dentists will disagree but that filling looks like a diy job.

 

[Dental Fear Not]

I'm not a dentist but I reckon you need a crown and maybe a root canal. But you definitely need to see a dentist, give up the coke and muesli while this is being treated. Stop using hydrogen peroxide. It cannot be good for the soft tissues in your mouth. Try to see a dentist who will do good quality work. Maybe the dentists will disagree but that filling looks like a diy job.

Thanks for the good advice, I will do so. So that's filling in the 2nd pic? If so, I paid €1100 for that back in 2012 at a posh dentist's clinic in central Berlin (the last time I was at the dentist!) - suffice to say I'll be going to a different one tomorrow, but there's no way of knowing if a dentist will do good quality work. I suppose there's Google Reviews but I don't much trust them much either. I also don't quite understand what's going on in the first pic, the broken outer-shell looks really worn-out & translucent when compared with the other teeth.

 

[Busybee]

Perhaps the peroxide has damaged the enamel. You cannot treat a dental infection with peroxide.

 

[MattKW]

Your composite filling is failing. At a minimum you need to have it replaced. Personally, I'd aim for a pin-retained amalgam followed soon by a crown. If the damage is not too bad you will avoid a root canal therapy. But the degree of pain you're experiencing is not good, and an RCT is more likely than not.The peroxide doesn't do any harm, but it doesn't do any good either, just a waste of time. Viel Glück!

 

[Dental Fear Not]

Your composite filling is failing. At a minimum you need to have it replaced. Personally, I'd aim for a pin-retained amalgam followed soon by a crown. If the damage is not too bad you will avoid a root canal therapy. But the degree of pain you're experiencing is not good, and an RCT is more likely than not.The peroxide doesn't do any harm, but it doesn't do any good either, just a waste of time. Viel Glück!

Thanks for the feedback, Matt. I got an appointment for tomorrow morning, couldn't get one any earlier. At least the pain, while constant, is dulled with Ibuprofen, and those sharp attacks are only intermittent. I wonder if taking the bad tooth out, root-canal treatment and whatnot might ease the constant head-pressure (like permanently wearing a motorcycle helmet) i've had for many years? It sure feels like the tooth should be pulled out. If it eases this head-pressure it will be a priceless effect, tho' i've got a feeling it may be caused not by one bad tooth, but by my constant teeth-grinding...i even do it during the day without noticing. I'll probably be prescribed one of those plastic teeth-gums, already tried them 6 years ago and they just felt horrible in the mouth...but maybe i should've stuck with it.

A question on the peroxide, if i may: i understood it that when it foams it means an infection is present and it's killing it. In the past a second peroxide-wash would for example only produce minimal foam, so i knew the first wash had effectively solved the problem, and felt it so as any pain would slowly ebb away. This time however there's always foam and the last couple of times last night it even produced more pain. I'd just like to better understand what's going on there.

 

[Busybee]

There was an EU directive in 2012 (2011/84/EU) which restricted the EU use of hydrogen peroxide in consumer dental products to 0.1% as the safety threshold. 0.1 to 0.6% is deemed as safe when supervised by a dental practitioner. Concentrations over this amount have been scientifically determined to be a risk to oral health. I'd suggest you do some research on the studies underpinning this legislation before continuing to self medicate in this way.

 

[Dental Fear Not]

There was an EU directive in 2012 (2011/84/EU) which restricted the EU use of hydrogen peroxide in consumer dental products to 0.1% as the safety threshold. 0.1 to 0.6% is deemed as safe when supervised by a dental practitioner. Concentrations over this amount have been scientifically determined to be a risk to oral health. I'd suggest you do some research on the studies underpinning this legislation before continuing to self medicate in this way.

oh i stopped using it already last night, haven't used it since first posting here, heeding your good advice. That directive you link is interesting as 3% hydrogen peroxide is cheaply available to buy in 1L bottles without prescription in any mainstream chemist. If that directive is from 2011 I wonder why they haven't restricted sales.

 

[Busybee]

These days its sale is restricted in the UK. I am sure you can find shops that sell it but it's not too readily available.

When are you seeing your dentist?

 

[MattKW]

[QUOTE="...A question on the peroxide, if i may: i understood it that when it foams it means an infection is present and it's killing it. In the past a second peroxide-wash would for example only produce minimal foam, so i knew the first wash had effectively solved the problem, and felt it so as any pain would slowly ebb away. This time however there's always foam and the last couple of times last night it even produced more pain. I'd just like to better understand what's going on there.[/QUOTE]
Bubbling peroxide doesn't necessarily mean that there's infection present, it only means that an enzyme, catalase is present, and this allows breakdown of the peroxide to release oxygen. Almost every living tissue contains catalase, so it could be a reaction to blood and tissue cells, just as much as it could be a reaction to bacteria. Hydrogen peroxide possesses a non-discriminating ability to kill, so it's not recommended to use on open wounds, including the mouth. It kills healthy cells, and damages platelets and connective tissues, and as a result can severely inhibit the body's ability to repair itself.

 

[Dental Fear Not]

These days its sale is restricted in the UK. I am sure you can find shops that sell it but it's not too readily available.

When are you seeing your dentist?

I got the appointment for tomorrow at 10am. I'll report back when I'm done

 

[Dental Fear Not]

Bubbling peroxide doesn't necessarily mean that there's infection present, it only means that an enzyme, catalase is present, and this allows breakdown of the peroxide to release oxygen. Almost every living tissue contains catalase, so it could be a reaction to blood and tissue cells, just as much as it could be a reaction to bacteria. Hydrogen peroxide possesses a non-discriminating ability to kill, so it's not recommended to use on open wounds, including the mouth. It kills healthy cells, and damages platelets and connective tissues, and as a result can severely inhibit the body's ability to repair itself.

aah that makes sense! cheers, very useful to know, especially the non-discriminating aspect...almost certainly i have open wounds along that bad tooth, so the peroxide was likely not doing much good killing stuff around there. i haven't used it since making the first post in this thread, so all good for now. I'll report back to the thread after I visit a local dentist tomorrow morning. I'm tempted to have the whole thing taken out, root 'n all, as i have a feeling it's contributing to my head-pressure (that and bruxism admittedly too). it just feels like it doesn't belong (not very scientific, i know).

 

[Busybee]

If it feels like it doesn't belong then there is a strong chance the nerve has died. I hope that's not the case but just the way you describe it makes me think it may be. Best of luck with the dentist and look forward to receiving an update!