I recently had to visit my dentist because one of my teeth was really giving me problems. It is a molar with a really big filling and in the last week it is all of a sudden really super sensitive to hot and cold, and even air. When I went in to see my dentist, he barely asked me at all about the problem, just blew some air on the tooth from different angles and asking what hurt. Then he put some desensitizing gel on it (I only know because I asked him what it was, or he would not have told me) and said if the pain lingered he would have to take out my tooth’s nerve. How could he possibly know that with a couple puffs of air?
I have braces on right now. Do you suppose that has anything to do with this? I’ve heard that braces can make your teeth sensitive. Or maybe that filling is loose or something. My doctor didn’t talk at all about what might have caused this, or if the problem is going to just go away on its own or what. He did not schedule me to have the nerve removed, though. Can you help me figure out what might be happening?
Carlie in Vicksburg, MI
Pain issues are sometimes very murky to diagnose, and sometimes very clear. The clinical presentation you describe sounds like a clearly diagnosed case.
If a tooth hurts when you blow air on it, that generally indicates that there is an protected, sensitive spot on the tooth. If you then put desensitizing gel on the spot and the pain goes away, that would indicate that the situation could potentially resolve without treatment. Transient pain indicates that the pulp (nerve) of the tooth is irritated, but possibly not critically.
If the pain lingers for more than a few seconds after application of the gel, the irritation of the nerve cannot heal on its own, and a root canal treatment is necessary. This is likely what your dentist was talking about when he said he would have to “take out the nerve”. In other cases, your dentist could test with cold, heat or even with electrical impulses to diagnose the source of the pain and extent of the problem.
It is possible that this problem arose from an issue with your braces, but pretty unlikely given what you have described. Your guess that something is wrong with the filling is a lot more likely–perhaps some leaking around it, or decay underneath. You may need to have the filling replaced with a composite white filling.
You have a lot of questions that really should have been answered by your dentist, and that seems to be the real crux of the issue. Great dental care requires trust and open communication, and that does not sound like the relationship you have with your dentist. This may be the dentist your parents chose for you, the only one you’ve ever seen, but that does not mean that you can’t ask for more information. If you don’t get all your questions answered, consider finding a new dentist.
For more information about a related issue, see our link about gum disease.