Jeffrey Gross, DDS, FAGD

Q: My Tooth Still Hurts

A: We all know that a tooth hurting is not a good thing. Furthermore, I am the guy who is supposed to take care of the problem and make him feel good. And lastly, I was surprised when he told me that he was still suffering. Let me tell you about this case and why it teaches an important lesson. I saw this patient last week as he suffered from a severe toothache on his upper left side. The tooth in question was a molar. The first molar came into his mouth when he was around six or seven years old. The first molars get their name because they are first in line as you go from front to back. There are two more molars behind this one. The last molar is commonly known as a wisdom tooth.

Since the first molar is in the mouth for so long, it often is one of the first teeth to get a cavity. As time marches on, more cavities can appear, and fillings get bigger and bigger. Large fillings can be a problem. Most often, the fillings start to break down. Food and plaque collect on these teeth, and decay undermines the fillings. As decay goes under the filling and into the tooth, pain begins. It first starts as mild sensitivity and then can progress into a full-blown toothache. The scenario that I just described happened to my patent last week. He experienced severe pain and came to me for relief. We all know the common saying that there is nothing worse than tooth pain. After determining the cause of the pain, we opted for the fastest and easiest treatment. We decided to treat the tooth with a root canal treatment. I can finish the procedure in 30-60 minutes, and the pain is gone. Just as described, the root canal procedure was fast and painless. After the anesthetic wore off, all the pain disappeared. He was happy, and so was I. The relief lasted for a couple of days until he ate a caramel candy. After he finished eating, the pain returned. The pain restart is unusual. Root canal therapy consistently makes the patient feel much better. When I saw him today for a crown procedure on the tooth in question, he told me that he was living on daily pain pills for relief. When I examined the tooth today to determine his source of pain, the cause was evident. His caramel candy fractured the tooth far below the gum line. The broken and jagged tooth ripped into his gum tissue, and pain meds were his only relief. I no longer could crown the tooth. My only treatment choice is tooth removal followed by an implant. The chance of tooth fracture is real with any tooth. The fracture rate magnifies on a tooth that has had a root canal treatment. The walls of the tooth are thin and thus weaker. A fracture’s reality is the prime reason we place a crown after performing root canal therapy.

If you have a tooth in your mouth with a root canal treatment but no crown, please do not wait any longer. Call your dentist or me to schedule an appointment to protect the tooth and guard your health. My number is 440.951.7856. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com