“#2 tooth with deep cavity - why infected after filling?”
About 10 weeks ago, I had the #2 tooth filled due to a deep cavity near the nerve. In the first 2-3 weeks afterward, the tooth was moderately sensitive to chewing/biting and slightly sensitive to hot/cold. In week 3 & 4 after, the bite/chew sensitivity resolved but the hot/cold sensitivity gradually increased until finally in week 8-9, it also resolved. In week 10, I suddenly got a sort of sharp yet diffuse pain on both the upper and lower right side of the jaw - not at all like that of a toothache or filling. Dentist gave an antibiotic (Clindamycin) which seemed to clear it up and now everything is fine - no pain. How could a filled tooth get infected? Is there a chance it will get infected again or is it possible that this is a one-time infection? Since there's no longer pain - could the tooth be dead? With such a deep cavity, would a root canal prevent future infections? I'm considering an extraction. I imagine that the #2 tooth won't affect chewing or cause any other issues? I'm 48 years old, for what that's worth. Any advice or info would be greatly appreciated! Basically I'm trying to figure out if I'm in the clear. I'm concerned about future infections - and don't understand exactly why things got infected in the first place.
Female | 48 years old
Complaint duration: 60 days
13 Answers
DentistDeepcavityfilling
You already answered. Tooth could be dead--need to see x ray, or pulpitis could be reversible, monitor for 6 mo,do again x ray in 6 month,
no need for extraction. If it becomes symptomatic, just do a root canal treatment, can be caries or nerve exposure.
no need for extraction. If it becomes symptomatic, just do a root canal treatment, can be caries or nerve exposure.
This is not an unusual situation, and many teeth with large cavities go through a similar path. Although the pain is gone, it may return, and the tooth nerve may possibly be dead too. Only way to confirm is with vitality testing. A root canal is rarely done preventively, usually reactively to pain. Tooth #2 is an important tooth for chewing, so I would not give up on it so easily. Many deep cavities can lead to further infections, and it is impossible to prevent entirely. It’s like saying “I want to drive a car, but I don’t ever want to get into an accident”. Some things are simply inevitable. However, good oral hygiene and regular professional care improves your odds, just like driving safely. Good luck.
Dr. Cyril Tahtadjian
Dr. Cyril Tahtadjian
After the restoration treatment, if decay was deep near the nerve, nerve react to the treatment. The tooth can be sensitive for 4-7weeks and recover from the filling treatment. Which you may feel normal. However, in some cases, the nerve can suddenly dies and starts to decompose in the nerve chamber. If this happens, the gas is formed the chamber can not be released which may cause swelling and pain. In this case, you will need root canal treatment.
When you have a deep filling sitting close to the nerve, the tooth can respond and get infected anytime. If you took clindamycin and the tooth feels better, that means you most likely need a root canal to remove the infected pulp tissue
The filling is deep meaning it is near the pulp chamber of the tooth (where the nerve and blood supply of the tooth is). What happens in a deep filling is that it can be so close to the pulp that it gets infected from just a few bacteria of the filled cavity. Now one has an infection in the nerve of the tooth -- this is painful and usually a sharp pain as opposed to a sensitive feeling of a cavity. The best treatment is to remove the bad nerve (which is dead or in the process of dying) and SEAL the space in the canal left by the bad nerve with an inert (doesn't react to the body) plastic-like material. This is called a root canal -- saves the tooth. You may have "referred pain" since the nerves connect in the back of the jaw, the upper pain is caused by the lower tooth and visa versa. Antibiotics help, but the SOURCE of the infection (dead nerve inside the canal) has to be removed and sealed as I said before, otherwise it will re-infect. Extraction would mean you would have a big hole and space in the jaw where the tooth was. Not a good choice, I don't think. Sorry, this is a lot of reading, but I can't explain it with less words.
Thank you for asking the question,
Dr. Arthur J. DeAngelo, B.S., DDS
Thank you for asking the question,
Dr. Arthur J. DeAngelo, B.S., DDS
Whenever a tooth is drilled to have a new filling placed or an old filling replaced, the tooth is subjected to trauma. Because a tooth is a live structure with nerve and blood supply the trauma to a tooth can show in forms of sensitivity after a filling. When this happens, the tooth is hypersensitive and letting you know that it is inflamed and this inflammation can result in death of the nerve or the tooth just getting over the inflammation and go back to normal. Based on what you have told me, you may have had an inflammation in the tooth and it has gotten better, I would not do any further treatment with the tooth unless it hurts you further down the road. I would also have x-rays taken of the entire tooth showing the root of the tooth over time to make sure there is not infection at the end of the root. (if a tooth dies, over time, the nerve and blood supply in the tooth rots causing an infection at the end of the root) This can be seen on x-rays and also if you become symptomatic meaning having a toothache in the tooth. For now no further treatment is suggested for the tooth if you are without symptoms.
Any time the decay is close to the nerve, there is a chance that the nerve will deteriorate. The sensitivity to heat was probably a sign that the nerve was dying. Antibiotics mask the infection for a while, they do NOT cure it.
It is possible that the nerve was already infected due to the deep cavity, but there was no clinical exposure and the dentist did the filling. There is a good chance that you would end up needing a root canal, especially the radiating pain to the lower teeth which you were getting is characteristic of a nerve infection. I would keep a watch and consult with your dentist if you have any symptoms.
Thanks.
Thanks.
Cannot give a diagnosis without a radiograph. However, it could be a sinus problem.
Hi there,
from the information that you have provided, yes a tooth with a deep filling can get infected from the nerve in the tooth dying caused by trauma from the filling that was done on it. Keep in mind, a tooth gets traumatized every time it has work done on it, the trauma is greater obviously when its a deep filling. The symptoms you were feeling very well could have been the nerve in the process of dying. I do not know if the pain you felt in week no. 10 was from the tooth or maybe muscle. If it was tooth and if it cracked you would still have again when you are eating or chewing, if not then crack is unlikely. If its muscle, you might still feel tenderness on that side of your face along your cheek. Monitor it for now and if anything changes, go see your dentist to get things re-evaluated. I wouldn't get the tooth extracted just yet.
from the information that you have provided, yes a tooth with a deep filling can get infected from the nerve in the tooth dying caused by trauma from the filling that was done on it. Keep in mind, a tooth gets traumatized every time it has work done on it, the trauma is greater obviously when its a deep filling. The symptoms you were feeling very well could have been the nerve in the process of dying. I do not know if the pain you felt in week no. 10 was from the tooth or maybe muscle. If it was tooth and if it cracked you would still have again when you are eating or chewing, if not then crack is unlikely. If its muscle, you might still feel tenderness on that side of your face along your cheek. Monitor it for now and if anything changes, go see your dentist to get things re-evaluated. I wouldn't get the tooth extracted just yet.
In a deep cavity there are always chances that the cavity and the bacteria have entered the nerve area. If the cavity had been there s long time that is always possible. The dentist is not always able to know if the bacteria have entered the nerve area. Placing the filling sometimes all that is needed but some times that bacteria over time will start to affect the nerve tissue causing infection.
Dr Jensen
Dr Jensen
Dear patient,
It sounds like you were dealing with a bite issue all along. All your symptoms are indicative of a reversible pulpitis. An adjustment to your filling would have alleviated a lot of your distress. It is common for this scenario to happen when back molars are filled because the compression forces are at their strongest toward the back of the mouth. The clindamycin helped the inflammation, but chances are there was never an infection. Your grinding eventually made the necessary adjustments. Please do not extract this tooth, second molars are important!
P.S. X-rays before and after treatment along with a visual exam would be the most accurate way to diagnose your condition.
Sincerely,
Dr. Toumanios
It sounds like you were dealing with a bite issue all along. All your symptoms are indicative of a reversible pulpitis. An adjustment to your filling would have alleviated a lot of your distress. It is common for this scenario to happen when back molars are filled because the compression forces are at their strongest toward the back of the mouth. The clindamycin helped the inflammation, but chances are there was never an infection. Your grinding eventually made the necessary adjustments. Please do not extract this tooth, second molars are important!
P.S. X-rays before and after treatment along with a visual exam would be the most accurate way to diagnose your condition.
Sincerely,
Dr. Toumanios
You may be in the clear or you may not be. It's tough to make a call without X-rays or seeing how deep your dentist filled the tooth. If you got a white filling, then post-operative sensitivity is common after a large cavity. The discomfort may come back just because the filling was so deep near the nerve. I wouldn't worry about the tooth for now and go enjoy life, but if you get pain again in the future, I wouldn't be surprised either because you did get a large filling near the nerve.
