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Old 24.08.2013, 20:27
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Any dentists on here? Need advice!

I had my first filling at the beginning of June when I was back in the UK. It was quite deep in my lower right 6 (I think), he said it was almost too deep to do a composite filling but he managed it. I have been suffering pain ever since (2 months), which is annoying as I had no pain when I went in. It is not a constant pain, but maybe once or twice a day for an hour, a dull ache on the whole lower right side of my jaw.

Is this normal? I don't want to go to a Swiss dentist as I've had bad experiences in the past, but nor do I want to fly over to the UK if there is nothing wrong.
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Old 24.08.2013, 20:31
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Re: Any dentists on here? Need advice!

Although I like the idea of inflicting pain on others, I couldn't work with my hands in other people's mouths ........ so I'm not a dentist, but it does sound a bit like (expensive) root treatment may be required.
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Old 24.08.2013, 20:43
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Re: Any dentists on here? Need advice!

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Although I like the idea of inflicting pain on others, I couldn't work with my hands in other people's mouths ........ so I'm not a dentist, but it does sound a bit like (expensive) root treatment may be required.
I hope not part of me things it's a nerve problem and part of me thinks it is just in my head. I'm a bit of a worrier and my pain often disappears when i'm assured my a dentist/doctor that there is nothing wrong (that makes me sound nuts). However if I go to a Swiss dentist I suspect they'd take my money regardless.
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Old 24.08.2013, 21:15
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Re: Any dentists on here? Need advice!

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Is this normal? I don't want to go to a Swiss dentist as I've had bad experiences in the past, but nor do I want to fly over to the UK if there is nothing wrong.
Sorry, I am a Swiss dentist and oral surgeon, so you probably won't take me seriously anway. What you describe can be a sign of normal, albeit slow healing of the nerve of the tooth, which most likely was the main concern of your dentist. Such a healing process can take many months, with sporadic bouts of sharp or dull pain in the tooth or in the whole area around it.

On the other hand, it can also mean that the nerve is about to lose its fight for survival. The problem is, a clear diagnosis is not possible without affecting the nerve even more. An x-ray picture can only be used to tell if the nerve is already dead and has caused an infected area around the root tip(s), which is rather unlikely according to the symptons you descrided. An assessment of all other causes of your pain is next to impossible.

There are two kinds of ways dentists deal with such a problem: One camp says let's wait and see. If the symptoms abate, all the better; if they get worse, we can still do a root canal therapy. The other side says, to be on the safe side, we'll do the root canal thing anyway, with the risk of killing a nerve that was on the mend, but hey, it could have been dying, and the root canal is better for our business than just waiting and not earning any money in the end.

It's up to you whom you want to trust.
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Old 24.08.2013, 21:25
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Re: Any dentists on here? Need advice!

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Sorry, I am a Swiss dentist and oral surgeon, so you probably won't take me seriously anway. What you describe can be a sign of normal, albeit slow healing of the nerve of the tooth, which most likely was the main concern of your dentist. Such a healing process can take many months, with sporadic bouts of sharp or dull pain in the tooth or in the whole area around it.

On the other hand, it can also mean that the nerve is about to lose its fight for survival. The problem is, a clear diagnosis is not possible without affecting the nerve even more. An x-ray picture can only be used to tell if the nerve is already dead and has caused an infected area around the root tip(s), which is rather unlikely according to the symptons you descrided. An assessment of all other causes of your pain is next to impossible.

There are two kinds of ways dentists deal with such a problem: One camp says let's wait and see. If the symptoms abate, all the better; if they get worse, we can still do a root canal therapy. The other side says, to be on the safe side, we'll do the root canal thing anyway, with the risk of killing a nerve that was on the mend, but hey, it could have been dying, and the root canal is better for our business than just waiting and not earning any money in the end.

It's up to you whom you want to trust.
Thanks for that, very informative. I'm sure not all Swiss dentists are terrible, but I went to one in Zurich and was told I needed 2 fillings. I went to my UK dentist as I was heading back for a couple of weeks and was told there was no decay and that it was flaws in the enamel that had been there since the tooth came through I'd have had 2 fillings for nothing. I've been a bit wary since then.

I'd be in the wait and see camp I think. See if it improves, fingers crossed. If not, nothing lost, root canal anyway. Thank you for your help!
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Old 24.08.2013, 22:00
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Re: Any dentists on here? Need advice!

I had a hole in my tooth (which I later had done back home in the UK). But for months (nearly a year) until I could manage to have it sorted out I had on-and-off pain.

I used Sensodyne Repair and Protect toothpaste which gradually made the pain go away (except when it was at it's most serious, but hey, come on, there's a big hole there, nothing works then ). It comes in a normal and whitening format. Either that or it was the psuedo effect.

It's also available in France as Sensodyne Répare et Protégé and in Italy as Sensodyne Ripara e Proteggi. I don't know if it's available in Switzerland unfortunately. But if you can find some or make a trip for some, maybe it will numb the pain a bit for you for now?
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Old 24.08.2013, 22:07
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Re: Any dentists on here? Need advice!

I actually use Sensodyne already, as I have super sensitive teeth. It probably won't have much effect in this case as the hole is filled now. I find an NSAID such as Neurofen works pretty well. It's just a dull pain, but it's getting a bit annoying after 2 months.
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Old 25.08.2013, 00:22
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Re: Any dentists on here? Need advice!

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Thanks for that, very informative. I'm sure not all Swiss dentists are terrible, but I went to one in Zurich and was told I needed 2 fillings. I went to my UK dentist as I was heading back for a couple of weeks and was told there was no decay and that it was flaws in the enamel that had been there since the tooth came through I'd have had 2 fillings for nothing. I've been a bit wary since then.
Also here, there are two camps of dentists, and it depends mainly on the university. There are those dentists like me who make a remark in the patient's record that makes clear that the dot was detected and probably should checked again later, and there are those who where told that every dark spot is caries that must be removed and filled. And if it wasn't caries, after removal it must get filled anyway, makes xxx.xx CHF / USD / GBP please. Since the spot got removed anyway, no one can ever prove it wasn't caries. Very practical for the dentist, but very often it is not their fault. It's the dental schools, whose opinions vary widely.

There are kind of religious wars between schools. Medicine, including dental medicine, is far from being an exact science.

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I actually use Sensodyne already, as I have super sensitive teeth. It probably won't have much effect in this case as the hole is filled now. I find an NSAID such as Neurofen works pretty well. It's just a dull pain, but it's getting a bit annoying after 2 months.
Sensodyne and similar products are meant to desensitize the dentin, mainly at the exposed root parts next to the gums. Cervical hypersensitivity is characterized by immediate reaction to hot, cold, sweet, sour and mechanical irritation (tooth brush, fingernail etc.). That's not your current problem.

Does pressure (biting / chewing) during an otherwise painless period trigger pain?
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Old 25.08.2013, 00:28
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Re: Any dentists on here? Need advice!

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Does pressure (biting / chewing) during an otherwise painless period trigger pain?
Sometimes, but not always. I can eat and be fine and other times it triggers the pain. But the pain can also appear without chewing/pressure, there doesnt seem to be a specific link/cause. What sets it off every time though is if I eat weetabix with cold milk.... Agony! I guess it must be the cold milk as the weetabix is very soft.
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Old 25.08.2013, 00:29
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Re: Any dentists on here? Need advice!

I think I want you as my dentist
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Old 25.08.2013, 00:56
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Re: Any dentists on here? Need advice!

Just dug out my treatment plan, showing the culprit. It is LR6.
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Old 25.08.2013, 02:51
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Re: Any dentists on here? Need advice!

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Sometimes, but not always. I can eat and be fine and other times it triggers the pain. But the pain can also appear without chewing/pressure, there doesnt seem to be a specific link/cause. What sets it off every time though is if I eat weetabix with cold milk.... Agony! I guess it must be the cold milk as the weetabix is very soft.
The reaction to cold milk shows that, most likely, the nerve is still alive, which is a good sign. The reaction to cold as well as the pain bouts without chewing also hint at certain problems with the blood circulation of the nerve, which often is the critical factor: Either it eventually recovers or it breaks down. Impossible to say without invasive examination, but since it has survived several months I'd say it's worth a try to keep it.
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Just dug out my treatment plan, showing the culprit. It is LR6.
The filling doesn't look very big, but that kind of graphic doesn't show the depth, which, in such a case, is more critical than the size. The fact your dentist was a bit reluctant to make a composite filling shows that he was fearing the nerve might act up. So far, the nerve has survived. As long as the pain isn't too annoying, I'd wait and give it a chance.
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I think I want you as my dentist
Thanks, but that's not very practical, because, when I'm not in the USA (just came back on Monday) I'm in the opposite corner of Switzerland.
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Old 25.08.2013, 10:05
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Re: Any dentists on here? Need advice!

Wow, I wish he'd explained the a composite filling might cause nerve issues. Much as I didn't want amalgam filling (too vain) it would be preferable to a root canal. He just said it might not be possible, which I assumed meant it wouldn't hold!

Thank you so much for all your help. I'll give it some more time & see what happens!
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Old 25.08.2013, 12:47
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Re: Any dentists on here? Need advice!

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Wow, I wish he'd explained the a composite filling might cause nerve issues. Much as I didn't want amalgam filling (too vain) it would be preferable to a root canal. He just said it might not be possible, which I assumed meant it wouldn't hold!
What I wrote about your dentist's concerns is not 100% bullet-proof. It's just by far the most frequent reason for a dentist to utter concerns in such a context.

And, by the way, besides amalgam having been made sort of politically obsolete by the media in this country already 20 years, most likely it wouldn't have been the right alternative either. When the nerve is at risk, I prefer glass ionomer cement, a fairly tooth-colored material that is much gentler to the nerve than most other filling materials but less durable. It's better to have to cover it with a harder material after a few years (where "few" may mean up to 30!) than having a filling that can withstand abrasion for 450 years but has a dead nerve underneath.

However, replacing the composite filling with glass ionomer would be wrong, because removing the composite filling would strain the nerve much more than leaving it alone.
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Old 19.11.2013, 19:40
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Re: Any dentists on here? Need advice!

Well, there may be something wrong already if you have been suffering for 2 months. Plastic fillings are "time bombs" if they are too big. Sounds like they killed the tooth.

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I had my first filling at the beginning of June when I was back in the UK. It was quite deep in my lower right 6 (I think), he said it was almost too deep to do a composite filling but he managed it. I have been suffering pain ever since (2 months), which is annoying as I had no pain when I went in. It is not a constant pain, but maybe once or twice a day for an hour, a dull ache on the whole lower right side of my jaw.

Is this normal? I don't want to go to a Swiss dentist as I've had bad experiences in the past, but nor do I want to fly over to the UK if there is nothing wrong.
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Old 19.11.2013, 19:47
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Re: Any dentists on here? Need advice!

I am Basel´s English dentist and agree with Greybeard. If the patient attends regularly, one can observe a potentially carious or dying tooth and intervene as indicated. If diet changes, an early caries can actually re-minerlaise. It happened to my own teeth. If diet deteriorates, caries can develop inside 6 months. Some schools used to teach Dr Black's old rules of dentistry: "extension for prevention" Nowadays, with anti-caries fluoride use so widespread, they teach "restriction with conviction" So. Find a dentist you trust and go regularly. Avoid mercury and big plastic fillings.

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Also here, there are two camps of dentists, and it depends mainly on the university. There are those dentists like me who make a remark in the patient's record that makes clear that the dot was detected and probably should checked again later, and there are those who where told that every dark spot is caries that must be removed and filled. And if it wasn't caries, after removal it must get filled anyway, makes xxx.xx CHF / USD / GBP please. Since the spot got removed anyway, no one can ever prove it wasn't caries. Very practical for the dentist, but very often it is not their fault. It's the dental schools, whose opinions vary widely.

There are kind of religious wars between schools. Medicine, including dental medicine, is far from being an exact science.


Sensodyne and similar products are meant to desensitize the dentin, mainly at the exposed root parts next to the gums. Cervical hypersensitivity is characterized by immediate reaction to hot, cold, sweet, sour and mechanical irritation (tooth brush, fingernail etc.). That's not your current problem.

Does pressure (biting / chewing) during an otherwise painless period trigger pain?
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Old 20.11.2013, 13:11
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Re: Any dentists on here? Need advice!

sorry this is so off topic but i have been become very dental conscious these days and the latest trend is the results of research by Dr. price and watson /ramiel. Wholly diet based he claims to heal dental decay and even reverse caries.
any insight on this seems quite impossible but it seems very promising.
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Old 26.11.2013, 00:17
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Re: Any dentists on here? Need advice!

Island Monkey, did your pain go away? Two months (now longer) is a long way to nurse pain. Such pain really isn't normal.
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Old 26.11.2013, 00:37
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Re: Any dentists on here? Need advice!

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sorry this is so off topic but i have been become very dental conscious these days and the latest trend is the results of research by Dr. price and watson /ramiel. Wholly diet based he claims to heal dental decay and even reverse caries.
any insight on this seems quite impossible but it seems very promising.
Caries can be almost entirely controlled by diet (plus, of course, decent hygiene). And yes, minute caries lesions can be repaired by nature. Not quite new though. Actually it has been common knowledge for more than 50 years.

Last edited by Captain Greybeard; 26.11.2013 at 02:50. Reason: Sloppy spelling, as usual.
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Old 26.11.2013, 09:31
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Re: Any dentists on here? Need advice!

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Island Monkey, did your pain go away? Two months (now longer) is a long way to nurse pain. Such pain really isn't normal.
It seems to have improved. I occasionally get some discomfort when biting on hot food, but I haven't had the excruciating jaw pain since Sept.
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