May
Dr. Copeland,
Should one of my mom’s anchor teeth hurt three weeks after her bridge was completed? The doctor shaved down some tooth to help, but it didn’t do any good. Please let me know what you think.
Thank you so much!
-Jane
Hi Jane,
If the tooth is just uncomfortable to biting or chewing it may be that only the periodontal ligament is bothered. This type of pain is usually relieved by adjusting the bite, and the patient can tell me just where it needs adjusting. Comfort is immediate.
However, pulps of teeth are often affected by procedures. It is called pulpitis and feels like it is coming from the “center” of the tooth. The question is whether the pulpitis is reversible or irreversible.
If reversible, the discomfort diminishes with time and may be bothered by stimulus such as hot or cold, but it will go away when the stimulus is removed. Irreversible pulpitis on the other hand is hallmarked by spontaneous/no rhyme or reason deep pain which lingers and may get worse when lying down. It will get progressively worse despite periods of acquiescence. Irreversible pulpitis indicates that the tooth is dying and treatments such as root canal therapy (to pull the nerve/blood supply to make it stop hurting) or removal are indicated.
The dentist can either test the pulp himself or refer your mother to an endodontist. I am more and more of the opinion that implants are a cleaner and more reliable therapy than root canal therapy in the long run. If Endo is chosen however, it should be done with a specialist using CBCT scan and microscopy.
In the root canal scenario, the bridge is usually retained. In the removal scenario the bridge may be sectioned behind the front “crown” and the remaining area treated as necessary.
My best,
Dr. Cynthia Copeland