Hi, I have been experiencing some weird tooth pain.  It comes as quickly as it goes and does not seem to last long( a few seconds) and has happened three times in the last 2 days.  It is not a throb pain, more a constant pain if that makes sense.  It feels like someone is touching ice cream to my tooth in the whole tooth but 10x worse, and is one of the worst pains I have ever experienced.  I am going to the dentist, I am just curious on your opinions.  Had a cavity filled in the tooth a couple months ago so not too sure why it would hurt all a sudden.  Thanks in advance.

Answer:

Thanks for submitting your question with us.  Now, the main piece of information that will determine the diagnosis of your tooth is:

Is the Pain provoked?

• Does the pain have a trigger point?  For instance, is it painful when you eat hot or cold food or drinks.
• Does the pain occur sporadically and unprovoked?  Does the pain come and goes as it pleases with no trigger point?  For example, the tooth becomes painful randomly throughout the day.
• Does the pain come when you bite down into food?  Or does the pain come when you open your mouth after biting down on food?

You’re probably wondering, why all the questions?  But believe it or not, answers to these simple questions can guide us down the right path to a correct diagnosis.  Let’s examine each answer:

Yes, the pain is provoked by eating cold/hot food or drink.

Then you have reversible pulpitis.  This means that you have slight inflammation of your pulp inside of your tooth.  This is caused by

• Bacteria/decay
• A recent deep filling without a protective base (Deep restorations need a protective layer underneath it to protect the tooth nerve/pulp)
• Recent deep cleaning

Reversible Pulpitis Treatment

Luckily, this can be easily treated by making a slight adjustment to the filling

No, the pain is not provoked by anything and occurs on its own

You may have irreversible pulpitis.  This means the pulp is damaged beyond repair.  This means that bacteria have leaked into your tooth nerve/pulp and are now irritating the tooth and needs to be removed to avoid serious infection.  Some signs of irreversible pulpitis include:

• Spontaneous, unprovoked pain
• On and off pain
• Continuous pain
• Pain lasts even after food/drink/or stimulus is removed
• Lying down or bending over produces pain

Irreversible Pulpitis Treatment

The treatment for irreversible pulpitis is a root canal treatment.

I feel pain when I bite down

Again, this indicates reversible pulpitis and can be treated by adjusting your filling.

I have pain when I open up after biting down

This indicates a fracture of the tooth.

Fractured Tooth Treatment

Treatment for this depends upon the extent of the fracture and can include anything from a new filling, or a root canal, or even an extraction.

For more information on tooth pain, check out our article here.

Also, see below for a descriptive chart of how to diagnose tooth pain.

We hope this helps and good luck,

Save My Smile Team

Hello, I have a tooth on my lower level that … stands taller than the other lower teeth.  This is very obvious…at all times…when I’m talking.  It makes me very self-conscious.  I’m not interested in braces but I am interested in lowering that tooth’s visibility.  Is it possible to file a tooth down shorter?  I am interested so that this tooth can be the same visible height as the other lower teeth.  It would help me to feel more comfortable smiling, talking and just living day to day.  I am a single mother and do not have the funds to do much for myself, which is why I’m looking for a “simple” solution which does not require a huge financial commitment.  Please reply.  I can’t tell you how much this affects my day to day life.

Answer:

Thanks for submitting your question with us.  And we completely understand the huge link between teeth and self-confidence.  First we will explain exactly what’s going on in your mouth, and then we will examine several options for its correction.

Teeth Move Throughout Life

Throughout life, teeth continually grow and move.  For instance, if you have a missing tooth, notice that over time the tooth adjacent to it will slowly drift into that open space.  From what you are describing, it looks like that tooth in the back of your mouth does not have a tooth above it (opposing it) and that is why the tooth continues to erupt, or “grow taller.”  Until there is a tooth, or prosthetic device (partial denture, implant, etc.) placed above it to oppose it, the tooth will continue to erupt.

How to Fix the High Tooth

So, what are some immediate and cost effective options:

• Have the tooth adjusted – To answer your specific question, yes, you can have the tooth filed down.  However, keep in mind the anatomy of a tooth (please see our article here on tooth anatomy for more details).  The dentist can take away tooth structure (in dental terms, adjust the occlusion) so that the tooth can appear more in line with the surrounding teeth.  This is the most cost effective option.  However, there is a drawback.  There is only so much tooth structure that the dentist can take away before encroaching upon the dental pulp.  Once near the pulp, the health of the tooth will be jeopardized.  Also, as stated before, the tooth in question will continue to gradually grow taller if there is not a tooth opposing it.
• Have a crown placed on the tooth – This option involves a little more money.  But with this option, the dentist will reduce the tooth so that it is aligned with the surrounding teeth, and then place a crown over the tooth so that the tooth will no longer continue to erupt.

Several other options include extraction and replacement with an implant, or extraction and replacement with a cantilever bridge, or even extraction and partial denture.

The best treatment really depends on how much the tooth has erupted.

We hope this advice helps and good luck,

Save My Smile Team.