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Dental and Oral Health (Adults)

Infection, pain, & swelling in roof of mouth

01/09/2009

Question:

I had dental fillings done by my dentist a month or so ago. I had some discomfort since that procedure and in the last couple of weeks I started getting swelling and pain in the roof of my mouth just behind my front teeth. I thought I bit the roof of my mouth during my sleep or something but the pain & swelling got so bad I couldn`t eat or sleep so I knew something else was up. Then a couple of days ago I found & pulled out a piece of cord that was imbedded in the gums in between my front teeth. I realized it was the cord the dentist used when filling my teeth a month ago! That`s when I decided to go see my dentist. She said my mouth is infected and that it appears the nerve in tooth #8 may be dying. She referred me to a specialist. He said that the X-Ray shows it appears to be a nacrotic tooth but when he touches the tooth with a cold swab it sends a really cold zing through my tooth. What does that mean? And how could my tooth have gone bad after it was just looked at and filled by my dentist?

Answer:

It is possible that the decay that the dentist removed and replaced with a filling was very near the pulp or nerve tissue in the tooth. In some cases, the pulp is necrotic but not symptomatic as the infection is draining through the decay. When the decay is removed and the tooth sealed up with the new filling, the infection has no place to drain. Thus it drains through the apex of the root, which causes swelling and pain in that area.

It is possible that the dentist said that this was a deep or big cavity. What that means is that it was near the pulp. Once a pulp becomes necrotic, the tooth must either have a root canal treatment performed or the tooth will need to be extracted. It is common when removing decay to not know if the pulp has been affected by the decay to the point that it is necrotic unless, as you are removing the decay, you expose the pulp. In that case, you would know that the pulp has been adversely affected because the decay has reached the pulp. It sounds as if the decay had affected the pulp, but you did not have a pulpal exposure.

I hope this has helped you understand why your tooth could hurt after the filling.

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Response by:

D Stanley Sharples, DDS
Clinical Assistant Professor of Primary Care Dentistry
College of Dentistry
The Ohio State University