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Molly Maloof, MD

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where am i feeling the pain?

i have 20yr old almagan fillings on tooth #,4 and 5.

when i drink cold beverages, i feel a slight pain coming from either tooth.

or could this be the pain from my tooth #3, which has a crack in it?

not sure.
Poster
  • Male | 36 years old
  • Complaint duration: 5 days

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Featured Answer

2 UpVoted this answer Venssa Knight, DDS Dentist, Park City
Sensitivity to a cold stimulus is a symptom for which there can be numerous causes. In addition, as you have made the reader(s) aware, the area from which the sensation comes is not always readily localized. Receding gums leading to exposed roots can be one cause since enamel seems to act as an insulator against a cold stimulus; clenching or gritting teeth (bruxism) can also lead to sensitivity. Deep decay, deep restorations (fillings), new restorations and some other recent dental treatments can lead to sensitivity,; dying nerves in teeth and cracked teeth are also causes; foreign objects such as fingernails, toothpicks, or food such as a popcorn hull, etc., stuck between teeth or between a tooth and gum can lead to sensitivity as well. Sensitivity that does not go away can indicate irreversible tooth-nerve deterioration, except in those cases where there is root sensitivity as mentioned above. Such slowly-dying teeth can give off pain signals that are difficult to localize. If due to recent dental treatment, the sensitivity will reverse itself if the nerve is healthy.

So, as you said, it could be tooth #3 that is the culprit, and 4 and 5 may be just fine. You dentist can test the teeth to see which tooth it is that is causing the problem and recommend treatment. Sometimes, though, testing may not reveal a single tooth to treat, in which case your dentist will probably recommend waiting for some period of time, usually a few days to a few weeks, and test again. If the nerve of a tooth is deteriorating, it will eventually reveal itself clearly so that treatment can be done on the right tooth to relieve your discomfort.
Glen Hall
100% chance #4 and #5 are also cracked. It is impossible to have a mercury amalgam filling shoved into a tooth, chewed on for 20 years, and not have cracks in it. You should be able to differentiate which tooth or teeth by isolating the cold on each one.
Your dentist can test the teeth to see which tooth it is that is causing the problem and recommend treatment. Your 20 year old silver fillings might be leaking or have recurrent tooth decay. Or you might have gum recession with exposed, sensitive roots.
Your 20 year old silver fillings might be leaking or have recurrent tooth decay. Or you might have gum recession with exposed, sensitive roots. Or it might be tooth #3. See your dentist for a diagnosis BEFORE it becomes a toothache.
If you have crack in #3, it is quite likely that your pain is coming from there. You will need a thorough examination from a dentist to determine the extent of the crack and treatment options.
J. Abe  Smith
A comprehensive evaluation by your dentist, utilizing radiographs (X rays) and clinical examination, is necessary to localize the source of your discomfort. There are many causes for temperature and/or biting discomfort and through proper diagnosis a successful and beneficial plan of action can be made to treat one, or a few of your teeth.
Ronald G. Worth
Amalgam fillings expand and contract with hot and cold and over time they can "crack" your teeth. When your tooth cracks you will often have hot and cold sensitivity. If you have pain in your tooth that does not go away in a few days, you should see a dentist. A crown may be necessary at best or an extraction at worse! Cracks can lead to infection getting into the root of the tooth so the sooner you get diagnosed and treated the better.
This is the time to allow your dentist to evaluate your teeth to determine the problem tooth or teeth! X-rays and thermal testing are some examples of ways to determine locations of tooth pain.
Lawrence Grodin
Yes it can be from any of the above, how do we tell? you ask. Well the answer is isolation. Take a fat straw from like McDonalds, burger king is too skinny. Fill it up with water , pinch it at the end and put it in the freezer, now you have an ice pencil.(Uuuhhh). Take a cork from a wine bottle (plastic won't do , has to be from a small village in France) wedge your jaw open on the left side with it. Not too hard loosie goosie. Roll up a small napkin and place it up above 3-4-5, tuck it under so the teeth are exposed and DRY, isolating them from the cheek. Now with your ice pencil (out of the plastic casing) touch one at a time, with another napkin cover the ones not being tested. At age 36 you might have some cold sensitivity, but the one that makes you jump is the main suspect. You still need radiographs , percussion, palpation, electric pulp test and some tarot cards to complete your diagnosis, but you are on your way my good man.
The sensitivity can be a result of any of those teeth if the dentin (layer beneath enamel) is exposed. Since teeth (more specifically, the pulp where the nerve resides) lack receptors called proprioreceptors to localize position or motion, pain from the dentin-pulp complex tends to be poorly localized. A classic symptom of a cracked tooth is sharp pain when biting. Another symptom is sharp pain when drinking cold fluids. Your dentist should be able to help distinguish between the sources of pain by conducting some tests. Please schedule a visit as soon as possible as the symptoms may worsen if left untreated.

Take care,

Chi H. Bui, DMD, MS www.theorthobee.com