Does my tooth need extracting?

Q. I have 1 (single) crown in my mouth #3 tooth. It is all porcelain. I have no metal fillings…. A 5 year old crown was removed and replaced 7 months ago because it was itching and aching dentist said maybe it was an allergy to the metal under the porcelain so we would replace it will all porcelain. Since the procedure I have been in pain. Loud crack was heard upon removal of crown. Dentist said it broke down too far but there was nothing we could do about it. Tissue was red and inflamed upon removal of crown. Burned and ached when tempory was placed. Endodontist said that it looked like the tooth could be re-absorbing (sp?). Have had a sting in the distal part of the tooth for 7 months. Was told that the distal root was sensitive and bleeding and needed a retreat root canal. Endodontist said the distal root had a black ring in the gutta percha used to fill canal. This was removed and replaced and I was told that the bacteria was causing the sting. Topical on tissue takes away the burning sensation for a short period of time. Oral Medicine doctors did allergy test to see if the sting was actually being caused by an allergy. Test proved negative. Oral Medicine said maybe a piece of cement was in the distal part of gum because the tissue bled when the explore was used. Periodontist evaluated tooth and the tissue around the tooth and the tissue had 4-5 pockets around the crown (All other tissue is healthy 2’s) Periodontist completed a crown lengthening because the tooth was broke down too far and had improper margins. Hurts to bite down on anything hard or crunchy. Tooth is sore to touch with tongue. Tooth aches and or stings in the distal part of tooth CONSTANTLY.(Sometimes I will have referred pain on the tissue next to #3) But mostly it is concentrated around only this tooth. Oral Medicine doctor said maybe it is Neuralgia but never did any diagnostic tests. Dr. put me on Gabapentin that did NOTHING for the pain instead just made me feel drugged. After 2 weeks I was still in pain and my friend had me make an appointment with a neurosurgeon. After reviewing my case he did not believe I have TN…I asked and was instructed on how to wean myself off of the Gabapentin. I visited my GP doctor last week. She contacted my neurosurgeon through email as she is also a U.W provider. He did not think he could help me. And I surely do not want to take up his time with unnecessary appointments. I am praying I can get your blessing and know that it is O.K. based on my history and symptoms to assume this is in fact is a tooth issue. I do not want to spend my time in any more pain just because another specialist wants to make a heroic effort to save a tooth that in reality is not going to get better…. In a nut shell…. Pain is the same as it has been during the 7 months…Constant sting/ ache. I do not have any triggers such as wind, cold, and eating on the opposite side of the mouth is completely comfortable even therapedic. It is just the left side #3 crowned tooth that is uncomfortable to chew on. A sharp pain is caused when I bite down and then slowly subsides. I have an appointment with an oral surgeon to evaluate the tooth for extraction tomorrow. This pain has had a very negative effect on my overall health. I have not wanted to exercise in 7 months because of the tooth hurting, yet eating is not a problem (on the opposite side) so I have gained 25 pounds. My blood pressure in October prior to the tooth’s pain was 117/76 it is now 159/90. Is it safe to say this is a tooth issue? I am allergic to iodine and would prefer to not chance a test that could pose a risk if this is truly just a tooth that needs to be extracted…Please advise…. Your thoughts are very much appreciated!!!! Thank you so much!
A. You may have a crack in the tooth that extends through the tooth. If this is the case the best option is often to have the tooth removed and have it replaced with a bridge or implant
Dr Julian Caplan – Director on the board of the BACD View My Profile Dr Caplan

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