Can a fast diagnosis of a sensitive tooth really be accurate?

February 16, 2010 – 7:24 pm

One of my molars has recently become really sensitive to everything - heat, cold, even air. The tooth has a large filling, so I started to worry that maybe the filling was thinning or something, or had a hole in it. I went to my dentist, and she blew air on it a couple of times, then put some kind of gel on that was to desensitize my tooth, and that did take care of the pain right away. She said if the pain had stayed, she would have to remove the nerve of my tooth, but I want to know how she could know that with a couple puffs of air? My dentist is always in a really big hurry, so I was too nervous to ask her to explain how she knew what was wrong, or if it could be anything else. I guess I am kind of nervous that she did not really figure out what is wrong.

Oliver in Bostwick

Dear Oliver,

Diagnosing the causes of dental pain issues can be a clear cut process sometimes, and it sounds as if this was the case with you. Different sensitivities tell your dentist fairly specific things about what is wrong with your tooth. Sensitivity to air is an indication of an unprotected spot on the tooth, which can be treated with a desensitizing bonding agent. In your case, the pain was transient, meaning that it went away after the desensitizing agent was applied. That further indicated that the pulp or nerve of your tooth was irritated, but had the potential to heal without interference. If the pain had lingered, your dentist would probably have recommended a root canal treatment, because that lingering pain would have been an indication of irreversible irritation.

You say your tooth has a large filling, and that causes some concern over whether or not that filling could be leaking, or have decay under it. Certainly most competent dentists would check the integrity of the filling first, to make sure that was not the cause of the pain. If the tooth continues to trouble you, it may be time to consider a root canal treatment and porcelain crown.

The greater issue here is your lack of trust in your dentist. Trust is the key to good health care, and dental care is no exception. If you are not comfortable asking your dentist questions, she may not be the right dentist for you.