How much of an emergency is my throbbing tooth?
December 18, 2017 8:16 AM   Subscribe

A 12-year old crowned tooth is throbbing when I walk around; I have a dental appointment in ten days. Is it okay to wait?

About 12 years ago, I was a 21 year old visiting France. I chomped down on a baguette, felt something like sand hit my tooth, and after many dental appointments and lots of throbbing pain, had a root canal and then a crown placed on that tooth. It’s the top leftmost molar.

No problems in the last 12 years, but about 6 months ago, I noticed a funky smell would be evident when I flossed that tooth. Kind of a stinky, unpleasant smell. I asked my previous dentist about it. She took an X-ray and said the tooth seemed just fine, no evident issues.

My insurance then changed, and I’ve been searching for a new dentist for the last little while. Just yesterday, that same tooth began throbbing, but only when I walk around or step hard on the ground, if that makes sense. Just sitting here, I don’t feel any pain.

I just made a dental appointment for 12/28, which is the soonest the community clinic could get me in. I’m wondering if this is potentially a bigger issue that shouldn’t wait 10 days. I also just got over a cold, which could be affecting the tooth as well. But I don’t be have a sinus infection (which has given me tooth pain in the past).

Anyone have experience with crowned teeth throbbing? Or funky smells when flossing?
posted by sucre to Health & Fitness (12 answers total)
Yes. It's fairly likely you have an abscess in or above that tooth. It's possible, but unlikely, that it will clear up on its own. The issue with dental abscesses in particular, as it was explained to me by dentists and doctors, is that the bone is fairly porous and the abscess can go in either direction, e.g. towards the outer facial bones (and into some things you don't want infected, not that you want anything infected) or drain through the roof of the mouth. I've had a root canal go bad and create a small opening in the gum nearby, which has drained for years and years because I've had other medical priorities and while the draining isn't great it prevents the issue from getting worse.

These things can go bad very quickly (hours). If you've had the issue for six months it's unlikely to get worse in the intervening couple of weeks, but you'll almost certainly need an extraction and post-procedural care unless you want to have the root canal redone. Some dental professionals do not approve of extractions of too many of your molars. If you do get the root canal redone, you want to see the right specialist (e.g. not necessarily a normal dentist).

One thing that's kept mine in check is good dental hygiene, as well as careful and regular use of Biotene mouthwash, salt water rinses, and cold teabags. If it gets any worse (fever, swelling) you need to go see someone post-haste.
posted by arimathea at 8:32 AM on December 18, 2017 [1 favorite]

How much pain can you stand? When I had something like this years ago I woke up crying and called the dentist as soon as I could reach him. It sounds like an infection and it could get worse fast. It would not hurt to try to get an earlier appointment, I would if it were me. Also dental infections can become systemic and make you really sick.
posted by mermayd at 8:36 AM on December 18, 2017 [1 favorite]

I had a wife who got gangrene trying to wait for an appointment. You talk about funky smells? Yeah, maybe not wait.
posted by Mr. Yuck at 8:42 AM on December 18, 2017 [2 favorites]

I'd go see someone ASAP because an infection in this area can get very serious and damaging very fast.
posted by quince at 8:43 AM on December 18, 2017

I would try hard to get in this week. Tooth stuff can go south really quickly, and can be basically debilitating if it prevents you from eating normally. If you wait a few days, lots of dental offices will be closing for the holidays and you might be stuck. You have more luck seeing someone today than on, say, Christmas.
posted by schroedingersgirl at 8:43 AM on December 18, 2017

Adding to the chorus: go see a dentist today if at all possible.
posted by Ms Vegetable at 8:45 AM on December 18, 2017 [1 favorite]

I know it’s a community clinic but are they aware of all this info when you made the appointment?

My dentist is often busy so once I called to make an appointment, without specifying what it was, first date was 2 weeks away. I then politely said “Actually my filling has fallen out and it’s making me pretty anxious and worried about eating ... any chance to move it up?” They fit me in the next day.

Suggest you call again, explain the situation and politely ask to be moved up. If they are resistant you can also offer to be standby for any cancellations/avails if your schedule has that flexibility.
posted by artificialard at 10:14 AM on December 18, 2017

Hey all! Thank you so much for chiming in here. I’m on the bus right now, heading toward the clinic. There were no available appointments today or tomorrow, but they have an emergency walk-in window from 1-3, so my goal is to be seen today. Also, I realized it’s actually been a YEAR since I asked my previous dentist about the funky smell, rather than 6 months. So I’m definitely due. Thank you all so much! I’ll leave a quick update after.
posted by sucre at 10:23 AM on December 18, 2017 [2 favorites]

No it is not OK get a more emergency type appointment to remove the crown. I had a crown over a rotten root, that nearly killed me, seriously I had cognition problems before it finally just fell off. When the root came out the dentist ran from the room with it because it was absolutely fetid. If it is on top, it is way too close to the brain to have a puncture wound type infection.
posted by Oyéah at 12:25 PM on December 18, 2017

Had to wait 2.5 hrs to see a dentist, but I did! They took x-rays, which they said looked fine. After examining the tooth, the dentist saw a small fracture on the crown. She said that because the root canal 12 years ago killed the nerve, the pain I’m feeling shouldn’t be nerve pain.

She thought it was possible that I chomped down on a hard nut or a piece of ice (this is possible) or that I’m grinding my teeth (also possible). She seemed to think it would resolve, and suggested flossing 2x a day instead of 1, dipping the floss in mouthwash, rinsing with warm salt water, etc.

I don’t feel 100% confident about it but I do have an appointment still set for 12-28, so I can follow up then. Hopefully it’s a safe simple as that. Thank you all again for your words of toothy wisdom!
posted by sucre at 3:15 PM on December 18, 2017 [2 favorites]

Yup, see a dentist ASAP. I had an abscessed tooth that masqueraded as a lumpy salivary gland infection for months. I had one day of intense pain and then months of appointments with specialists who never hit on the right answer :P Good luck!
posted by Calzephyr at 4:02 PM on December 18, 2017

If the crack in the crown is making your bite strange then yes, I've had gum/root pressure pain from my bite being bad or chewing too excitedly under my crown/root canal. They should be able to detect an abscess on the x ray and will surely be able to follow up at the next appointment.
posted by Crystalinne at 9:04 PM on December 18, 2017

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