DD has pain after filling - I’m really worried

[Scaredofthefentist]

DD was born with a tooth with no enamel. Dentist put a filling in when she was 5. Aged 13 a different dentist replaced the filling with a new one, she took an X-ray and apparently 50% of the tooth has decayed. The filling was just over 2 weeks ago. The dentist said she may need a root canal in future but to see how DD goes with the filling.

DD told me today that the tooth has started hurting and is painful to eat on. It has been ok previously.

Im now really worried the filling has failed and she will need a root canal. She is only 13 and not her fault the tooth came through with no enamel. The rest of her teeth are fine.

Would they sedate a 13 year old for this?

I rang the dentist and the earliest they can see her is Wednesday. I’m just so worried.

A root treatment really isn't that bad, it's more involved than a filling but in my experience no more painful (ime the only pain is the initial injection but no pain after that).

Sedation will probably be easier to get privately than on the NHS but YMMV.

An extraction is a better option at 13. There’s no way a tooth that bad will last until she’s 73! Even with root canal and a crown.
Sedation- specialist referral either NHS (long edit) or private ££. It is actually worth £500 to get your child out of pain, if you can afford or have a credit card.
Best option probably to have it accessed and dressed and then refer NHS for it out.

DD had root canal on a front tooth when she was 10, had the usual local anaesthetic jag but wasn't too traumatic. In fact she had so much pain beforehand that she said it just felt good to have no pain - she'd had trauma & broken tooth which had become infected. Longer term will need cap/crown bit will be her decision when old enough.
Her older DB had a tooth removed & this was more traumatic to him tbh

I would be surprised if they sedate her. My 13 year old just had 4 teeth out at one appointment (2 on each side for her braces) and she had local anesthetic.

I have a tooth, or rather had a tooth with no enamel.

It started with a filling-the only one I had before I was about 25yo.

Then the first quarter of the tooth dropped out. That was filled.

Then the second quarter and I was given a crown.

Then the crown came out with the rest of it.
I had root treatment and another crown.

It isn't painful (except the cost of the crowns!) and I would suspect the best thing for her to do is have it out and root treatment. My current dentist (not the one who did the other treatment, and whose general aim is to always save a tooth if possible) said that he's not known a tooth without enamel survive long into adulthood with all the will and treatment in the world.
Looking back the worst thing was the trying different things in the hope of saving it. I'd have been better having it straight out - and would also have saved the cost of one of the crowns.

For sedation, my dd always has sedation for any treatment. The anaesthetist comes to the local dentist, and is absolutely wonderful at keeping her relaxed.

But she's an adult, and I suspect it may be different for a child. But if your dd is at all nervous, then I'd ask about it.

I mentioned having the tooth removed but the dentist seemed keen to try root canal first. If it was extracted what are the options for the future?

Thankyou so much to everyone commenting, really helping me calm down. I just feel so worried and hate the thought of her having to undergo such painful treatments. So so unfair that this damn tooth has no enamel!

They can do this via general anaesthetic if need be but probably at a children's hospital where they deal with teeth

Have a good think about all options

She could maybe have the tooth removed for now and a dental implant in the future and a plate / denture to fill in the gap till then

Which tooth is it?

You can request 'demand' General anaesthetic and your case I would

Obviously GA come with their own issues hence it is not common practice

Most 13yos would be able to have a root canal without sedation. It should not be a painful procedure

Many root filled, crowned teeth will last for many years. Especially in a a patient with good oral hygiene. If she is not due Orthodontics it wouldn't be wise to extract until older unless absolute necessary as the tooth will maintain both bone and space until an implant can be placed.

Pain after a filling thouugh does not automatically mean it needs root canal, it can be normal. Don't panic just yet!

You cannot either request or demand a general anaesthetic for a root canal.

struggling are you a dentist? You sound very knowledgeable.

The dentist is doing a referral to orthodontics due to gaps in her teeth although she said as the NHS criteria for referrals is so high DD probably wouldn’t qualify. I will pay whatever it takes though if she definitely needs orthodontic treatment.

I have never had root canal myself but have heard horror stories from others who say it is horrendous with only a 50% success rate. This is why I’m so anxious.

Is your 13 year old due to have any orthodontics OP? Perhaps this poor prognosis tooth could be one of the planned extractions, if so.
It sounds like a hypoplastic first permanent molar-6. If hypolastic 6s are identified early as poor longterm prognosis, then planned extractions at a time-critical point usually 8.5-9.5 yrs, there can be a reasonable outcome in that the 2nd permanent molars -7s can erupt in a 'drifted' forward position, so that there is no or little residual spacing at the back of the mouth.
At 13, if no planned ortho and your DD's permanent teeth are already naturally well aligned, your daughter will have an inevitable space if this molar /6 is extracted. You can ask your general dentist to refer her to the local community dental service for Conscious Sedation. I'm 99.9% sure this will be Inhalation Sedation (nitrous oxide/oxygen), obviously with local anaesthetic. If you live in a city with a dental hospital nearby, your dentist may refer your DD there instead. There may be the possibility of IV sedation there but only if inhalation sedation has been attempted first. Extraction under GA is also a possibility, under the care of a Community dental service -these usually have a district general hospital extraction GA list as part of their remit. Or, GA in the dental hospital. Children with trickier medical histories who need to have GA extractions often have to be referred to a tertiary Children's hospital like Alder Hey for example. Any such referral has long waiting times presently, depends where you are in the country.

Root canal treatment and crown -is your DD the cooperative type? Will she sit nicely with her mouth open and allow the high street dentist to place rubber dam? If so, this is not an unreasonable option in a well aligned 13 year old. If cooperation is not great, there is pretty much zero chance of any Community or Hospital based Paeds dentist doing molar RCT under Conscious Sedation. This is just not going to be viable at the back of the mouth with rubber dam, clamps, access and complicated by the sedation nasal hood. Maybe if there was a bleeding disorder -Willebrands or something like hypodontia, that may be an exception. But, it is a very, very difficult /impossible to do molar endo under Inhalation Sedation.
So lots of variables would affect the clinical situation your daughter is currently in. Good luck.

The other thing to mention is that in a 30y +career, mainly Community dental service, I have never known any child or teenager have molar endodontics under GA at our local DH or tertiary children's hospital. Endodontics /RCT under GA is limited to single-rooted teeth with a reasonable long term prognosis; the aim is always not to have to repeat a dental GA within a 5 year period.

I had pain 2 days after a filling a couple of years ago, and it was an abscess. I had emergency root canal on that tooth and I've had no problems since (touch wood). Root canals aren't as bad as everyone makes out. That tooth was my second root canal. I was nervous for the first one because I heard awful stories, but what helped me to relax was reading up about how it's done. Once I knew and I had been through it myself, the second was easy to get through.
I hope it gets sorted for your DD quickly :)

My filling did this, it was so sore for a while. It did settle down though. Hopefully your daughters will do the same.