Turns out this is a very common symptom...it usually is associated with a back tooth and is often caused by a crack in a tooth. The crack is more like a hair-line fracture somewhere down in the depths of the tooth, and is almost never visible on x-ray.(if a crack if visible on x-ray then you have real trouble!) When you bite down and the crack is nudged just a wee bit then you feel that sharp pain...and this must be treated before the tooth cracks and breaks even further.
Here is an example...a nice big molar tooth with a silver filling...on the surface it looks OK but the x-ray shows decay lurking underneat...and the patient has reported the ambiguous pain on biting! So we decided to remove the silver filling and see what is underneath
Once the silver is out we can see the decay quite clearly...
I proceed to carefully remove the decayed portions only and when I am done I begin looking for the crack...and there it is...
..to try and visualize it even better I shine a special lite on the tooth and there it is under this lighting...quite clear..running the entire length of the tooth.
There is nothing more I can do right now...the tooth needs to have a cap in order to prevent the tooth from cracking any more...so I bond in a tooth colored filling for today
and the patient is rescheduled and we will begin the cap at the next visit...
see you next time!
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