Chronic Tooth Pain: Seeking Solutions After Years of Discomfort

Q: Chronic Tooth Pain: Seeking Solutions After Years of Discomfort

Dear Ms. <br>ANN： Hello! As mentioned, you have been through a lot! The issue on the upper left may be related to your wisdom tooth, which could be causing damage to the upper first molar. <br>The upper right seems to be a cavity issue, along with tooth sensitivity, which can tru

I have had a toothache for over two years, but my gums are not swollen!

Hello Doctor: Two years ago, I had a cavity in my upper left molar, and the dentist recommended extracting my wisdom tooth before treatment.
I followed their advice and had it removed.
However, two days later, I experienced severe biting pain in my upper molar and the teeth below it.
Out of desperation, I opted to have the molar ground down, not realizing it would require a root canal.
I went through with it, but the pain persisted after the procedure, and I later discovered that the disinfection process also caused more pain.
The discomfort has since eased somewhat, but I still experience pain when consuming very hot or cold foods, and I often have pain for no apparent reason.
Is this normal? I have visited around ten different hospitals and clinics, but none have identified any abnormalities; they only suggested extraction if the pain worsens.
I still cannot get a crown, and I have difficulty biting down, with minimal biting pain.
Additionally, I had a resin filling done on my upper right molar, which caused significant pain for a week.
The dentist advised me to endure it, but after a month of pain that made me nauseous, I insisted on having it removed.
They replaced it with IRM, but I still experience pain to this day.
Biting down is somewhat more manageable, and the pain from hot and cold foods is less severe, but I still feel pain when I haven’t eaten anything.
The IRM has not been replaced yet, and I have consulted many clinics, but they usually tell me to keep observing or suggest a root canal.
I am afraid that I will end up in the same situation as with my upper left molar, where the root canal did not improve anything.
The doctors have determined that it is not a nerve issue.
After numerous consultations, I have undergone many dental cleanings and sensitivity tests, but three months later, I began experiencing pain in the side of my lower front teeth as well.
Using dental floss also causes pain, and the discomfort fluctuates.
Is it possible that I have a crack? The X-rays did not show any abnormalities, and the dentist only mentioned that I have sensitivity and recommended using desensitizing toothpaste, which has not helped at all.
I have had an MRI to check for trigeminal neuralgia, which was ruled out, and I have undergone many other tests for various health issues, all of which came back normal.
I tend to grind my teeth, and after the wisdom tooth extraction, my teeth shifted significantly.
I tried using an occlusal splint to prevent this, but it only made my lower teeth more misaligned, leading to painful biting, so I stopped using the splint.
Could you please advise me on where to seek a second opinion? I would like to resolve these pain issues and consider orthodontic treatment, but I am 38 years old.
Is it still appropriate for me? When I try to explain everything to the doctors, they seem overwhelmed and hesitant to treat me, often wanting to dismiss me.
Which type of specialist should I consult next? I have already seen specialists in periodontics, endodontics, oral surgery, and general dentistry.
Thank you!

ANN, 30~39 year old female. Ask Date: 2018/04/20

Dr. Huang Tingfang reply Dentistry

Dear Ms.
ANN: Hello! As mentioned, you have been through a lot! The issue on the upper left may be related to your wisdom tooth, which could be causing damage to the upper first molar.
The upper right seems to be a cavity issue, along with tooth sensitivity, which can truly affect your quality of life.
I recommend visiting a medical center for a more detailed examination! Please communicate openly with your doctor! Thank you! Wishing you peace! Sincerely, Dr.
Huang Ting-Fang, Dentistry.

Reply Date: 2018/04/20

More Info

Chronic tooth pain can be a debilitating condition that significantly impacts your quality of life. It sounds like you've been through a lot with your dental health, and it's understandable to feel frustrated and overwhelmed by the ongoing discomfort. Let's break down your situation and explore potential avenues for relief and treatment.

Firstly, it’s crucial to understand that tooth pain can arise from various sources, including dental decay, gum disease, tooth fractures, or complications from previous dental procedures such as root canals. Given your history of tooth extraction, root canal treatment, and ongoing pain, it seems that your dental issues may be multifaceted.

1. Understanding Your Pain: The pain you're experiencing could be due to several factors:
- Nerve Sensitivity: After a root canal, some patients experience lingering sensitivity or pain, which can be exacerbated by temperature changes (hot or cold). This could be due to inflammation or irritation of the surrounding tissues.

- Jaw Alignment Issues: You mentioned that your teeth have shifted after the extraction of your wisdom teeth. Misalignment can lead to uneven pressure on your teeth, resulting in pain during biting or chewing.

- Possible Cracks or Fractures: If you are experiencing pain when using dental floss or when pressure is applied, it could indicate a crack in the tooth that may not be visible on X-rays.

2. Seeking Specialized Care: Since you've already consulted multiple dentists and specialists without satisfactory results, it may be beneficial to seek out a dental specialist who focuses on pain management or a multidisciplinary clinic that can address complex dental issues. Here are some suggestions:
- Oral and Maxillofacial Surgeon: They can evaluate your jaw alignment and any structural issues that may be contributing to your pain.

- Endodontist: A specialist in root canal treatments who can reassess the previous root canal and determine if further treatment is necessary.

- Prosthodontist: If you are considering dental implants or crowns, a prosthodontist can help design a treatment plan that restores function and aesthetics while addressing your pain.

3. Pain Management Strategies: While you continue to seek a definitive diagnosis, managing your pain is essential. Here are some strategies:
- Over-the-Counter Pain Relief: Medications like ibuprofen or acetaminophen can help manage pain. However, consult your doctor or dentist before taking any medication, especially if you have other health conditions.

- Cold Compresses: Applying a cold compress to the outside of your cheek can help reduce inflammation and numb the area temporarily.

- Avoiding Hard Foods: Stick to softer foods that require less chewing to minimize discomfort.

4. Considerations for Orthodontic Treatment: At 38, it is still possible to pursue orthodontic treatment, but it may require a tailored approach. Many adults successfully undergo orthodontic treatment, and advancements in technology, such as clear aligners, can make the process more comfortable. However, it’s essential to address your current pain and dental health before starting any orthodontic procedures.

5. Mental Health Support: Chronic pain can lead to anxiety and depression, as you've experienced. It might be beneficial to seek support from a mental health professional who understands the impact of chronic pain on mental well-being. Cognitive-behavioral therapy (CBT) can be particularly effective in managing pain-related anxiety.

In conclusion, navigating chronic tooth pain requires a comprehensive approach that addresses both the physical and emotional aspects of your experience. By seeking specialized care, managing your pain effectively, and considering your mental health, you can work towards finding relief and improving your overall dental health. Don’t hesitate to advocate for yourself and express your concerns clearly to your healthcare providers; your comfort and well-being should always be a priority.

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