Jaw and Tooth Pain: Possible Causes and Solutions

Q: Jaw and Tooth Pain: Possible Causes and Solutions

Hello： It is recommended to follow the instructions of the physician at Veterans General Hospital, to return for a crown placement, and to observe for any tooth fractures. <br>Additionally, please have the physician re-evaluate the condition of the temporomandibular joint and the

Cheek pain and dental occlusion pain?

On Wednesday night, I suddenly experienced pain on the inside of my left oral cavity before going to bed, but it wasn't clear which tooth was hurting.
The pain was severe enough that I took a strong dose of acetaminophen.
When I woke up the next day, the pain had subsided to a mild discomfort.
On Thursday afternoon, I visited a dental clinic for a full-mouth X-ray and a thorough examination of my teeth.
At that time, no specific tooth was painful when tapped, and there were no obvious signs of cavities or inflammation.
The dentist suggested it might be a muscle strain in the oral cavity and advised me to massage the area for relief.
However, on Friday morning, after a pain-free night, I became very frustrated when I called my child to wake up, and suddenly, I experienced excruciating pain in my teeth.
The pain was so intense that I cried and immediately took a strong dose of acetaminophen.
Ten minutes later, the pain completely disappeared, but around 9 AM, it started again.
I then went to the Veterans General Hospital, where I felt significant pain in the first lower left tooth, especially when it came into contact with the upper teeth (even slight biting caused severe pain).
The doctor performed an X-ray examination, which also showed no obvious cavities.
He suggested that it might be a cracked tooth due to biting on something hard and advised me to schedule an appointment for a crown.
He prescribed pain relief and anti-inflammatory medication, but when I tried to eat lunch afterward, I found it impossible.
The pain was unbearable, making it impossible to eat solid food; I could only drink liquids.
Even when chewing on the right side, any movement would cause pain in the left side.
The lower left tooth would hurt intensely upon contact.
I took the general pain relief and anti-inflammatory medication prescribed by the hospital, but it was ineffective.
Even when I wasn't moving my mouth, I felt persistent muscle spasms in my cheek.
Ultimately, I resorted to taking strong acetaminophen to manage the pain.

Initially, I had pain on the left side of my mouth for two days before the severe pain in the first lower left tooth became apparent.
Could this be a cracked tooth or a jaw joint issue? I consulted three different dentists over three days, and all said the X-rays showed no obvious cavities.
The first dentist suggested that it might be due to stress and muscle stiffness (on the first day, there was no specific tooth pain, only discomfort in the cheek and inside the mouth).
The second dentist suspected a cracked tooth (on the second day, both the inside of the mouth and specific tooth pain occurred simultaneously).
The third dentist said the jaw joint appeared normal and there were no obvious cracks, and he slightly adjusted the occlusal pain in the lower left tooth.
Currently, I have been taking strong acetaminophen and anti-inflammatory medication for two days, and the pain has improved.
However, the first lower left tooth still hurts when it comes into contact with the upper tooth.
I also continue to feel discomfort in my cheek from muscle spasms.
Although the pain level has improved, the situation persists.
I can only drink liquids and swallow soft foods, as I cannot chew solid food.

What should I do next? Are there any signs I should watch for to help identify the underlying issue? Thank you.

Ms. Chen, 30~39 year old female. Ask Date: 2021/08/15

Dr. Lin Jiayong reply Dentistry

Hello: It is recommended to follow the instructions of the physician at Veterans General Hospital, to return for a crown placement, and to observe for any tooth fractures.
Additionally, please have the physician re-evaluate the condition of the temporomandibular joint and the trigeminal nerve.
Sincerely, Lin Chia-Yung, Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/08/15

More Info

Understanding jaw and tooth pain can be complex, as there are numerous potential causes ranging from dental issues to muscular problems. Based on your description, it seems you have been experiencing significant discomfort that has evolved over a few days, initially presenting as generalized pain in the left side of your mouth and later localizing to a specific tooth.

Possible Causes
1. Dental Issues:
- Cracked Tooth: The sudden onset of severe pain when biting down could indicate a cracked tooth. This type of injury may not always be visible on X-rays, especially if the crack is small or located beneath the gum line. The pain often worsens with pressure and can lead to sensitivity to temperature changes.

- Cavity or Decay: While your X-rays did not show any obvious cavities, it's still possible that there are areas of decay that are not easily detectable. Sometimes, early-stage cavities can be asymptomatic until they reach a more advanced stage.

- Gum Disease: Inflammation of the gums can also lead to pain and discomfort, particularly if there is an infection present. This could explain the initial generalized pain you experienced.

2. Muscle Strain or Jaw Issues:
- Muscle Strain: As suggested by one of the dentists, muscle strain from clenching or grinding your teeth (often exacerbated by stress) can lead to pain in the jaw and surrounding areas. This could explain the initial discomfort without a specific tooth being the source.

- Temporomandibular Joint Disorder (TMJ): Problems with the jaw joint can lead to pain that radiates to the teeth and face. Symptoms may include clicking or popping sounds when moving the jaw, as well as muscle tightness.

Recommended Actions
1. Follow-Up with a Dentist: Since you have already seen multiple dentists, it may be beneficial to consult with an oral surgeon or a specialist in TMJ disorders for a more comprehensive evaluation. They may perform additional imaging, such as a cone beam CT scan, which can provide a clearer picture of the jaw and teeth.

2. Pain Management: Continue using the prescribed anti-inflammatory medications as directed. If over-the-counter pain relievers are not effective, discuss with your doctor the possibility of stronger medications or alternative therapies.

3. Dietary Adjustments: Since chewing is painful, stick to a soft diet that requires minimal chewing. Foods like smoothies, soups, and mashed potatoes can provide necessary nutrition without exacerbating your pain.

4. Jaw Exercises: Gentle stretching and relaxation exercises for the jaw may help alleviate muscle tension. Avoid clenching your teeth and try to be mindful of your jaw position throughout the day.

5. Heat Therapy: Applying a warm compress to the affected area can help relax the muscles and reduce pain. This can be particularly effective if muscle strain is contributing to your discomfort.

6. Monitor Symptoms: Keep track of any changes in your symptoms. If you notice increased swelling, fever, or if the pain worsens significantly, seek immediate dental care.

Conclusion
Your situation is multifaceted, and while some improvement has been noted, the persistence of pain suggests that further investigation is warranted. Pay close attention to your symptoms and maintain open communication with your healthcare providers. They can guide you through the process of diagnosis and treatment, ensuring that you receive the appropriate care for your condition.

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