Chronic Tooth Pain: Is It Gum Issues or Dental Problems?

I have been experiencing tooth pain for a long time?

I have been experiencing tooth pain for a long time, specifically between my first and second molars.
I have consulted several dentists who said there is no issue with my teeth.
Sometimes, after brushing my teeth, the pain seems to lessen.
Could this be a problem with my gums or my teeth? Occasionally, the pain radiates to my cheek.
My first molar had a deep cavity previously and underwent root canal treatment, and there is a post inside, along with a crown.
Both adjacent gums are somewhat painful.
Could this be related to the crown being placed too deeply? Should I see a specialist?

Xiao Ping, 40~49 year old female. Ask Date: 2022/12/07

Dr. Zeng Guanghui reply Dentistry

It is possible that the gap between the two molars is prone to accumulating bacteria and food debris, leading to recurrent inflammation and pain in the gums.
If using dental floss and interdental brushes does not effectively clean the space, it is recommended to return for a follow-up appointment with a dentist for a thorough examination.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/12/07

More Info

Chronic tooth pain can be a complex issue, often stemming from a combination of dental and gum problems. Based on your description, it seems that you are experiencing persistent pain primarily between your first and second molars, which could be indicative of several underlying issues.

Firstly, since you mentioned that your first molar had deep decay and underwent root canal treatment, it is crucial to consider the possibility of complications arising from that procedure. Root canal treatments can sometimes fail, leading to persistent pain due to residual infection or inflammation in the surrounding tissues. Additionally, if a post was placed inside the tooth during the root canal treatment, it could potentially cause discomfort if it is too long or improperly positioned.

The presence of a dental crown (or "cap") on your first molar could also contribute to your symptoms. If the crown is not fitting properly, it may exert excessive pressure on the surrounding teeth and gums, leading to pain. This misalignment can cause discomfort not only in the tooth itself but also in the adjacent gums and even the jaw, which might explain the pain radiating to your cheek.

On the other hand, gum issues cannot be overlooked. If you are experiencing pain in the gums surrounding these teeth, it could indicate periodontal disease or gingivitis. These conditions can cause inflammation and tenderness in the gums, leading to discomfort that may feel like it is originating from the teeth. In some cases, gum disease can also lead to pockets forming between the teeth and gums, which can trap food particles and bacteria, exacerbating the pain.

Given that you have seen multiple dental professionals without a definitive diagnosis, it may be beneficial to seek a second opinion from a specialist. A periodontist, who specializes in gum disease, can evaluate your gum health and determine if there are any underlying issues contributing to your pain. Additionally, an endodontist, who specializes in root canal treatments, can assess the condition of your treated tooth and ensure that there are no complications from the previous treatment.

In the meantime, maintaining good oral hygiene is essential. Continue brushing and flossing regularly, and consider using an antibacterial mouthwash to help reduce inflammation and bacteria in your mouth. If you find that brushing alleviates some of the pain, it may indicate that the discomfort is indeed related to gum health.

If the pain persists or worsens, it is crucial to follow up with a dental professional who can conduct a thorough examination, including X-rays if necessary, to identify any underlying issues. They may also perform tests to assess the vitality of the tooth and the health of the surrounding structures.

In summary, your chronic tooth pain could be due to a combination of dental and gum issues. It is advisable to consult with a periodontist and an endodontist to get a comprehensive evaluation of your oral health. Addressing both the gum and dental aspects will be key to finding relief from your discomfort.

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