Tooth Pain: Causes and Solutions for Dental Issues

Q: Tooth Pain: Causes and Solutions for Dental Issues

Miss Winny： There are many reasons that can cause tooth pain, and it is not necessarily due to dental issues; however, a differential diagnosis is essential. <br>Since I have not personally examined your oral condition and do not have your past medical records, I still hope you c

Defeated by my teeth~

Hello Doctor: I have cavities in both of my lower teeth, which have been filled before.
After a few years, following the extraction of my upper left wisdom tooth, the doctor advised me to have the fillings redone.
A few weeks later, I suddenly experienced pain in the left side of my cheek when opening my mouth, so I returned to see the doctor.
He mentioned that my lower left wisdom tooth was also deeply decayed, which was causing the issue, and recommended extraction.
However, since I had just had the upper tooth removed not long ago, I requested the doctor to place some medication to temporarily avoid extraction.
Despite this, the pain in my left cheek did not improve, but after two weeks, it subsided.
I thought it might have been due to biting something hard earlier.
However, just two days later, I began experiencing pain on the right side of my cheek.
I had to visit a different clinic, where the doctor suggested that the issue was due to bone damage and advised me to rest at home.
After a few days of rest, the problem persisted, so I returned to my original clinic.
The doctor indicated that the pain was related to the wisdom tooth at the back on the right side, and the tooth in front of it was painful when tapped or while chewing.
Since it was unclear which tooth was causing the issue, the doctor recommended extracting the less critical wisdom tooth first and then monitoring the situation.
After the extraction, the front tooth still hurt, so the doctor had to perform a root canal treatment.
After some time, the pain in my cheek ceased, and I could chew without discomfort.
However, just a few days later, the fourth tooth from the back on the left side started to hurt whenever it came into contact with water.
The doctor protected the nerve with medication and after a few days of treatment, it no longer hurt.
The doctor explained that during the re-filling process, he found that the decay was too deep and had to grind a bit off, which led to this issue.
But within two days, the third tooth from the back began to hurt.
Since it was covered by a crown, it pressed against my gums, but I didn’t feel pain; instead, there was a dull ache.
An X-ray revealed inflammation at the root, and the doctor drilled a small hole in the crown.
Upon doing so, he found pus inside, so further treatment was necessary.
The doctor placed medication inside and advised me to return in a month, during which he also extracted the left back wisdom tooth.
To prevent pain near the cheek from the extraction site, he placed medication, and after a few days, since there was no pain, I removed the medication.
However, after removing the medication, my upper teeth on both sides started to hurt when chewing.
I have already spent half a year dealing with dental issues, and I am unsure which teeth might have problems next.
Could you please tell me if my tooth pain is purely caused by dental issues, or could there be other underlying reasons? Additionally, I have had over a dozen X-rays taken in the past six months, including two consecutive days of X-rays.
Could this lead to any problems? Thank you!

Winney, 20~29 year old female. Ask Date: 2006/07/27

Dr. Lin Qingye reply Dentistry

Miss Winny: There are many reasons that can cause tooth pain, and it is not necessarily due to dental issues; however, a differential diagnosis is essential.
Since I have not personally examined your oral condition and do not have your past medical records, I still hope you can visit a larger medical center or take the time to come to our hospital, where we will be dedicated to serving you.
Dr.
Lin 2006.07.28

Reply Date: 2006/07/27

More Info

Tooth pain can be a complex issue that stems from various dental problems, and your experience highlights several common concerns that many patients face. Based on your description, it appears that you have been dealing with a series of dental issues, including cavities, potential nerve damage, and possibly complications related to your wisdom teeth. Let's break down the potential causes of your tooth pain and discuss possible solutions.

Causes of Tooth Pain
1. Cavities and Tooth Decay: You mentioned having cavities and that some teeth have been filled. Cavities can lead to sensitivity and pain, especially if they are deep and close to the nerve. If the decay is not completely removed during the filling process, it can continue to progress, leading to further pain.

2. Wisdom Teeth: Your experience with wisdom teeth is significant. Impacted or decayed wisdom teeth can cause pain in adjacent teeth and even lead to infections. The pressure from these teeth can also affect the surrounding bone and soft tissue, leading to discomfort.

3. Nerve Damage or Pulpitis: If a tooth's nerve is inflamed (pulpitis), it can cause severe pain, especially when biting down or when exposed to temperature changes. This condition often requires root canal treatment to alleviate the pain and save the tooth.

4. Gum Disease: If you have gum disease, it can lead to inflammation and pain in the gums, which may radiate to the teeth. This condition can also cause pockets of infection that may require treatment.

5. Jaw Issues: Sometimes, pain can be referred from the jaw or temporomandibular joint (TMJ) disorders, which can cause discomfort in the teeth and face.

Solutions and Recommendations
1. Comprehensive Dental Evaluation: Since you have already undergone multiple X-rays and treatments, it is crucial to have a thorough evaluation by a dental professional who can assess the overall health of your teeth and gums. They may recommend additional imaging or tests to identify underlying issues.

2. Root Canal Treatment: If a tooth is found to have significant nerve damage or infection, a root canal may be necessary. This procedure involves removing the infected pulp, cleaning the canal, and sealing it to prevent further infection.

3. Regular Follow-ups: Given your history of dental issues, regular follow-ups with your dentist are essential. This will help monitor any changes in your dental health and address issues before they escalate.

4. Pain Management: For immediate relief, over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage discomfort. However, these should not replace professional treatment.

5. Oral Hygiene Practices: Maintaining good oral hygiene is vital. Brush twice daily with fluoride toothpaste, floss regularly, and consider using an antibacterial mouthwash to help reduce plaque buildup and gum inflammation.

6. Dietary Considerations: Avoiding sugary foods and drinks can help prevent further decay. If you consume acidic or hard foods, be cautious, as they can exacerbate sensitivity.

Concerns About X-ray Exposure
Regarding your concern about the number of X-rays you've had, dental X-rays are generally considered safe, and the radiation exposure is minimal. However, it is essential to ensure that X-rays are only taken when necessary and that your dentist follows guidelines for radiation safety. If you have concerns, discuss them with your dentist, who can explain the necessity of each X-ray and any potential risks.

Conclusion
Tooth pain can be multifactorial, and it is essential to address each issue systematically. Your experience underscores the importance of communication with your dental care provider. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another dentist may provide additional insights and treatment options. Remember, maintaining good oral hygiene and regular dental visits are key to preventing further complications.

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