Pain Below Teeth #36 and #46: Possible Causes Explained - Dentistry

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Understanding pain in the area surrounding teeth #36 and #46 can be quite complex, as there are multiple potential causes for discomfort in this region. The pain you are experiencing could be attributed to several factors, including dental issues, periodontal problems, or even referred pain from other areas.

1. Dental Caries or Cavities: One of the most common causes of tooth pain is dental caries. If there is a cavity in tooth #36 or #46, it can lead to sensitivity and pain, especially when biting down or applying pressure. Given your history of dental work on tooth #36, it’s essential to ensure that there are no new cavities or that the previous fillings have not failed.

2. Periodontal Disease: The discomfort you feel may also be related to gum disease. If the gums around these teeth are inflamed or infected, it can lead to pain and swelling. Periodontal disease can cause the bone that supports the teeth to deteriorate, leading to further complications. If you notice swelling in the gum tissue around teeth #35, #36, or #37, it may indicate periodontal issues that require treatment.

3. Impacted Wisdom Teeth: You mentioned that your lower wisdom teeth (#46) are horizontally impacted. Impacted teeth can exert pressure on adjacent teeth, leading to discomfort. This pressure can cause inflammation in the surrounding tissues, contributing to pain in the area of tooth #36. If the wisdom teeth are causing issues, extraction may be necessary to alleviate the discomfort.

4. Nerve Issues: Another potential cause of pain could be related to the trigeminal nerve, which supplies sensation to the face and teeth. If there is irritation or inflammation of this nerve, it can lead to pain that feels like it is coming from the teeth, even if the teeth themselves are healthy. This is something that may require evaluation by a neurologist if dental examinations do not reveal any issues.

5. Bone Issues: The "bump" you describe could be related to the underlying bone structure. Conditions such as osteitis or bone infections can cause localized pain. If the pain persists, imaging studies such as a 3D cone beam CT scan may be warranted to assess the bone and surrounding structures for any abnormalities.

6. Referred Pain: Sometimes, pain in the teeth can be referred from other areas, such as the jaw or even the sinuses. If you have sinus issues, it can lead to discomfort in the upper teeth, while jaw problems such as temporomandibular joint (TMJ) disorders can cause pain in the lower teeth.


Recommendations:
- Dental Evaluation: It is crucial to have a thorough dental examination, including X-rays, to identify any cavities, gum disease, or other dental issues. A 3D X-ray (CBCT) may provide a more detailed view of the bone and surrounding structures.


- Periodontal Assessment: If gum disease is suspected, a periodontal evaluation should be conducted to assess the health of the gums and the supporting bone.

- Consultation with a Specialist: If dental evaluations do not reveal any issues, consider consulting a neurologist to rule out nerve-related problems.

- Monitor Symptoms: Keep track of when the pain occurs, its intensity, and any associated symptoms (such as swelling or sensitivity to temperature). This information can be helpful for your healthcare provider in diagnosing the issue.

In summary, pain in the area of teeth #36 and #46 can arise from various dental and non-dental causes. A comprehensive evaluation by a dental professional is essential to determine the underlying cause and appropriate treatment.