Hi Louise,

Clearly without seeing your mouth clinically and with no radiograph, it is hard for me to say it could possibly be this or that. Atypical Odontalgia is more common than realized and yes it is often misdiagnosed by dentists. However, you have described definitive clinical symptoms that are obviously visible. So AO does not really fit your descriptions.

Do you have or have you had periodontal disease? Or gingivitis? Does this tooth have filling in it... what type of filling is it...is it a recent filling... is it large? The premolar that the dentist root planed recently... is it swollen around that tooth also? Does that tooth still hurt?

You asked about diagnosing a dying nerve in a tooth..... it is not always black and white. Some people have pain without swelling on a particular tooth as the nerve is dying. This pain may progress, swelling may develop... or it could stop hurting (which by the way does not indicate that the tooth is better). Other people state that they never had pain but the infection from a dead nerve is picked up on an x-ray.

When you grind your teeth, there is tremendous force put on the periodontal ligaments that hold the teeth in the jawbone. This could result in throbbing pain in a tooth (teeth), in the jaw, loose teeth ... swelling can occur as inflammation sets in and everything to do with that area of the mouth hurts. A long term chronic bruxing habit can actually cause tori to grow. I'm not saying this is definitely your problem but I think it may at least be a contributing factor.

If you have already had a panoramic xray done that definitively came up negative, then the only other xray would be a dental ct scan.

You said that the dentist you saw is a general dentist but works as an oral surgeon. Which one is he? Some general dentists perform oral surgery but they are not specialized in oral surgery.... big difference unless they have had specific training in oral surgery. The oral surgeon at the hospital... did she take a panoramic xray?

Bryanna






QUOTE=redhen75;953709]Hi Bryanna

I have already had this done around 2 weeks ago and have seen an oral surgeon at our local hospital.

She examined the left jawline area and advised there was nothing she could find either.

She sent me away with some conservative management exercises to do and a possible diagnosis of atypical facial pain or atypical odontalgia!!

The X-Ray apparently shows nothing untoward so I am getting some reassurance from that, but what has happened is the pain has gotten worse since I saw her and the swelling has got worse too.

The x-ray that was taken last week wasn't panoramic just a normal dental x-ray so do you think I should ask for a further panaoramic one to be done now the pain has gotten worse?

I was thinking of asking for an MRI scan to see if it could pick up anything?

I really cannot see how there is nothng wrong with all the pain and swelling I have. The dentist I saw last week also works as an oral surgeon so I am guessing he knows what he is talking about, but he wasn't certain whether the nerve had died or is dying in my tooth.

Could the tests that dentists perform still not pick up a dying nerve or would they definitely pick it up?

My right molar exhibited no signs of a dying nerve after all the relevant tests, but yet when finally my previous dentist opened the tooth up she found the nerve was very inflamed! I am puzzled as to why this could be as surely these tests are reliable?

Therefore, I am guessing this could be the reason for the swelling and lump in my gums and pain in my molar as it has happened before.

I have been doing the exercises they have given me to do religiously every day at any given moment I remember but still have no relief..this makes me feel that it isnt my TMJ problem that is causing the swelling and pain.


I wonder if your thoughts are the same?

Regards

Louise [/QUOTE]