Louise,

Amalgam fillings always have microscopic or larger cracks in them because for one thing the metal expands and contracts with varying temperatures. Any amalgam filling that is more than a few years old is in this category. I bring this up because bacteria gets in these cracks at a slow but steady rate which can ultimately cause inflammation with the pulp leading to death of the nerves. So you may have a slowly dying tooth there. This is not always evident on a typical dental xray unless decay is visibly seen and/or a pathological area is seen at the root of the tooth. Again, this may or may not be your problem.

I am curious as to why the dentist root planed the premolar....???

I would be that your regular dentist is going to refer you to an endodontist for a root canal. If for no other reason than to stop your complaining about it.... I know that is terrible isn't it??! The last thing you need is another root canal... you've been down that road and look what happened.

Someone else posted on here suggesting the possibility of a fractured root. Again this is commonly seen with molars that have amalgam fillings. From what you have described previously, your dentist did the usual checks for a fracture and they were negative. But that doesn't mean it's not fractured because these things can be hard to diagnose and they are rarely picked up on an xray.... unless the xray is taken at a bisecting angle which sometimes picks up the fracture, but not always.

I'm sorry this is not all that helpful. Just keep your wits about you and remember the pitfalls of root canal therapy. Don't let anyone decide what is in your best interest...hear all of the options and decide for yourself what is best.

Keep us posted...
Bryanna

Hi nibiruwayne,

Thanks so much for sharing your opinion with Louise's dental problem. As you can see she is in a lot of discomfort and has certainly been seeking help from her dentists.

I'm assuming you are a dentist? Can I ask where... are you in the US?
The reason I ask is because I believe it would be very difficult to find a dentist in the US who uses or even knows about MyoralDNA saliva testing. It might be a good idea to have something like that done... but where and who?

Bryanna

Hi there

The information that nibiruwayne has posted seems totally plausible to me.

The pain is getting worse in the left molar today and cannot be seen till Weds now so just going to have to dose up on painkillers till then.

I live in the UK so referring to endodontists is difficult as there arent many around the area where I live and is very expensive.

I am more inclined though to just tell my dentist to take the damn tooth out as I did last year as I have no faith in root canals anyway and have read some horrific information about them recently....I certainly don't want that to interfere with my fertility treatment I am due to have very soon, so will just have to be firm with my dentist.

Bryanna - The emergency dentist I saw root planed the pre-molar as when he tested all my back teeth to see if the nerve was dying that pre-molar hurt the most. I am sure he would be leaning toward this tooth as being the culprit, but I am 95% sure that it is my molar as the lump is underneath that tooth and the pain is emanating from it into the teeth either side.

Can I ask one more question please? My top left set of teeth are aching too and I am wondering if that is because of the aching in my lower set of teeth? I know they are all connected but I am just worried that the top set are problematic also? I do recall my top right set ached when my right molar was aching before it was extracted but I just want to check.

Many thanks for all your help so far and will keep you posted.

Regards


Louise

Louise,

You can ask as many questions as you like I want to be able to help you as much as I can.

I agree about removing a tooth instead of root canaling it because the root canal cannot revive a dead tooth and make it well again. Systemically dead teeth are always a huge risk every time.

With regard to the upper teeth hurting as well as the adjacent teeth ... it is absolutely possible that it is referred pain from the lower molar. Everything is connected and when there is inflammation, and you can see that there is, all of the nerve endings and ligaments associated with that inflamed area will respond as if they were directly involved. Anytime you have a long standing inflammation like this, the healing time after the source is removed may or may not be longer than anticipated.

I urge you to think twice about starting the fertility process until this situation is completely remedied. I imagine there is a timing issue with fertility but please be mindful of what your asking your body to go through and do what you intuitively feel is best for you.

Feel free to come here anytime and talk or ask questions.... I will offer you whatever I can.

Keep rinsing with the warm salt water and applying moist heat to that area. If nothing else, it may reduce some of the discomfort.

Hang in there..... this will be over sooner than later.

Bryanna

Thanks Bryanna.

I dont start treatment till beginning of March so got a few weeks yet.

Will see what my dentist advises on Wednesday and will let you knoe.

Thanks so much for all the advice so far youve been really helpful.

Louise

Hi Bryanna

Sorry I have just thought of another question!!

The pain that I get only seems to happen during the day...my sleep is never disturbed, I still have the swelling and bony lump there though so I wonder if this is usual for a root fracture?

I keep getting asked by the dentists if the pain keeps me awake at night to which I can only reply no!

Its so frustrating as I know there is something wrong yet they all seem to think there isnt anything wrong - its going to be hard to be firm as this is my 3rd dentist in just over a year! I just hope that they take my word for it.

Also if they do take the tooth out as my last molar was difficult to extract should they consider sedating me? I am not too keen to be conscious of what is going on this time round.

Thanks

Louise

Louise,

Sometimes when a tooth is fractured it can hurt only after it has been chewed on or annoyed in some way and then the pain may or may not linger ... even sometimes during brushing your teeth it could hurt and then stop. If you grind your teeth at night, the tooth may only hurt during the day and may or may not get progressively worse. Or if you grind during the day, not a night, the tooth may get progressively more painful throughout the day and then calm down during your sleep. Other times, it can hurt less frequently because it has to be moved in a certain way to be aggravated. Sometimes the pain is mostly temperature sensitivity. It all depends on where the fracture is, how large it is and how your teeth occlude together.

The swelling is actually more of a concern than the pain. Does it stay swollen 24 hours a day or swell up after you are awake for awhile? Also, are you taking pain meds before you go to sleep or anything like a muscle relaxer at night?

I am still wondering why the dentist deep scaled the premolar. That is usually done if a problem with the gum, such as in a deep pocket, is suspected. Otherwise it can add insult to injury more so than if not done at all.

Ask this dentist to take an xray at a different angle. It's called bisecting. Perhaps the problem is not being picked up on the xray because they keep taking them from the same angle. Just ask... "could you take this xray from a different angle than the usual straight on to see if anything shows up from that perspective?" Sometimes assistants don't know what bisecting means :/
Also, if the xray is digital, ask them to send you a copy to your email and then you may be able to post it here.

Let me know....
Bryanna

Hi Bryanna

Thanks for further info it makes total sense to me and fits my problem
...the area feels permanently swollen but gets progressively worse mid morning and then is at its worst in the evenings.

I am taking meds when I go to bed ....paracetemol and ibuprofen but not alot though 400mg and 1000mg respectively.

The dentist root planed as indeed he thought I had gum problems but since then the pain has gotten alot worse. So i guess he has made an already bad situation worse.

I am concerned about swelling most myself as it feels worse..just hope my usual dentist is willing to listen tomorrow.

Regards

Louise x

Louise,

So he did think you may have gum problems? In just that area?
I am wondering if he stirred up some bacteria but did not actually remove it when he scaled that tooth...?? That in of itself could cause swelling and pain especially if there was something already brewing anywhere in that area.

Okay, so you are taking acetaminophen and ibuprofen at night prior to bed. That dosage would definitely reduce the pain and some inflammation.

The dentist you are seeing tomorrow is this the same one who did the scaling?

Bryanna

Hi Bryanna

Well I have got absolutely nowhere yesterday when I saw my usual dentist.

She has basically advised that I have TMJ disorder specifically in the left jaw area and its just a case of mananging the pain, undertaking the exercises I was given by the oral surgeon and just sitting and waiting!

She has offered to make me a splint for my mouth to prevent the clenching and grinding so this is something I will take up.

She has said that TMJ pain will present in teeth and she tested my teeth again by tapping them. The teeth either side of the problematic tooth hurt when she tapped so she advised that as they have no decay and no fillings then it must be TMJ as there would be no way I would have pain in them if I didnt have the problem.

She has advised me to go to see my Doctor to ask for some muscle relaxants but I said that as I would be starting fertility treatment soon this wasnt really an option as I wouldnt be able to take that sort of drug when on the fertility drugs.

So....I am feeling a bit upset, a bit frustrated and very anxious.

She categorically said that she would NOT be drilling teeth nor would she be extracting them so I have to try and manage with what I have.

I was unable to ask about a bisecting angle x-ray as the appt ended so abruptly and I just felt that I was going over old ground again.

I do feel that my comments to the oral surgeon that I saw on 21.1.13 have been used to lean towards a diagnosis of TMJ problem...this was that I have a 2.5 year daughter who had open heart surgery when she was born and that I had to conceive via fertility treatment. It has really upset me that this was even used in the letter as she appeared to take a great deal of time asking me about my family life...I can understand she has to get a feel for what goes on in my life but using it to make a diagnosis is not on!

My dentist has now used this information and it supports her diagnosis of TMJ too. She said to me yesterday that the lead up to fertility treatment can be quite stressful....to which I replied I am quite aware of that I have done it 3 times!!!!

So, I am going to see my Doctor and see what she can suggest. I may ask for a further referral to the hospital for a further x-ray on that area to see if that helps.

I did mention that I am having the same symptoms as the right molar that was pulled and that my pain totally went after the tooth was removed...my dentist told me that as i have the TMJ problem there is no guarnatee that the pain will not return...is this correct?

Can you give me any further advice on TMJ and its management?

Thanks


Louise