Hi Bryanna

I wrote to you back in October last year with a problem surrounding my LR6 molar post extraction ....thankfully I can say that it has healed up nicely and am experiencing no further problems...

However, the problem seems to now have transferred over to the left hand set of teeth.

Back in Nov 2012 I noticed a hard bony lump appear under my Lower Left 6 Molar (second one from back) - it wasnt painful at all but I mentioned it to my dentist who told me it was bone. So I went away happy with that diagnosis.

Two months later and I now have swollen and sore gums surrounding the hard lump and my lower left 6 molar has been hurting with a throbbing ache on and off. If I push this tooth with my tongue it hurts and if I feel around the hard lump area and swollen gums that hurts too.

I have been back to see my dentist yesterday who has taken an x-ray of this area and yet again cannot find anything wrong, no infection, no nasties, no decay in my teeth.

He did the tap test of my teeth and the aforementioned tooth did not hurt when he did this but when he tapped the pre-molar next to it it really hurt. So what he did was a deep clean of the pre-molar to see if that helped. It is actually really hurting today and again when I probe the Lower left 6 Molar with my tongue it hurts.

I have been daignosed with TMD and have been told to do specific exercises to help this condition. I know I clench my teeth in my sleep and have noticed I do it during the day but what I want to know is would it really affect my gums in this way? The dentist I saw yesterday said that by clenching and grinding it would erode the gum therefore causing the problem I have...but I am not totally convinced.

The reason why is that the previous tooth that was extracted had similar problems and the tooths nerve was actually inflamed ..once the tooth was taken out (after unsuccessful root canal) the pain disappeared immediately.

Could you give me some guidance or if you have any idea what could be causing this it would be really useful.

I have been advised to use Interental brushes and use Corsodyl mouthwash for 3 weeks to see if that improves the problem.

I am just very anxious about this as I am due to start a course of fertility treatment soon and am worried that it will interfere with this should I have any problems with my teeth. The last thing I want to be doing is having tooth problems during a course of fertility treatment.

Hope you can shed some light?

Louise

Hi Louise,

It sounds to me like you have some ongoing gingivitis. Anytime plaque accumulates along the gum line irritation, redness, and pain will occur. Perhaps you could try using a electric toothbrush? These remove plaque very well.

The benign bony growth that you have are called Tori. If this growth is near the gum line and the plaque is accumulating there, it will cause a swelling, pain and redness in that tooth and the adjacent teeth. Could that be what the dentist was referring to?

It is imperative to make sure that you do not have periodontal problems and that your oral hygiene is very thorough prior to any fertility treatment. During pregnancy, the gums will swell from the pregnancy hormones and if there are any gum problems prior to the pregnancy, the swelling will be worse and very uncomfortable.

Do you wear a night guard for your bruxing habit?

Bryanna

A
Hi Bryanna

Thanks for the information.

The Tori that you describe is further down my gum towards the area where it meets my jawline. From the Tori it then feels swollen all along the groove and its getting more and more irritating as its hurting and can be sore to touch. When I have my mouth closed I am now more aware of it being there (the Tori and swollen area) whereas before it was painless, no swelling from the Tori and wasnt aware of it when mouth closed. The molar directly above the lower left 2nd from back (I never had wisdom teeth) is the One that aches.

I have had a few different ideas of what it is....gum problem related to TMJ and even atypical odontalgia! I am certain there is a problem due to the swelling but as said before there is no evidence to determine a definite diagnosi

No one has offered a nightguard though?

I spent a whole year with pain and debilitation with my right molar and as I have a young toddler I cannot go through the uncertainty and pain a second year in a row.

Do u think I could pproach my Doctor other than my dentist as getting nowhere fast again.

Louise,

I would recommend to see an oral surgeon and have a panoramic x-ray done. This x-ray shows the jawline in much more detail. It could be an anomaly that is not being picked up on a small periapical x-ray.

Let us know the outcome of that. Try not to worry... we're hear to help as much as we can.

Bryanna

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

This may or may not be useful ... but years ago I had tetanus and could barely stand, so I didn't brush my teeth. I got a horrible infection around one of my dental implants. The pain was excruciating. The swelling was so bad it affected my vision.

I didn't have money for a doctor or dentist. So, I tried vitamin C. I took quite a lot, I forget how much... probably something like three or four of the 250mg tablets a few times an hour for several hours on end.

The swelling decreased.

In a day the pain was vastly less.

I've still got the bad implants because my Medicaid won't pay for removal because they are implants. The infection doesn't appear to count. (I live in New Mexico where savings like this are essential, and the state used $20M to help Iron Man II be made... Yes, I don't approve.)

So, I'm still using vitamin C to keep the infection under control, and this is more than 5 years later.

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]

Hi Consider This,

Vitamin C is the best thing on the planet!!! I take 4-5 grams of a very specified C daily. But it took me 3 months to work up to that level. Vitamin C comes in a variety of forms and depending on which one it is, determines how much should be taken at one time. Especially when just starting out because it can cause kidney problems in some individuals if they take too much for a long period of time or too much too quickly and do not drink several glasses of water every day, throughout the day.

I have seen vitamin c work miracles... seriously, no doubt about that. But it cannot cure or alter a bone infection that is caused by a dental implant. It may subside some physical symptoms and actually slow down the progression of the infection for a long time, depending on the individual. But the fact is, the infection will eventually become resistant to the vitamin c and in the meantime the infection is taking it's toll on your immune system.

Have you been to a dentist in the last 5 yrs and had xrays to see if this infection has spread? If not, I really urge you to do so because it's the only way of knowing if the vitamin c has been that miracle that you hope it has.

Thanks for sharing your story... all the best to you!
Bryanna

Louise,
What you describe can be a fractured root. A hairline fracture which can create a vector or pathway for more virulent bacteria to enter. This can cause the pain you are describing. Unfortunately, there are not good reliable tests to diagnose a root fracture. The only way to remedy the problem is to have the tooth extracted.
If I am uncertain of this being the problem, I will typically do a MyoralDNA test to determine if any high risk, moderate risk, or low risk pathogens are in a concentration above the norm. If so, it is a good indicator, barring no other areas of concern, that the tooth is likely fractured. If it is fractured, a root canal will not remedy the situation. If the tooth has not had a root canal, one should be accomplished, at the recommendation of your endodontist, as the tooth may be necrotic (nerve already dead or dying) and you are still receiving symptoms.
It is impossible to diagnose and recommend treatment in a forum such as this and you should only rely on a professional. If you wish to retain the tooth , you should probably see an endodontist firtst.

Hope this helps.

HI Bryanna

In answer to your questions

a) tooth in question has an old amalgam filling which has been there for
15 yrs at least maybe more

b) have never knowingly been advised I have had PD nor gingivitis
c) the root planes tooth is a little swollen and still hurts a little too but not as much as molar.
d) the oral surgeon I saw at hospital is a woman and she did the panoric xray on 21.1.13
the guy I saw at my dental surgery last week works as a dentist and as an oral surgeon at the hospital

Have been in lots of pain all day so going to try to see my regular dentist tomorrow...any further advice appreciated but will keep u informed.


Louise