Hello there Hope everyone had a wonderful weekend.
After a long period of dental problems and pain due to two infected root canals, followed by both of them being extracted, loooong recovery process and getting used to a new Carlson bridge, I am back with another question- I am due to see my dentist end of this coming week, but want to get this question out before than, because it is an issue I have dealt with since a long time (approx. two or three years), and so far, my wonderful dentist was not able to determine any cause for my issue other than an obvious TMJ issue.

So, here it goes: Since I started flossing at least once a day about 7 or 8 months ago, I noticed that whenever I floss between two of my molars (upper left jaw), there will be a twinging pain when I pull the floss out and upwards. Now, I have not experienced any pain when brushing (except occasional tooth sensitivity, where a few of my molars will be super sensitive- has become better with dicthing commercial tooth pastes and changes in my diet)- also, no pain when chewing or drinking hot/ cold. Only when I pull up the floss after cleaning the space between, it hurts. Not the gum, but the tooth twinges. My dentist could not find anything so far, no cavity (and he has a machine that he holds close to the teeth and it will detect even smallest cavities), no infammation, no sensitivity to tapping or pressure (again, it does not feel like an abscessed tooth at all, just twinges when I floss), also, he did a bite test on all my molars on that side where he put a toothbrush-like plastic (without the bristles) on each cusp and had me bite down to see if there were any cracks. Nothing.
I am at a loss as to what this could be... it is not a major pain, but even a slight twinge, one would like to know what is going on, right?
Maybe our wonderful Bryanna has any ideas and input? Or maybe someone else has dealt with a similar problem before?
Thanks, everyone
Meera

Hi Meera Dasi,

Hope your previous dental problems have resolved and the carlson bridge has become comfortable for you.

The twinges that you feel in between the two upper molars can be due to some interproximial (in between the teeth) gum recession exposing a little bit of root surface which could be really minor and not easily detected clinically.... could be a hairline crack in one of the teeth which would give you more symptoms if it were deep .... could be an inflamed gum tissue underneath the gum due to a piece of hard calculus or a piece of fibrous tissue that gets irritated when flossed..... could be an ill fitting restoration that needs to be replaced. Do you find that food gets stuck in that area? If so then the dentist may be able to re-contour the shape of that interproximal area so food does not get stuck. Is that area difficult for you to reach and are you forcing the floss in there?

If all tests come up negative.... try using a different type of floss. Use a "tape" rather than a string. See if that helps.

Hi Bryanna, thanks for the reply!
My Carlson bridge took me over two months to get used to, and a lot of adjusting from my dentist, he also made the connection between the fake tooth and the adjustment tooth less "tight", so now I feel a hundred times better with it. It still feels a bit "strange" from time to time, just not like a real tooth, but after all, it IS not a real tooth ;-).

Concerning the flossing problem- the two teeth in that area are pretty tightly spaced (it is two molars), and getting the floss to go in is fine but when I want to pull it upwars, and back out, it gives me "nervy" twinges for a few seconds. I am using very thin floss now which works better. It almost feels as if there is a "bump" or protruding tiny edge towards the cusp of the tooth, but I am not sure if I have a composite filling there- I will post my last panoramic X-rays, maybe you can even see first glance whether there is a filling or not? Sorry I had to post so many x-rays, but my untrained eye cannot make out which is the right one :-(. The twinges occur between 12 and 13. Last time, my dentist checked for crakcs using a plastic, bristle less toothbrush and checked all cusps in that region individually, he also shone a certain light there, could not see anything. I am scared of cracks, and am wondering what other symptoms would go along with that? I have no sensitivity when biting or drinking hot and cold. I am wondering, maybe it would even help if he just made the space between those teeth a tad bigger so it is easier for me to floss there.
Also, pay no attention to the root canals on the X-rays, they are gone, those are the ones that I got removed a few months ago :-).

Thank you!
Meera

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Actually, I just flossed and there is a twinge between 12 and 13 and 13 and 14. I used very thin floss this time, and it is only a tiny twinge now. This is a new floss that I just opened and it is super thin, thinner than the one I used until now. Even with that one though, its kinda hard to get it up and out, it kind of gets stuck before I manage to pull it all the way up, and that causes the pain.

Hi Meera,

Thanks for posting the xrays! Okay just so you know, you posted 4 bite wings and one periapical xray, no panoramic xray.

I do not know which is your left or right side as it depends on how you copied them... face down, face up.

So the 5th xray that you posted... 1,2,3,4,(5)... shows a large cavity on the distal portion of the 1st pre molar tooth. This is an interproximal area between the 1st and second pre molars. If you look at that xray at the 1st tooth on all the way to the right you will see a large dark (black) area on the tooth above a bright white area (filling) and next to a dark line (nerve) down the center of the tooth. This is deep decay and may actually be in communication with the nerve. There may be some pathology going on at the root of this 1st premolar which would mean that the cavity has reached the nerve. So I don't know if this is tooth #13 or #5 as the xrays do not indicate left or right. The adjacent tooth, the second premolar #14 or #4 may also have decay on the mesial side (interproximal area towards the 1st pre molar) above the white filling and also above that on the root surface. You also have some interproximal bone loss on both of these teeth which means that you are flossing a bare root surface which could be sensitive. These areas of concern are also on the (3rd) and (4th) xrays that you posted. So which ever side of the mouth that xray is of, those areas need to be evaluated.

The 1st and 2nd xrays, (1), (2), 3,4,5, show that you have interproximal restorations on both premolars and the first molar. You also have a piece of calculus on the mesial near the gum line on the first molar. So if these 2 xrays are of your left side, then you could be getting hung up on that piece of calculus with the floss.

I'm sorry if you were not aware of the cavities :/ Or perhaps they have been restored since these xrays were taken? Which side of your mouth is the last xray (#5) that you posted?

Hi Bryanna, and thank you!
Sorry I should have clarified that the big decaying area is tooth Nr 5, so on my right side, and this is where I had gotten my second root canal due to the tooth not calming down after two attempts to fill it. Then, I had this tooth extracted and now it is replaced by a Carlson bridge. This means, what you said about restorations between teeth and a piece of calculus, that would be my left side, the side where I get the pains. Does that make sense? One thing is, the restorations should not be leaking or anything, since he tested them about 6 months ago with some kind of machine or sensor that can pick up even the beginning stages of decay or bacteria... so I wonder, what else could be wrong then? And, what does it mean to have a piece of Calculus?
Thank you for all your help :-)
Meera

Hi Meera,

Okay, good to know. It is hard for me to remember everyone's case here unless I refer back to the original posts. So yes, In now recall tooth #5 was decayed, infected and root canaled... then extracted. Tooth #4 on the mesial (interproximal) side, did your dentist do any fillings on that area since that xray was taken? If not then you may have 2 areas of decay or it could be what is called burnout. But I think it would be wise for your dentist to recheck that tooth for decay.

Regarding the left side, tooth #14 the first upper molar appears to have a piece of calculus or tartar on the mesial up near the crest of the bone. It is hard to confirm that on this xray as it could also be a shadow or reflection off of the root. Teeth #12 and 13 both have restorations but the margins look good on this xray. There is some bone loss (not a lot) and some root exposure underneath the gum. So the initial contact between the fillings when you bring the floss up in between the teeth could be tight and then when you bring the floss up further you are rubbing against the exposed root surface. Also, that area where you feel the floss is getting stuck or hung up could be a slight overhang on the filling, although it is not evident on this xray. Ask your dentist to floss in there and let him see what you are talking about.

In the meantime, try the tape floss. String floss can be a bit harsh on the gum tissue in areas that are tight. The tape slides easier and is not as abrasive on the root surface as the string.