Toothache treatment

[pacergal]

I had a tooth that had a root canal. Every few years, I would have a day or so of pain on that side, I would be extra diligent with flossing and using fluoride mouthwash, thinking it was maybe inflamed gums.
A few years ago, the pain never went away. Turns out, one root was missed. The remaining root had been infected for years, which caused bone infection. Ended up with another root canal, an apioectomy and bone graft. Still had problems and finally had the tooth removed and implant done.
I never ignore a toothache anymore. My body is telling me something!

OP-- an infected root may inflame and cause pain off and on. I would encourage you to see a dentist and have X-rays. As a previous poster mentioned, cardiac problems have been associated with dental bacteria.

 

[REWahoo]

Boho, I think I recall reading a study that a lack of dental care over a prolonged period of time can result in an exaggerated belief one's abilities - like the ability to pick winning stocks. Can't find it at the moment, but I'll keep looking.

 

[Bir48die]

I had a tooth that had a root canal. Every few years, I would have a day or so of pain on that side, I would be extra diligent with flossing and using fluoride mouthwash, thinking it was maybe inflamed gums.
A few years ago, the pain never went away. Turns out, one root was missed. The remaining root had been infected for years, which caused bone infection. Ended up with another root canal, an apioectomy and bone graft. Still had problems and finally had the tooth removed and implant done.
I never ignore a toothache anymore. My body is telling me something!

OP-- an infected root may inflame and cause pain off and on. I would encourage you to see a dentist and have X-rays. As a previous poster mentioned, cardiac problems have been associated with dental bacteria.

I have probably 6-7 root canals and 3 on one tooth. Long story short that tooth was taken out. The one next to it had cracked a couple years prior so a major spend for two implants to replace them. Now I have another molar that looks like it needs a root canal. Just in the process of having two crowns replaced and we're trying to figure out if it's root canal before new crowns seated.

 

[Boho]

Wait you haven't been to the dentist in 30 years? Not even for a cleaning

Correct. Even before the tooth pain I flossed twice a day and I brushed all surfaces of my teeth from various angles (not all 30 years but in the last several). I even brush the biting edges of my front teeth (with the bristles pointing upwards and downwards). And backs...I wonder how many people even do that. Nothing rotted away or fell out.

I have slight translucent streaking and slight pinkish discoloration at the end of one of my top front teeth and sometimes it's a little sensitive to the cold tap water when I rinse out my mouth after brushing and it's even slightly shorter than the other one. I know it's possible resorption but it hasn't progressed in years. I just noticed it one day years ago and I don't think it changed.

I've had some dark discoloration between molars for 30 years, on a tooth that was filled 30 years ago, but I had it before professional cleaning and filling, it was still there after it, and it's no worse now.

Maybe all my plaque is covering the cavities and preventing pain and creates a supporting structure and my teeth will collapse if it's chipped away. I don't see any plaque looking stuff though.

 

[Boho]

Wow, I don't think I documented exactly when my toothache began but it's been about 6 months. I can't say I'm 100% over it but normally it only hurts slightly, sometimes, when I purposely eat certain things on the bad side. I started eating on that side, in the back where the toothache is, on purpose because you have to put pressure on your teeth to keep your jaw strong, which in turn prevents tooth problems. Sometimes in addition to brushing normally I firmly press down and sideways on my back teeth with my toothbrush, but I don't press firmly when I use the brushing motion. I want to start chewing gum so I can exercise my jaw without getting food caught in my sensitive area.

I still use my alcoholic mouthwash a maximum of once a day. I read that alcoholic mouthwash can cause deterioration of the root or jaw or something, so that's another reason to exercise my jaw.

I said "normally it only hurts slightly" because at certain times, I think when there's certain food stuck in my gums by my left wisdom tooth, sideways pressure can cause significant pain that I can feel from from chewing something firm or from pressing against my teeth with the back of my tongue. I may have Pericoronitis even though I'm in my 50s, though the top of my wisdom tooth is completely visible. After I clean out my mouth, a tongue press test doesn't cause pain.

I've mentioned that grape skin caused this. It began with extreme soreness of the gum by my wisdom tooth. I'd had prior experience with mouth soreness after eating grapes so I knew to wash out my mouth, and I attempted to wash it very well, but I think that may have caused the problem. I bet I pushed grape skin deeper in my gums as I repeatedly rinsed my mouth. I quit eating grapes but now when I rinse other things out of my mouth I start gently on the right side where I haven't had problems. I don't want the food there getting to the bad side of my mouth. Then I'll rinse the bad side and sometimes use a toothbrush to see if I can get any food out, rather then pressurizing my mouth with water. Vigorous water swishing while attempting Dizzy Gillespie cheeks is the last step.

There were a couple of times when I rinsed, flossed, rinsed, brushed, and rinsed again, then reached the mouthwash stage and a food particle came out.

I started using fluoride mouthwash in addition to the alcoholic and non-alcoholic antiseptic mouthwash, so I can rinse well after brushing without worrying about washing away the fluoride. I've tried two, didn't like either, but I think there's a flavor of ACT that I'll end up liking. The "less intense" Listerine Nightly Reset seemed perfect because I didn't want yet another product that burns (even mint toothpaste is slightly strong to me) but the glycerin or whatever leaves a coating in my mouth that I don't like so I started looking for something else.

 

[Boho]

I have had several root canals. Some hurt like the devil, others were relatively pain-free procedures. I have never understood why.

I read about a year ago on a dentist's or endodontist's website that pain from a root canal is caused by missing some of the nerves when attempting to numb them. You have to inject each one and sometimes even after multiple tries you can miss one.

Also, The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia.

I don't know whether the following dentist is doing the right thing but I understand it better in light of the above:

“Should the dentist have, during my initial visit, prescribed an antibiotic?” This is very controversial.

I always prescribe antibiotics at the time I diagnose the need for root canal therapy and the patients never have post-operative pain. That is not what is taught in dental schools today. The treatment you received [not prescribed antibiotics] is considered the standard of care today, and unfortunately, the result you received [pain] occurs in one out of five patients.

When I read that recently, I wondered whether you could just take OTC pain medication, like that same Dr. recommended in other responses on that same page:

It is often helpful to alternate Tylenol and Ibuprofen every 4 hours. In other words, take 800 mg Ibuproven every 8 hours. Four hours later take two extra strength Tylenol (2 x 500mg) and take the Tylenol every 8 hours. Do not take either one more frequently. So every 4 hours you will be alternating 800 mg Ibuprofen with 1,000 mg of Tylenol. That should help with the pain. Tests show that is as effective as Codeine and not nearly as addictive. The antibiotics will take 48 to 72 hours to fully kick in. Once it does, the need for pain medication will decrease.

You can take Tylenol 500 mg (2 extra strength) along with Motrin (two 200 mg) every 8 hours. Or when you get your antibiotic prescription you might be able to get a stronger pain medication prescribed too.

Well, I had a toothache last night that wasn't even as bad as a level 9 or 10. I had high hopes for Extra Strength Tylenol and the little grocery by me sold me a two pack of capsules. I swallowed one, hesitated on the other and decided to bite it a little, sort of reflexively (I used to chew aspirin a little before swallowing) but I punctured it and wasn't sure it was safe anymore so I spit it out. I went to the supermarket and bought a whole bottle and took another one (within about 1 to 1-1/2 hours of the first). No noticeable improvement.

So, I'm thinking maybe "a stronger pain medication prescribed" for use post root canal, and maybe antibiotics pre-root canal are good ideas.

But:

"The downside is that some will have an allergic reaction to the antibiotic. I always tell the patient that if a rash or difficulty breathing develops, stop the medication and call me."

More fun.

 

[HadEnuff]

Are you still experiencing discomfort from the same area you were when you started this thread back in October?

Any swelling at all?

Have you had it evaluated by a dentist?

 

[harllee]

I go to the dentist every 6 months (just went a couple of days ago) for the normal cleaning. I want to keep my teeth healthy. I had to have a root canal earlier this summer due to a cracked tooth that abcessed. Very painful at the time but now all is well and the tooth has healed and was saved. If I were having any type of tooth pain I would go to the dentist ASAP.

Boho--why won't you go to the dentist? Are you afraid? There are some dentists that work with people who are afraid, they use laughing gas, etc.

 

[Boho]

Are you still experiencing discomfort from the same area you were when you started this thread back in October?

Any swelling at all?

Have you had it evaluated by a dentist?

Yeah, same area. Not really any noticeable swelling, but sometimes, when it's sensitive and I bring my teeth together, I feel the bad side bite before the good side, like maybe a little swelling is causing the tooth to ride higher. At this moment, it hurts somewhat but I'm not feeling that "left side biting first" feeling.

No, still not evaluated by a dentist. Today/last night was the only significant problem I've had in about a year. I'll be looking into getting insurance though.

 

[Boho]

Boho--why won't you go to the dentist? Are you afraid? There are some dentists that work with people who are afraid, they use laughing gas, etc.

I don't know how to handle my no-insurance situation. I want my employer to insure me, but I don't have one. I also want the dentist to do the right thing, because the wrong thing can be hugely expensive and painful, and I don't know how to make that happen either. I wish dentists handed you a copy of the x-rays and there was a website where you could post it and get a bunch of opinions.

 

[Boho]

Any swelling at all?

Swishing refrigerated water helps significantly, so yeah, I guess there's some swelling. Just not really visually noticeable.

 

[harllee]

I don't know how to handle my no-insurance situation. I want my employer to insure me, but I don't have one. I also want the dentist to do the right thing, because the wrong thing can be hugely expensive and painful, and I don't know how to make that happen either. I wish dentists handed you a copy of the x-rays and there was a website where you could post it and get a bunch of opinions.

I don't have dental insurance either--I looked into it and dental insurance is not worth the cost. Many dentists will give you a discount for payments out of pocket and some will work on a payment schedule. As for finding a good dentist, I have found that asking friends for recommendations is a good idea. Also, if you live near a dental school you might be able to get the work done there at a reduced cost. When I had my root canal my dentist (who I trust) showed me the Xray so I could see the problem. He also gave me a quote of the cost ahead of time (but I was in so much pain I would have paid most anything).

 

[Boho]

(but I was in so much pain I would have paid most anything).

Yeah, I haven't had significant pain like that. I'm thinking maybe my back going out caused a little system-wide inflammation and that's why the tooth flared up. And still it's not a 9 or 10, and swishing ice water helps.

 

[iloveyoga]

At the first sign of tooth ache I go to the dentist for a professional appraisal.

I spend as much dough as needed (root canal, crown, pull) as needed to make it go away.

This!

 

[MissMolly]

Swishing salt water is supposed to help with swelling. Try that. Can't hurt. Just don't swallow it

 

[Boho]

Swishing salt water is supposed to help with swelling. Try that. Can't hurt. Just don't swallow it

Yeah, warm salt water, to draw out the infection. I'm thinking about that but ice water makes it feel better faster.

 

[bada bing]

I go to my dentist 3 times a year for cleanings and exam plus whatever treatments we agree on. I've been covered by employer dental insurance, but it only covers $1500 a year + one cleaning. Last 10 years I've structured my dental procedures to use up the $1500 annual coverage and not much more. Last spring I had the final old amalgam filling replaced with porcelain , so I no longer have any mercury in my mouth. Amalgam fillings work great in young teeth, but as you age, teeth become more brittle and amalgams start cracking. A couple of my fillings were 50 years old.

I'm a bit ashamed to admit it, but 15 years ago I was working ex-pat and it wasn't convenient to get to a stateside dentist. I didn't see one for 6 years. I didn't have any major acute issues during that time, but my overall oral health declined in spite of being careful about hygiene. It happened slowly enough that I didn't notice it until I resumed regular dental visits. The difference in how my mouth now feels day to day convinced me to never skimp on the dentist again. Dental treatment can be a bit of a luxury, but I don't mind putting a few $1000 a year into my mouth. Money well spent.

Boho, I'd offer the observation that you might be surprised the subjective difference a few scheduled dental visits make. I know that was my experience after not seeing one for years. Another benefit is the most popular dentists in my area won't see a non-patient out of office hours for emergency treatment. My dentist hasn't been taking new patients for a couple years now. I haven't had any issues but it is good to know that if I had something really hurting on Saturday night, I could get it quelled quickly.

 

[Boho]

Boho, I'd offer the observation that you might be surprised the subjective difference a few scheduled dental visits make. I know that was my experience after not seeing one for years.

I'd definitely like to know what an x-ray says, but I wouldn't necessarily want professional treatment based on the results, just because a dentist tells me I need it, and that could be awkward. Out of pocket second opinions sound expensive (along with everything else). I've heard about people "needing" all of their teeth pulled. I'm going to do some research into what symptoms people have when they need that. I don't have any grey/black teeth like some people have, and I think my gum line looks normal enough. If a dentist tries telling me I need a hand full of teeth fixed or removed, I won't be easily convinced.

I heard there may be stem cell therapy to fix teeth and gums in a few years. I wonder what that cost would be and how insurance would handle it.

Another benefit is the most popular dentists in my area won't see a non-patient out of office hours for emergency treatment. My dentist hasn't been taking new patients for a couple years now. I haven't had any issues but it is good to know that if I had something really hurting on Saturday night, I could get it quelled quickly.

I like that. And some doctors have a different doctor that could take care of you when they're off, if you have questions or whatever, which is also good. I've seen doctors who didn't have that.

 

[Brat]

If you have a dental school in the area get on their patient list. Usually they put low income on their priority list but sometimes they need a patient with a specific demographic.

Story here: My son had a Hispanic laborer on his crew who obviously needed help with his teeth. He worked to get him on the dental school's patient list. He now uses that clinic as his regular dentist and many of his teeth have been saved.

 

[Boho]

My toothache lasted less than 24 hours. I think it was the first time I got no night's sleep because of pain. I also had restless leg syndrome on the same side as the toothache.

I rinsed the left side of my mouth with so much cold water that my tongue ironically felt kind of dry when I rubbed it on the roof of my mouth. I don't know whether I gradually cleared out infection by rinsing so much or cleared away debris (I may have I felt a new food particle a couple of times after dozens of rinses, even after flossing) or if I just had inflammation that subsided or what, but the tooth now feels the same as it did for the year before yesterday's problem. Meaning, when I wake up after sleeping on the left side of my face and bring my teeth together, I feel the slightest pain/sensitivity in my wisdom tooth, just for the first couple of bites.*

I partially blame my recumbent exercise bike for hurting my back and causing inflammation that got to the already somewhat bad gums around my wisdom tooth, but even decades ago I occasionally had a problem with food getting caught back there, and my wisdom tooth looks like it may not have fully erupted. I think grape skin got caught there last year, causing major irritation and starting the current problem, which sounds like pericoronitis and I may need a operculectomy by a periodontist, in addition to a root canal. Or, since it's just a wisdom tooth, getting it pulled may be best, but then I lose some chewing efficiency.

* Well, that's not the only issue. When I snap my teeth together even during the day I sometimes feel the slightest pain, and chewing way back there can sometimes hurt.

 

[socaldonnan]

In middle of July DH mentioned a molar was bothering him. Though for 25+ years we’ve been seeing same dentist DH has a Medicare Advantage plan that he pays additional for dentistry. I suggested since he’s paying for this plan see the dentist he was assigned. DH looked up doctor, called and made an appointment. Dentist inspected his teeth, took x-rays and determined DH needed a root canal. When DH returned home, told me that a root canal was needed. I suggested that he call our long-time dentist to get a second opinion. DH went for second opinion and though he attempted to bring x-rays from first dentist was unsuccessful. Second dentist took x-rays. He asked DH if he recently had any popcorn? Though he doesn’t normally eat popcorn he tried some gourmet type. The dentist thought based on X-ray and the fact popcorn was involved a piece may have gotten stuck in the tissue of his tooth gum area. His recommendation was for DH to use his Sonic care toothbrush, gingerly floss and water pic and see if that clears up. I also recommended a little dab of peroxide around tooth. I just asked him how his tooth & gum were feeling and he said excellent no pain or discomfort

 

[Boho]

Dentist inspected his teeth, took x-rays and determined DH needed a root canal...went for second opinion...attempted to bring x-rays from first dentist...was unsuccessful...[new X-ray showed] popcorn was involved...Sonic care toothbrush, gingerly floss and water pic...I just asked him how his tooth & gum were feeling and he said excellent no pain or discomfort

And who knows how often that happens. I once tried getting a record from my father's insurance company to see what the doctor sent them to justify a procedure. They said to ask the doctor for it. It's more likely to be legit if you get it from the insurance company though, and I would have even paid for it. There's potential for better oversight.

X-rays should be made available to patients.

Let a dentist try that crap with me...

 

[harllee]

You need to find a very good dentist (not necessarily the cheapest) and one that you trust.
I suggest talking to friends and see if they have a very good dentist they can recommend.
Boho, you really need to see a good dentist. Go in for a consultation and see what the dentist says. It will cost some money but it is necessary if you want to save your teeth for the long run.

 

[mn54]

And who knows how often that happens. I once tried getting a record from my father's insurance company to see what the doctor sent them to justify a procedure. They said to ask the doctor for it. It's more likely to be legit if you get it from the insurance company though, and I would have even paid for it. There's potential for better oversight.

X-rays should be made available to patients.

Let a dentist try that crap with me...

by law, at least here in MN., the xrays have to be transfered upon request by the patient. If they are digital xrays, which most are these days, there should be no charge. if they are film xrays there could be a small charge to copy them.

 

[pacergal]

OP--
Perhaps if your wisdom tooth has not fully erupted, it may be pushing against the molar next to it, causing pressure/pain to the roots. Frequently, wisdom teeth need to be removed because of this.
(I am not a not a dentist)
I would encourage you to find a dentist and have a check up with X-rays. It really sounds like you have been fighting some sort of tooth decay or root infection for some time. That is not going to go away.
Sometimes, a dentist will charge you less if paying with cash. At least here they do.