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Painkillers and Unruly Toothaches

Tomb1

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[MENTION=7]Totenkindly[/MENTION]
It could be coincidental that the work you had done in those areas left similar pain in the top and bottom molars. I'm not an expert on neuroanatomy but I do know that the trigeminal nerve consists of three branches. The middle branch runs across the middle of the face and supplies sensation to the top molars. The lower branch (the inferior alveolar nerve) runs across the lower part of the face and supplies sensation to the lower molars. These two branches only converge at the trigeminal ganglion. The trigeminal ganglion is up by the spinal chord in the dura mater. So if you're having a pain in both your top and lower molar areas, then I would say go see a neurologist before proceeding with any dental solution because it could involve some issue with the trigeminal ganglion. It's actually not uncommon for people to initially mistake neurological issues for dental issues because of the fact nerve issues can stimulate pain in areas of the teeth.
 

Tellenbach

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Read up on serrapeptase treatment of sinus infections; this is an enzyme that allegedly breaks up the biofilm (bacterial slime) in the sinus.

If it were me, I'd just extract those 2 suckers; you can get dental implants later.
 

Tomb1

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If it's a neurological issue, then the dental extractions may make it worse.

"Dental problems loom large for anyone with TN because the trigeminal nerve goes to both face and teeth. Some people are initially misdiagnosed by a dentist and have unnecessary root canals and/or extractions. Later on, major dental work can make the pain of TN worse or it can end a remission."

http://tnac.org/tnac/articles/dental_work.pdf

"As one of the symptoms is pain in the upper molar and premolar area, dental surgeons need to be aware and recognize this condition in the Dental Office for early referral and management of this distressing condition, rather than unnecessary dental procedures including extraction."

http://medind.nic.in/eaa/t05/i1/eaat05i1p22g.pdf

Given that an ondontogenic pathology appears to have been ruled out by your dentists and the initial pain showed up in both your top and lower molar, there's possibly an issue stemming from a compression in the trigeminal ganglion -- the cause of which is usually vascular. The top and lower molar are supplied by two separate nerve branches (maxillary and mandibular) that only converges at the base of the skull. Trigeminal neuralgia 1 pain is often described as a unilaterally paroxysmal pain with no pain in between attacks. Trigeminal neuralgia 2 features a constant background pain in between attacks.The "going nutty on me" pain on Friday and the difficulty you had getting sleep sounds pretty intense. Worth having ruled out first by a neurologist before getting any teeth extracted...imho
 

Totenkindly

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I read the symptoms of TN on their official national group site and it doesn't sound like what I am experienced / have experienced, but thanks for bringing it to my attention. I will keep it in mind.

Currently I've got some tylenol with codeine, a muscle relaxant, and an antibiotic in case there's something going on. An inspection of my ears and throat today did not find an infection in either. The examiner pressed on my jaw hinges, back gums, etc., and it caused no pain at the time. You can press on them and it doesn't trigger pain, it feels like it's inside. The TMJ thing came up and he also suggested a mouthguard, so I found a decent one and will set it tonight; I know I bite down on my back molars a lot out of stress and maybe that will also help for the moment. I basically bought a few days of time to go over my options at least, that was my concern for this weekend. I'm still dealing with the pain but it's been more manageable on the drugs I got.
 

Z Buck McFate

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It's my experience - if it is a bruxism (grinding teeth) issue - even a cheap drugstore guard will help within a couple days, if not overnight. And it's a good way to find out if that's the issue before spending a lot on a custom/dentist guard.
 

Totenkindly

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The dentist took me over lunch.

Good news: We know what's wrong. (this is the worst part of the experience -- I had no idea even in what direction to go in, it's been a "bring me a rock / no, bring me another rock" scenario so far.)

Bad news: It turns out that bottom tooth right BEFORE my back molar is the culprit. The back tooth does have a cavity to deal with, but the other tooth is abscessed. It's also had a prior root canal and crown. So now I have to go to an endodontist and have the tooth recleaned and refilled again, and then recrowned. Lovely!

They did more extensive x-rays of the jaw area rather than the teeth themselves, I'm not sure why this wasn't done before.

Anyway, waiting for a call back about an appointment time this week hopefully. As it is, I have Weds off -- that would be nice to not have to take sick leave. Meanwhile, I can keep taking the antibiotic and the pain meds and stick it out until the new root canal.

Meanwhile, I will keep trying to wear the mouthguard. I felt like it was a little helpful, although it could also be the antibiotic.
 

Z Buck McFate

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I imagine the Tylenol with codeine is probably the biggest hero in the story thus far. Glad to hear you were able to get your hands on some, and that they know what's wrong now. That's gotta be a big relief in itself.
 

rav3n

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The dentist took me over lunch.

Good news: We know what's wrong. (this is the worst part of the experience -- I had no idea even in what direction to go in, it's been a "bring me a rock / no, bring me another rock" scenario so far.)

Bad news: It turns out that bottom tooth right BEFORE my back molar is the culprit. The back tooth does have a cavity to deal with, but the other tooth is abscessed. It's also had a prior root canal and crown. So now I have to go to an endodontist and have the tooth recleaned and refilled again, and then recrowned. Lovely!

They did more extensive x-rays of the jaw area rather than the teeth themselves, I'm not sure why this wasn't done before.

Anyway, waiting for a call back about an appointment time this week hopefully. As it is, I have Weds off -- that would be nice to not have to take sick leave. Meanwhile, I can keep taking the antibiotic and the pain meds and stick it out until the new root canal.

Meanwhile, I will keep trying to wear the mouthguard. I felt like it was a little helpful, although it could also be the antibiotic.
Perhaps it's time to get a new dentist.
 

Totenkindly

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Perhaps it's time to get a new dentist.

Yeah, this one was a different dentist than the one I was seeing there... same practice, different dentist.

----

The codeine is great, I just came home after a bad pain attack at work. That + the muscle relaxer has me pretty laid back....
 

oxyjen

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Maxillary sinusitis?

Maybe a tooth abcess, I'm not sure. I would think the dentist would catch that though.

In either case, you need antibiotics and good pain meds. You can try going to walk-in acute care. You could also try your luck on tele-visit (my health insurance has offered online visits for a vastly discounted rate than in person, but I"m not exactly sure how they differentiate what they can treat via distance and what issues they need to see you in person for).

Good luck. Tooth pain is hell. I hope you can figure out what's going on, and get it treated.

I'm not a dentist but I did stay at Holiday Inn last night.

Glad you figured out what the hell was going on. I too am side-eyeing the dentist that didn't catch the problem originally. I'm sure you're probably getting charged for multiple visits for this single issue...a little annoyed on your behalf. But I can understand that you're likely happy about anything that gets you one step towards total relief from the pain.
 

Totenkindly

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someone canceled so I got into the endodontist today. They did more x-rays and tests and found the culprit tooth. It'll need a root canal and a crown. Currently my appt is set for Thursday afternoon but they might have an opening tomorrow morning (since I have off tomorrow... but Thursday I'd barely miss any work since I start at 6am). I'm not excited to get a root canal, but at least they'll numb me up AND I'll know the problem will be fixed.

There's some other minor damage to teeth in that area (one of the ones with a filling has small cracks starting in the teeth, no doubt from my compulsive chomping). I have a bad habit of chewing hard things, including ice... I know it's not good for me, but I have trouble if I don't pay attention and have hard stuff in my mouth. They'll work with me on the TMJ related stuff after, right now they will alleviate the acute pain by fixing the major bad tooth.

I'm not a dentist but I did stay at Holiday Inn last night.

Glad you figured out what the hell was going on. I too am side-eyeing the dentist that didn't catch the problem originally. I'm sure you're probably getting charged for multiple visits for this single issue...a little annoyed on your behalf. But I can understand that you're likely happy about anything that gets you one step towards total relief from the pain.

A lot of it is covered by insurance (my health plan + my dental insurance), so that's positive. I'm annoyed that the first dentist wasn't really sure what was going on.

But yeah, right now I just want the pain to end. I can think more clearly afterwards. it sucks when your life just becomes a 24 hour cycle about how to mitigate pain without screwing yourself up in some other way. (It gives me a lot of sympathy for folks who deal with chronic intense pain.)
 

rav3n

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someone canceled so I got into the endodontist today. They did more x-rays and tests and found the culprit tooth. It'll need a root canal and a crown. Currently my appt is set for Thursday afternoon but they might have an opening tomorrow morning (since I have off tomorrow... but Thursday I'd barely miss any work since I start at 6am). I'm not excited to get a root canal, but at least they'll numb me up AND I'll know the problem will be fixed.

There's some other minor damage to teeth in that area (one of the ones with a filling has small cracks starting in the teeth, no doubt from my compulsive chomping). I have a bad habit of chewing hard things, including ice... I know it's not good for me, but I have trouble if I don't pay attention and have hard stuff in my mouth. They'll work with me on the TMJ related stuff after, right now they will alleviate the acute pain by fixing the major bad tooth.



A lot of it is covered by insurance (my health plan + my dental insurance), so that's positive. I'm annoyed that the first dentist wasn't really sure what was going on.

But yeah, right now I just want the pain to end. I can think more clearly afterwards. it sucks when your life just becomes a 24 hour cycle about how to mitigate pain without screwing yourself up in some other way. (It gives me a lot of sympathy for folks who deal with chronic intense pain.)
Hope you get in tomorrow! Btw, perhaps ask the endo if what this article recommends, might help to prevent future cavities.

https://www.livestrong.com/article/541766-can-taking-calcium-rebuild-teeth/

While there is no evidence that taking calcium supplements rebuilds the teeth, certain forms of calcium applied directly to the teeth can strengthen and repair enamel and enhance the beneficial effects of fluoride.

Amorphous Calcium Phosphate
Amorphous calcium phosphate, or ACP, helps prevent the breakdown of tooth enamel, which can lead to tooth decay. It also repairs enamel by stimulating recalcification. Because calcium phosphate attracts fluoride, ACP increases the amount of fluoride that can get into the enamel, boosting its resistance to tooth decay. Because of its restorative effects on tooth enamel, ACP can also reduce tooth sensitivity.

ACP Products
ACP is an ingredient in some fluoride toothpastes, mouth rinses, chewing gums and lozenges. Professionally applied products with ACP include tooth-whitening systems, fluoride varnishes, in-office cleaning paste and treatments to help with sensitive teeth. ACP may be incorporated into dental materials used for orthodontic treatment or for restoring decayed teeth.

Cheese and Teeth
The American Academy of Pediatric Dentistry says that certain cheeses -- including aged cheddar, Swiss, mozzarella and Monterey jack -- help protect the teeth against cavities and promote enamel repair, especially when eaten alone or at the end of a meal. These cheeses stimulate saliva flow, washing away food residue and cavity-promoting bacteria. They also contain large amounts of calcium and phosphorus, which protect against acids in the mouth and promote enamel repair.
 

misfortuneteller

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I'd use Co-Codamol when I don't have access to antibiotics which honestly is way better than most antibiotics sometimes since it doesn't give me any shitty side effects.
 

Totenkindly

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The combination of the antibiotic and the root canal seems to have resolved the major issue. Once the novacaine wore up last evening, I could eat, had no real pain (although there's still a residual weirdness / fake ache, like my jaw remembers / hears the echoes of the screaming pain of the last week and is still uneasy), and even slept in a bed finally last night, which annoyed the cats because they were getting used to sleeping wherever they wanted in my bed.

I just need to schedule for a crown within the next month, with my regular dentist.

Now that the acute problem is gone, I can sense other things... including the sinus stuff. There's sinus pressure impacting my upper teeth, for example. It was just all overshadowed by the problem tooth.

The tooth was in such bad shape that even after they shot me up with all that novacaine on the left side, when he drilled out the filling and started to touch the tooth itself, it wasn't numb in the pulp and my hand shot up and knocked the tray out of the way. (I couldn't talk, because they had the rubber mat and jaw propped open and all that.) I felt bad, but he also knew I couldn't help it; he said it was so inflamed, it needed direct dousing with novacaine once it was exposed. As soon as he doused it, I didn't feel anything more... but the left side of my tongue was also numb for a few hours after that. (My brain tells me the response was logical and there's no way anyone could have sat through that without being numbed; I still felt embarrassed though, over the involuntary response.)

I'm glad I had multiple forms of insurance, although I guess one could make the case that I'm simply paying bi-weekly instead of a lump sum. Still, the cost of the root canal was only about 22% or so of the total cost of the procedure, if I would not have had any insurance. I don't know how people who can't afford the work deal; you kinda have to get it done regardless if you're in that much pain, and then you go into debt.
 
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