Current dental woes

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ttf_timothy42b
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Current dental woes

Post by ttf_timothy42b »

I've had a rather bad toothache on the upper left side several days.  It hasn't required an opioid, Motrin has been sufficient, but the cold sensitivity is extreme, and it also aches on the lower and in the jaw joint.  I'm having trouble sleeping.

They got me in today, but the dentist couldn't find anything wrong on top.  She did X-rays, an exam, and she used that cold stuff.  The bottom spot reacted strongly to the cold, and took its time easing up.  The top didn't react much and eased up immediately.

There are bridges top and bottom, and none of the teeth have root canals.

So her diagnosis is root canal needed on the lower tooth, nothing on the upper, have an impression for a bite guard for the jaw clicking.  Nothing on the x-ray, no infection, no need for antibiotics. 

Okay, but I'm in pain on top where they didn't find anything, and if I take the sedation like usual I wait 5 weeks in pain before the root canal on the bottom.  (I can go in in 10 days if I forego sedation.  Maybe just get some Xanax from my primary care.  I am a very very bad dental patient, hard to get through anything without a little help.) 

She thinks the top is referred pain from the lower.  I think I have two problems and she didn't find the second.  I've been very satisfied with this dental practice though. 
ttf_robcat2075
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Current dental woes

Post by ttf_robcat2075 »

Teeth are a hassle.

You'd think intelligent design would have come up with something easier to maintain.
ttf_ronkny
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Current dental woes

Post by ttf_ronkny »

Quote from: timothy42b on Dec 18, 2017, 10:00AMI've had a rather bad toothache on the upper left side several days.  It hasn't required an opioid, Motrin has been sufficient, but the cold sensitivity is extreme, and it also aches on the lower and in the jaw joint.  I'm having trouble sleeping.

They got me in today, but the dentist couldn't find anything wrong on top.  She did X-rays, an exam, and she used that cold stuff.  The bottom spot reacted strongly to the cold, and took its time easing up.  The top didn't react much and eased up immediately.

There are bridges top and bottom, and none of the teeth have root canals.

So her diagnosis is root canal needed on the lower tooth, nothing on the upper, have an impression for a bite guard for the jaw clicking.  Nothing on the x-ray, no infection, no need for antibiotics. 

Okay, but I'm in pain on top where they didn't find anything, and if I take the sedation like usual I wait 5 weeks in pain before the root canal on the bottom.  (I can go in in 10 days if I forego sedation.  Maybe just get some Xanax from my primary care.  I am a very very bad dental patient, hard to get through anything without a little help.) 

She thinks the top is referred pain from the lower.  I think I have two problems and she didn't find the second.  I've been very satisfied with this dental practice though. 
Xanax or Triazolam are great alternatives to IV sedation. Just don't operate the wood chipper while you are on it. Triazolam and Xanax are metabolized rather quicky.
Sounds like an irreversibly inflamed tooth on the bottom needing a root canal. That pain can radiate to the upper jaw on the same side if severe enough. I'm betting it's just the lower tooth since the cold sensitivity you described could not be replicated on top. Only on the bottom.
ttf_harrison.t.reed
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Current dental woes

Post by ttf_harrison.t.reed »

Quote from: robcat2075 on Dec 18, 2017, 10:28AMTeeth are a hassle.

You'd think intelligent design would have come up with something easier to maintain.

[s]Intelligent design[/s] Darwinism says it's OK to die at age 30, when your offspring is an adult.

But then again, hunter gatherers studied last century rarely had any dental problems at all.
ttf_timothy42b
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Current dental woes

Post by ttf_timothy42b »

They didn't have any Hershey bars available.

At home my top teeth are more cold sensitive.  At the dentist office my bottom tooth was.  I hope she is right about which tooth. 

She wants to impression my teeth and make a bite guard to wear at night.  $630.  (Insurance pays 80%)

Walmart sells a kit for $15 that does the same thing, but the package says be careful never to use it for TMJ, or bruxism, or sports.  Then.........what would it be for?  Seems like those are the only three things you'd want a bite guard for. 
ttf_ronkny
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Current dental woes

Post by ttf_ronkny »

Quote from: timothy42b on Dec 18, 2017, 02:31PMThey didn't have any Hershey bars available.

At home my top teeth are more cold sensitive.  At the dentist office my bottom tooth was.  I hope she is right about which tooth. 

She wants to impression my teeth and make a bite guard to wear at night.  $630.  (Insurance pays 80%)

Walmart sells a kit for $15 that does the same thing, but the package says be careful never to use it for TMJ, or bruxism, or sports.  Then.........what would it be for?  Seems like those are the only three things you'd want a bite guard for. 
If you are a heavy grinder you'll wear through over the counter nightguards in no time. A good NG made by a good lab will last at least 10 years.  It is more comfortable too. Any NG will protect your teeth from being worn down. Chewable NG's are bad for TMJ issues and definitely not for sports. Not sure why it would say "not for bruxism".
I had two bruxer patients last week fracture unrestored posterior teeth and needed crowns. A $650 NG would have been a good investment.
ttf_timothy42b
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Current dental woes

Post by ttf_timothy42b »

I don't grind at all.  The dentist I saw (and she's not familiar with my teeth, she's part of a practice) said a bite guard would position my jaw better during sleep and help with the jaw clicking which must be at least mild TMJ. 

I don't do any contact sports, not even tennis, so I'm probably not going to need a sports guard. 
ttf_Doug Elliott
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Current dental woes

Post by ttf_Doug Elliott »

IMO it's always worth getting a second independent opinion, especially in dentistry issues.
ttf_ronkny
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Current dental woes

Post by ttf_ronkny »

Quote from: timothy42b on Dec 19, 2017, 08:58AMI don't grind at all.  The dentist I saw (and she's not familiar with my teeth, she's part of a practice) said a bite guard would position my jaw better during sleep and help with the jaw clicking which must be at least mild TMJ. 

I don't do any contact sports, not even tennis, so I'm probably not going to need a sports guard. 
Meh.  A NG will not reposition the jaw unless it's designed to do that. Then it would be an orthotic which is a bit more complicated and expensive to design with lots of follow up appointments. Clicking is not a bad thing. Sometimes it's anatomical, past trauma, clenching (NG's don't help for clenching because most people who clench do it during the day). NG's can take the pressure off your TMJ because you can't grind as hard. They also protect your teeth from wear, fracturing and recession/ab-fraction.
BTW, 90% of patients I see, that have excess wear,  say they don't grind. Then I show them a photo of the edges of their teeth and have them grind in extreme left right and forward positions and I show them how their teeth have ground so they fit together like pieces of a puzzle. They shouldn't fit like pieces of a puzzle when you slide left right, forward and forward left or right. Most guys have no idea that they grind. They just wear things down or break things. Most women have symptoms (pain, headaches, locking).
ttf_Steve Foote
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Current dental woes

Post by ttf_Steve Foote »

I had a toothache which wasn't even bad enough for medication.
My dentist used a test which has not been mentioned. He used the handle of his mirror to gently tap the chewing surface of the teeth in the painful area. The culprit was quickly identified! X-Ray confirmed the presence of infection around the root. A root canal (which was nothing like the horror stories everyone hears) took care of the problem.
At home I tried tapping with the handle of my tooth brush. Same results.
You might give this a try and see if it works for you.
ttf_ronkny
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Current dental woes

Post by ttf_ronkny »

Quote from: Steve Foote on Dec 19, 2017, 12:10PMI had a toothache which wasn't even bad enough for medication.
My dentist used a test which has not been mentioned. He used the handle of his mirror to gently tap the chewing surface of the teeth in the painful area. The culprit was quickly identified! X-Ray confirmed the presence of infection around the root. A root canal (which was nothing like the horror stories everyone hears) took care of the problem.
At home I tried tapping with the handle of my tooth brush. Same results.
You might give this a try and see if it works for you.
Percussion test is good but the Cold test works better. And a tooth that responds to cold with intensity and lingers is a hot tooth that needs a root canal. A cold test on a dead tooth would result in no response then percussion and an xray will usually identify it. 
I've done this a few times. Image
ttf_timothy42b
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Current dental woes

Post by ttf_timothy42b »

I made the appointment for the root canal, but with the holidays it's still a week off.

I'm having second thoughts though.  The cold sensitivity has gone away.  I have a dull ache on top and bottom but it didn't require motrin yesterday.  Shouldn't a bad tooth stay bad?  The bit feels high though. 
ttf_ronkny
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Current dental woes

Post by ttf_ronkny »

Quote from: timothy42b on Dec 20, 2017, 05:37AMI made the appointment for the root canal, but with the holidays it's still a week off.

I'm having second thoughts though.  The cold sensitivity has gone away.  I have a dull ache on top and bottom but it didn't require motrin yesterday.  Shouldn't a bad tooth stay bad?  The bit feels high though. 
so when teeth need root canals it is usually because; the decay went in to the nerve, fracture into the nerve, there was trauma in the past, an oops by the doc, idiopathic reasons numerous other reasons, and some just give up over the years because of decay, drilling, chewing, fracturing, more drilling, etc. Remember that blood vessels go into and out of the tooth. When there's inflammation for a long time, the tooth pulp swells, creates back pressure (hurts bad or is really cold sensitive) then over time, because the blood supply can't get into the tooth (due to back pressure) the pulp dies. The pain goes away for a while until the infection sets in and then the pain comes back. This back pressure and subsequent infection can "lift" the tooth out of its socket by just a little bit but enough to notice that your tooth feels like you're hitting it to hard when you bite.
This is all speculation since I personally have not examined you so trust your doc or find someone you do trust.
ttf_ronkny
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Joined: Sat Mar 31, 2018 11:58 am

Current dental woes

Post by ttf_ronkny »

Quote from: timothy42b on Dec 20, 2017, 05:37AMI made the appointment for the root canal, but with the holidays it's still a week off.

I'm having second thoughts though.  The cold sensitivity has gone away.  I have a dull ache on top and bottom but it didn't require motrin yesterday.  Shouldn't a bad tooth stay bad?  The bit feels high though. 
so when teeth need root canals it is usually because; the decay went in to the nerve, fracture into the nerve, there was trauma in the past, an oops by the doc, idiopathic reasons numerous other reasons, and some just give up over the years because of decay, drilling, chewing, fracturing, more drilling, etc. Remember that blood vessels go into and out of the tooth. When there's inflammation for a long time, the tooth pulp swells, creates back pressure (hurts bad or is really cold sensitive) then over time, because the blood supply can't get into the tooth (due to back pressure) the pulp dies. The pain goes away for a while until the infection sets in and then the pain comes back. This back pressure and subsequent infection can "lift" the tooth out of its socket by just a little bit but enough to notice that your tooth feels like you're hitting it to hard when you bite.
This is all speculation since I personally have not examined you so trust your doc or find someone you do trust.
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