A long and Frustrating Journey
I met a new patient yesterday, who proceeded to tell me a story that involved three different dentists. She politely asked me to listen to a tale that encompassed months of mouth pain agony with her mask in place. I want to share some of the details and how she came to me. She lived on the West Side of Cleveland and came to see me based on a recommendation. However, before that recommendation followed a long and frustrating journey.
“I Am Experiencing Horrible Mouth Pain!”
A few months back, she began to experience pain on the right side of her face. The source of the discomfort felt like it was coming from a tooth or a few teeth. Naturally, she called her dentist for his thoughts and a solution. The dentist proceeded to tell her that she had cavities present on several teeth. Cavities can be painful and cause aching. She scheduled a visit to rectify the problem with fillings.
Adjusting The Bite After A Filling May Do The Trick
After the anesthetic wore off, the mouth pain returned. At times the pain was better, but then it returned with a vengeance. The proper course of action involved calling her dentist and getting his opinion. He recommended that she come in and get the bite adjusted. If the bite is not correct, teeth will respond negatively. I have written multiple columns about the trauma and problems that can occur when the bite is off. She saw the dentist, who made some minor adjustments to her bite. At first, she thought that she was home free, but the pain came back as time went on.
Tooth Sensitivity is Normal And Wont Last
Since her treatment only involved fillings told me that she did not have severe decay on these teeth. I don’t know how many teeth were involved, but she informed me that multiple teeth had treatment. Whenever we treat a tooth in any way, the chance of a reaction is always there. If more than one tooth is part of the plan, the potential for issues will increase.
I believe that this fact then led her dentist to tell her that tooth sensitivity is normal. How long can this uncomfortable feeling last? “It can last for months. Sometimes the pain can last for even six months.” Then all of a sudden, the pain will stop. She felt better when she heard this.
Perhaps A Root Canal Is in Order?
Hearing something is one thing. It is hard to stay on the intellectual page when you are hurting, and the pain is monumental.
She needed a solution to her pain.
She sought out the help of another dentist. The magnitude of pain was so severe that her new dentist felt that she needed a root canal treatment. This approach is very reasonable as we often do a root canal procedure to alleviate severe pain.
Unfortunately, the pain did not go away.
The dentist recommended a second root canal on another tooth as obviously the tooth he treated was not the problem, or at best not the whole problem.
Getting a 3rd Opinion
Upon hearing this, a red flag went up, and she looked to go elsewhere. I just had finishing treating her friend, and she recommended me to her.
I listened carefully to her story and then examined her. When I touched the gum next to the painful tooth, she screamed at the top of her lungs.
Finally a Proper Diagnosis!
Together with all of her history, I knew that she did not have a tooth problem. Her problem is a nerve problem, and I referred her to a neurologist. She needed medicine, not fillings or root canals.
Like other patients and cases, we’ve discussed, not all mouth pain is a result of a dental issue. Sometimes dental issues are actually medical issues.
Teasing out a problem, which we call differential diagnosis, is a challenge. Sometimes it is trial and error, but it is crucial to proper treatment.
I compliment the patient for sticking with the process and finding a solution.
If you have a persistent issue that needs some attention, please call us at 440.951.7856.
Nicole or Cat will answer and help you get better. I look forward to hearing from you.
Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine in the Department of Comprehensive Care.