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Medical Forum / General / Dentistry / May 2005Please help, I am in pain
Hello, I am 33 years old. I have 2 wisdom teeth on top that have been partially through the gum for quite some time. The lower wisdom teeth are under the gum. Over the last few days I have had an excruciating pain on the upper left side of my head and teeth. I though maybe my wisdom tooth was coming through more and pressing on my other teeth causing severe pressure. It is so intense, I am in tears. Nothing will take the pain away. I thought maybe Pericoronitis but I don't really feel swollen on my gum around that tooth, and definately no pus. My entire left top arch just KILLS and I can't figure out what is going on. I guess it hurts the most towards the back but it is not red on the gums, or swollen that I can see. I will call a dentist tomorrow, but in the meantime what will help the pain? Could it be my wisdom tooth pressing harder against the other teeth? The pain is unbearable, no joke. What do you think could cause this much pain? Also, I had a cold last week and still feel a little clogged up on the left side (just a little) but that would not make my teeth (the whole left side) hurt... It feels like extreme pressure and a horrid headache. Thanks. > Hello, > [quoted text clipped - 18 lines] > > Thanks. Especially if your pain varies with the position (lying down, sitting up), esp. with the congestion, there is a significant chance you may have a sinus infection. If you can touch around the gum with your finger and there is no pain, it is unlikely that pericoronitis is the problem. If you haven't had a checkup recently and don't know the status of your other teeth, it certainly is possible that you have a nerve going sour in one of your teeth. If you are a regular patient at a dentist you certainly should try to call today for at least symptomatic relief, or to give you some pain meds. Good luck, Steve  SignatureCut the nonsense to reply >> Hello, >> [quoted text clipped - 29 lines] > If you are a regular patient at a dentist you certainly should try to call > today for at least symptomatic relief, or to give you some pain meds. Without seeing an x-ray, my guess would be deep decay on #15 or 16 that has gone into the nerve. Any hot/cold sensitivity? Any pain when you tap on the teeth? Thanks so much for the replies. My cold is pretty much gone, and the pain is constant no matter if I sit or stand or lay down. When I feel in the back of my mouth back behind the wisdom tooth, I guess it is a bit sore, but it seems like it is not sore enough to be this intense. This pain is unreal and is causing my whole head to throb for 2 days. I was seen by a dentist a few months back and was told the wisdom teeth need to come out, but that was the only problem. I was waiting for my new insurance to kick in because I had a crappy managed care plan. Can the wisdom tooth grow in more at age 33? If so, would the pressure of pushing on the other teeth be THIS intense? I do have on filling on this side of the mouth, but I don't think there are any problems with it. The filling is not loose or coming out. It really almost feels like my wisdom tooth is "in" further. If it IS Pericoronitis, can you tell me what would help the pain, and would it be so bad that I am up all night and day in tears? > Thanks so much for the replies. My cold is pretty much gone, and the > pain is constant no matter if I sit or stand or lay down. When I feel [quoted text clipped - 11 lines] > tell me what would help the pain, and would it be so bad that I am up > all night and day in tears? Pericoronitis pain is usually not that severe. I'm thinking that NOYB is right--you have a dying nerve. There need not be anything obviously wrong with the filling--the nerve of the tooth may well have been injured by the decay and/or the filling, esp. if the decay was deep--months or even years ago, and the nerve just picked this time to become an acute problem. You'll need to see someone promptly. Good luck, Steve SignatureCut the nonsense to reply >> Thanks so much for the replies. My cold is pretty much gone, and the >> pain is constant no matter if I sit or stand or lay down. When I feel [quoted text clipped - 18 lines] > ago, and the nerve just picked this time to become an acute problem. > You'll need to see someone promptly. This is purely a guess, and can only be confirmed with exam and x-ray: #15 has deep distal decay into the nerve due to the partially erupted wisdom tooth causing food impaction and/or plaque retention in that area. The recommendation in my practice: all *partially* erupted wisdom teeth should go. I've seen too many times where the 2nd molar's health is jeopardized by a partially erupted wisdom tooth...and then the patient loses *two* teeth when the pain sets in. > Hello, > > I am 33 years old. I have 2 wisdom teeth on top that have been > partially through the gum for quite some time. The lower wisdom teeth > are under the gum. Over the last few days I have had an excruciating > pain on the upper left side of my head and teeth. I must warn you: this may aggravate the pain, but it might help with the pain as well: Bathe the back teeth on that side with cold water. What happens? If the pain diminishes, there's a good chance that one of the teeth is going into pulpitis and will need a root canal. What about when you clack your teeth together? Does that make the tooth/teeth hurt more or not? As SB has said: you need to see the dentist. SignatureFinally: take out the TRASHH > Bathe the back teeth on that side with cold water. What happens? If the > pain diminishes, there's a good chance that one of the teeth is going > into pulpitis and will need a root canal. That trick worked for me last time, big time! (thanks Joel) I ended up spending the night with an ice chest next to the bed. Took my cup of ice right into the operatory. Vaughn > > Bathe the back teeth on that side with cold water. What happens? If the > > pain diminishes, there's a good chance that one of the teeth is going [quoted text clipped - 5 lines] > > Vaughn Yep...that's Pulpitis, allright SP SignatureFinally: take out the TRASHH >> Hello, >> [quoted text clipped - 9 lines] > pain diminishes, there's a good chance that one of the teeth is going > into pulpitis and will need a root canal. Pulpitis indicates a vital nerve. If cold *helps*, then it's probably necrosis with acute apical abscess. If cold makes it worse, it's pulpitis. If the cold sensitivity lingers, it's irreversible pulpitis. AFAIK, ice doesn't help a tooth with a diagnosis of pulpitis. > > I must warn you: this may aggravate the pain, but it might help with the > > pain as well: [quoted text clipped - 5 lines] > Pulpitis indicates a vital nerve. If cold *helps*, then it's probably > necrosis with acute apical abscess. I'm talking cold applied to the crown, and not to the face around the tooth. > If cold makes it worse, it's pulpitis. > If the cold sensitivity lingers, it's irreversible pulpitis. A normal tooth does not responde to cold. If it is a 'Hot Tooth' (irreversible inflammation with pain) it _is_ soothed by cold and aggravated by hot. If the tooth is _transiently_ aggravated by cold (sensation ceases as soon as the cold stimulus is stopped) it is reversible pulpitis (hyperhemia). If the pain elicited by cold lingers, you have irreversible pulpitis, as you do in case of a delayed response to hot. If the tooth is sensitive to percussion or digital pressure, there is an abcess somewhere. This may not show up on the xray for some time yet. Y'all can correct me if I'm wrong, but that's my story and that's how I learned it. So sayeth the Pipe SP SignatureFinally: take out the TRASHH >> > I must warn you: this may aggravate the pain, but it might help with >> > the [quoted text clipped - 9 lines] > I'm talking cold applied to the crown, and not to the face around the > tooth. There should be no difference. >> If cold makes it worse, it's pulpitis. >> If the cold sensitivity lingers, it's irreversible pulpitis. > > A normal tooth does not responde to cold. Sometimes it does, but it doesn't linger. Think about those cold-sensitive abfraction lesions. > If it is a 'Hot Tooth' > (irreversible inflammation with pain) > it _is_ soothed by cold and > aggravated by hot. I assume you're talking about inflammation of the periapical region...not inflammation of the pulp. In such a case, the nerve is necrotic. >If the tooth is _transiently_ aggravated by cold > (sensation ceases as soon as the cold stimulus is stopped) it is > reversible pulpitis (hyperhemia). Or normal! > If the pain elicited by cold lingers, > you have irreversible pulpitis, as you do in case of a delayed response > to hot. Yes. >If the tooth is sensitive to percussion or digital pressure, > there is an abcess somewhere. Not always. You can have AAP (Acute apical periodontitis) with irreversible pulpitis...and it may be percussion/palpation sensitive. An "abscess" doesn't form until the nerve become necrotic. >This may not show up on the xray for some > time yet. AAP or very early AAA (Acute apical abscess). However, a diagnosis of a "very early AAA" requires that the nerve test non-vital. > Y'all can correct me if I'm wrong, but that's my story and that's how I > learned it. Pulp status possibilities: 1) Normal--can be cold sensitive, but doesn't linger 2) Pulpitis (Reversible)--cold usually hurts, but doesn't linger 3) Pulpitis (Irreversible)--cold usually hurts, and lingers 4) Necrotic--cold sometimes helps, heat sometimes hurts or does nothing Periapical status: 1) normal 2) AAP--pain to percussion, sometimes to cold 3) CAP--many times asymptomatic, radiographic radiolucency, no effect to cold 4) AAA--significant pain/swelling, cold helps 5) Suppurative apical periodontitis--draining fistula 6) Condensing Osteitis If cold helps, that tooth is necrotic with AAA. >Pulp status possibilities: >1) Normal--can be cold sensitive, but doesn't linger [quoted text clipped - 12 lines] > >If cold helps, that tooth is necrotic with AAA. I'd buy that for a dollar. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>Pulp status possibilities: >>1) Normal--can be cold sensitive, but doesn't linger [quoted text clipped - 15 lines] > I'd buy that for a dollar. > -- Should I send along my Paypal account info? after the Pipe blathered: > > Y'all can correct me if I'm wrong, but that's my story and that's how I > > learned it. [quoted text clipped - 15 lines] > > If cold helps, that tooth is necrotic with AAA. Hmmmm.... Gonna check in my Franklin Wein (once I find it again...) Thanks SP SignatureFinally: take out the TRASHH after the Pipe again blathered: > > Y'all can correct me if I'm wrong, but that's my story and that's how I > > learned it. [quoted text clipped - 3 lines] > 2) Pulpitis (Reversible)--cold usually hurts, but doesn't linger > 3) Pulpitis (Irreversible)--cold usually hurts, and lingers In my book, so does hot, as pressure builds in the pulp chamber. This is before the heightened pressure blocks blood flow. > 4) Necrotic--cold sometimes helps, heat sometimes hurts or does nothing I don't get how you can say this: Necrosis==>cell death ( nerve, in this case). No blood flow. So, no nerve conduction. Then what is your definition of a hot tooth? Thanks SP SignatureFinally: take out the TRASHH > after the Pipe again blathered: >> > Y'all can correct me if I'm wrong, but that's my story and that's how I [quoted text clipped - 11 lines] > > Then what is your definition of a hot tooth? One shaped like Paris Hilton? >> Then what is your definition of a hot tooth? > >One shaped like Paris Hilton? Angelina Jolie ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> Then what is your definition of a hot tooth? > > [quoted text clipped - 6 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Gonna check in my Franklin Wein (once I find it again...) SP SignatureFinally: take out the TRASHH >> >> Then what is your definition of a hot tooth? >> > [quoted text clipped - 5 lines] >Gonna check in my Franklin Wein (once I find it again...) >SP Ya'll gots funny names fer yer unitz up thar in Kaanaadaa -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> >> Then what is your definition of a hot tooth? > >> > [quoted text clipped - 8 lines] > Ya'll gots funny names fer yer unitz up thar in Kaanaadaa > -- http://www.google.ca/search?hl=en&q=Franklin+S+Weine&meta= SP SignatureFinally: take out the TRASHH > >W_B <no_one@nowhere.net> wrote: > >> >> Then what is your definition of a hot tooth? > >> > [quoted text clipped - 7 lines] > > Ya'll gots funny names fer yer unitz up thar in Kaanaadaa I was about to post that I could pull mine down off the shelf and blow the dust off it. Glad I was slow to post.!! <VBG> >> >W_B <no_one@nowhere.net> wrote: > [quoted text clipped - 12 lines] >I was about to post that I could pull mine down off the shelf and blow the >dust off it. Glad I was slow to post.!! <VBG> Good one ! -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> >W_B <no_one@nowhere.net> wrote: > > [quoted text clipped - 15 lines] > Good one ! > -- Laugh if you want, but I find Weine much easier to understand that Cohen and Burns. The sixth ed will be the last, as it is difficult to revise your manuscripts when being dead. All-Tempa-Cheers SP SignatureFinally: take out the TRASHH >> >> >Gonna check in my Franklin Wein (once I find it again...) >> >> >SP [quoted text clipped - 12 lines] >All-Tempa-Cheers >SP Woosh.... Sound of joke passing SP at light speed... -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> >> >Gonna check in my Franklin Wein (once I find it again...) > >> >> >SP [quoted text clipped - 17 lines] > Sound of joke passing SP at light speed... > -- 'Guess so... Wadden't be the first time.... I'll go cry in my tea now.... and then I'm Gonna check in my Franklin Wein (once I find it again...) SP SignatureFinally: take out the TRASHH >> If cold makes it worse, it's pulpitis. >> If the cold sensitivity lingers, it's irreversible pulpitis. [quoted text clipped - 14 lines] >So sayeth the Pipe >SP I'd buy that for a dollar. Yet, some 'normal' teeth do respond to very cold, especially in those with parafunction. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com The last time I had a wisdom tooth that was in that much pain, it was infected. What dentists call "abscess", which is another word for infected. I was fortunate enough to have access to antibiotics, which helped incredibly much. I also found out that mixing ibuprophen (ingredient found in Motrin) and acetaminophen (ingredient found in Tylenol) worked well for the pain. This isn't reccomended, because it increases the toxicitiy. What really did the job was when the oral surgeon removed the offending tooth. The hydrocodone I had filled at Walmart turned out to be useless. Wish I'd had it filled at a real drugstore. I hope others can learn from my mistake. SignatureChristopher A. Young Learn more about Jesus www.lds.org www.mormons.com Hello, I am 33 years old. I have 2 wisdom teeth on top that have been partially through the gum for quite some time. The lower wisdom teeth are under the gum. Over the last few days I have had an excruciating pain on the upper left side of my head and teeth. I though maybe my wisdom tooth was coming through more and pressing on my other teeth causing severe pressure. It is so intense, I am in tears. Nothing will take the pain away. I thought maybe Pericoronitis but I don't really feel swollen on my gum around that tooth, and definately no pus. My entire left top arch just KILLS and I can't figure out what is going on. I guess it hurts the most towards the back but it is not red on the gums, or swollen that I can see. I will call a dentist tomorrow, but in the meantime what will help the pain? Could it be my wisdom tooth pressing harder against the other teeth? The pain is unbearable, no joke. What do you think could cause this much pain? Also, I had a cold last week and still feel a little clogged up on the left side (just a little) but that would not make my teeth (the whole left side) hurt... It feels like extreme pressure and a horrid headache. Thanks. > The last time I had a wisdom tooth that was in that much pain, it was > infected. What dentists call "abscess", which is another word for [quoted text clipped - 3 lines] > in Motrin) and acetaminophen (ingredient found in Tylenol) worked well for > the pain. Smart move. The combo works very well. >This isn't reccomended, because it increases the toxicitiy. Not really. Especially in the short term. > What really did the job was when the oral surgeon removed the offending > tooth. > > The hydrocodone I had filled at Walmart turned out to be useless. Wish I'd > had it filled at a real drugstore. This statement makes no sense. Thanks so much for the replies! Saw a dentist today, and he actually thinks one of the muscles in my cheek is cramped up or spasming or something. I had gallbladder surgery last week and he thinks I had been grinding my teeth at night or something to get through the pain. I also have a filled tooth that may need a root canal at some point, but he thinks the muscle in my cheek is radiating the pain. Kinda like TMJ or something. I really don't understand, but I am willing to give his treatment a shot. He prescribed a muscle relaxer and vicoprofen and told me to give it 48 hours to see if it is better! I hope he is right! > Thanks so much for the replies! Saw a dentist today, and he actually > thinks one of the muscles in my cheek is cramped up or spasming or [quoted text clipped - 6 lines] > and told me to give it 48 hours to see if it is better! I hope he is > right! The way to know if a chewing muscle is causing pain is to freeze it just like you would do for a tooth that needs a filling. You palpate around on the cheek, find the worst offending area, and clean the skin and inject a small amount of ansesthetic. If the muscle spasm is contributing to the pain, it will diminish and may even finally cease. This is temporary, but it allows the clinician to separate out the influences of the musculature to facial and jaw pain. I know it sounds brutal, but it isn't really. If you're still not sure when you see your dentist again, you can have him try this. Cheers SP SignatureFinally: take out the TRASHH > The way to know if a chewing muscle is causing pain is to freeze it just > like you would do for a tooth that needs a filling. You palpate around [quoted text clipped - 9 lines] > -- > Finally: take out the TRASHH Okay, will do! It does actually feel a bit better this morning so I am praying he is correct. I just can't believe that a muscle in my cheek was causing such intense pain in my teeth and the worst headache I have ever had. Unbelievable. All I can say is, if this treatment works, I will be really impressed with this dentist. Thanks for all the advice I got here, you were very nice to respond! > Thanks so much for the replies! Saw a dentist today, and he actually > thinks one of the muscles in my cheek is cramped up or spasming or [quoted text clipped - 6 lines] > and told me to give it 48 hours to see if it is better! I hope he is > right! Of course! TMD. That's the trouble with trying to diagnose over the internet... Do you all think this is reasonable? That the stress of the surgery caused me to clench my teeth and grind at night causing this pain? Will a cramped muscle in the cheek refer pain all through the teeth and head? Touching my cheek from the outside does not hurt, but when he was feeling around from the inside yesterday, it did hurt. I took the meds last night and then felt better this morning, but the pain started to come back so I took another vicoprofen and I will take a muscle relaxer tonight, since that's what the directions say (only at night). He prescribed Flexeril. Thanks everyone! > Do you all think this is reasonable? That the stress of the surgery > caused me to clench my teeth and grind at night causing this pain? > Will a cramped muscle in the cheek refer pain all through the teeth and > head? Touching my cheek from the outside does not hurt, but when he > was feeling around from the inside yesterday, it did hurt. Hurts from the inside: Medial Pterygoid muscle spasm... this could be true. >I took the > meds last night and then felt better this morning, but the pain started > to come back so I took another vicoprofen and I will take a muscle > relaxer tonight, since that's what the directions say (only at night). > He prescribed Flexeril. Thanks everyone! SignatureFinally: take out the TRASHH |
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