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Medical Forum / General / Dentistry / August 2007Is It My Sinuses Or Teeth?
I have had tooth pain on and off for 15 years. Many crowns, frequent cleanings, about 8 root canals. I get x rays when I have pain and the dentist finds nothing on the x-ray but since they can't see through crowns, I wonder what's really going on. But here's what's happening today. I had a steak for lunch. I am always careful with hot and cold foods. I don't know if I bit down too hard, the steak was kind of tough...but my right upper eye tooth felt a slight pain. It is not crowned but has 2 fillings. The pain wasn't bad enough for me to see someone today, just on and off twinges and I am having trouble figuring out which tooth it is because I feel it on all the upper teeth. A few nights ago on the OTHER side, my left eye tooth, lateral incisor and even behind that near the back started hurting, a very piercing pain when I laid on my right side when I went to bed. Then I laid on my back and it went away. I even feel some pain on my bottom teeth. It is very humid in the east and I am wondering if it's my sinuses. Can you feel pain in the eye teeth with sinuses? I just had a cleaning and the dentist said he didn't see any cavities...did not do x-rays as I'm not due for them but I am concerned because either heat or pressure brought on the pain and it wasn't just momentary. I feel no signs of an abscess, I hope it doesn't need a root canal. I almost feel better knowing that it's on both sides, so I tend to think it's my sinuses, this happens so often. Can this humidity outside exacerbate sinus problems, pressure? I have been to neurologists who ruled out trigeminal neuralgia and just don't know why I go through this so often. I also feel it in my temples...could it be originating there in the trigeminal nerve and just traveling down the mandibular and maxillary nerves, causing the pain on both the top and bottom? If anyone can recommend a dentist in NYC who specializes in neuro stuff or who can figure this out, I'd appreciate it. BTW, I am a female (username just picked randomly). > I have had tooth pain on and off for 15 years. Many crowns, frequent > cleanings, about 8 root canals. I get x rays when I have pain and the [quoted text clipped - 30 lines] > specializes in neuro stuff or who can figure this out, I'd appreciate > it. BTW, I am a female (username just picked randomly). Back in the dark ages when I taught at NYUCD, there was a facial pain center run by one Frederick Curro--very smart and a nice guy, but I haven't heard of him in years--you could try to look him up or contact NYUCD. The best facial pain guy I know is Daniel Tannenbaum, in Manhattan--I'm home so I don't have his card with me. Steve > ------------------------------------------------------------------------ NTI  Signature/ Amatus / >> I have had tooth pain on and off for 15 years. Many crowns, frequent >> cleanings, about 8 root canals. I get x rays when I have pain and the [quoted text clipped - 39 lines] >> >> ------------------------------------------------------------------------ > NTI Ditto. I think we've identified another clencher. Steve >> NTI > [quoted text clipped - 3 lines] > >Steve Give them the link: www.headachehope.com Steve, thank you for that referral. I will look hm up. Many years ago I did go to NYU Head and Facial Pain Center. I took Elavil for a while and it helped but I never want to go that route again. I looked up NTI and that does seem to be a good idea since the pains often come when I am under a lot of tension. Do most general dentists have them? If anyone knows a dentist in NYC that could fit me with one, I'd appreciate a referral. I googled it and the list did not include the U.S. and I don't want to just pick someone from the web. If someone could answer my question about the pain from either tension or sinuses being felt in the eye teeth, I'd appreciate it. > Steve, thank you for that referral. I will look hm up. Many years ago I > did go to NYU Head and Facial Pain Center. I took Elavil for a while and [quoted text clipped - 7 lines] > could answer my question about the pain from either tension or sinuses > being felt in the eye teeth, I'd appreciate it. It is possible, but your description of sharp pain isn't typical. Sometimes facial pain syndromes can be very hard to figure out. The change in pain perception with posture can suggest association with sinus problems, but trigger points can suggest neuralgic pain. Obviously I'm just guessing here. While you may well be a clencher your symptoms don't sound quite right here anyway. You want a dentist to evaluate your recent pain and rule out any fractures or infections of the painful teeth. Chronic clenching often leaves signs that will point treatment in a certain direction (such as NTI) but I wouldn't recommend that without seeing you. There are just too many possibilities at this point. Steve > ------------------------------------------------------------------------ An NTI is one thing that you can recommend without actually seeing a patient. It is non-invasive and completely reversible. Clenching is almost always a major component with these symptoms. It may not be the only problem, but I have seen many similar cases where adding an NTI helped a great deal. The NTI helps calm everything down where it is easier to diagnose and treat the rest of the teeth. That lets you find out if any teeth are really cracked or just sore from the extreme abuse being placed upon them. You don't want to start crowning, re-treating endo, or extracting teeth if they don't really need it. Talk to these patients and they often tell of having a painful tooth that was filled, then crowned, then endo'd, and sometimes even extracted. Calm down the clenching, and there may be a lot less dental work indicated. An NTI may not eliminate all of the pain either, but if you can turn a 10 into a 4-6, that is still worth it. JMO, Steve Chronic clenching often leaves signs that will point treatment > in a certain direction (such as NTI) but I wouldn't recommend that > without seeing you. There are just too many possibilities at this point. > > Steve What is the price range of an NTI? $450-$850 Signature/ Amatus / What is the price range of an NTI? ------------------------------------------------------------------------------ > An NTI is one thing that you can recommend without actually seeing > a patient. It is non-invasive and completely reversible. That's kind of like the chicken soup rationale. Of course, the dentist doing an NTI will have seen the patient. My only concern is that often patients who have been on the facial pain merry-go-round for a long time can become desperate. There is no harm for sure in trying an NTI, but parameters should be placed on what is being attempted, and a time frame for accomplishing it. Many facial pain syndromes take a long time to figure out. My mother had an atypical case of trigeminal neuralgia. It was far from a textbook case, but in the end (and after many interventions) it responded to Tegretol. I don't disagree that simple modalities with limited downside should be attempted first. Often though, these patients have been through the mill, and have already been seen by people far smarter in this area than I. Unless I have a good idea that I've managed to pick up on some clinical finding that somehow has been missed by others, I try to find the smartest people I know to try to help these people. steve > Clenching is almost always a major component with these symptoms. It > may not be the only problem, but I have seen many similar cases [quoted text clipped - 22 lines] >> >> Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > My only concern is that often patients who have been on the facial > pain merry-go-round for a long time can become desperate. > steve And it is very likely that not one single 'Dr.' has tried the easiest and safest method to help lessen their symptoms. The more one visits specialists for 'help', the more likely one of them will do something expensive, irreversible and yet still ineffective. If the basics have never been tried before, I think that's a good place to start. I'm not saying to make promises that you can't keep, but at least reduce the parafunctional activities to see what's left. Chances are no one else will. The results can be dramatic. Steve > I have had tooth pain on and off for 15 years. Many crowns, frequent > cleanings, about 8 root canals. I get x rays when I have pain and the [quoted text clipped - 30 lines] > specializes in neuro stuff or who can figure this out, I'd appreciate > it. BTW, I am a female (username just picked randomly). Frank, you may want to consider extracting all your teeth. Just kidding. LOL...Allergies can cause teeth pain. Pain can be tricky, so approach with extreme caution. If your dentist do not find any absess or need for filling or root canal, then the chances are something else causing it such as allergies, recent root canal work which can normally will loosen up in time and pain gone. >> I have had tooth pain on and off for 15 years. Many crowns, frequent >> cleanings, about 8 root canals. I get x rays when I have pain and the [quoted text clipped - 37 lines] >something else causing it such as allergies, recent root canal work >which can normally will loosen up in time and pain gone. Fails to consider nocturnal or diurnal parafunction. Probably just needs an NTI. www.headachehope.com >which can normally will loosen up in time and pain gone. Here's a trivia question for you Trivia Mastur<bater>: What do you call someone that chronically ignores dental problems ? Scroll down... Wait for it... A denture wearer. I had a similar problem of long term sensitivity and small pain when I slept in a certain position or bit hard on that upper eye tooth. It had big fillings and a root canal. I also had a sinusitis history. The dentist gave me a 10 day treatment of antibiotics because the xray showed a small abcess. The problem remained and the dentist offered further treament options such as to redo the root canal. I opted for extraction instead and you could actually see the entire abcess affixed to the tip of the root. Six months later it feels like the right decision. I have had tooth pain on and off for 15 years. Many crowns, frequent cleanings, about 8 root canals. I get x rays when I have pain and the dentist finds nothing on the x-ray but since they can't see through crowns, I wonder what's really going on. But here's what's happening today. I had a steak for lunch. I am always careful with hot and cold foods. I don't know if I bit down too hard, the steak was kind of tough...but my right upper eye tooth felt a slight pain. It is not crowned but has 2 fillings. The pain wasn't bad enough for me to see someone today, just on and off twinges and I am having trouble figuring out which tooth it is because I feel it on all the upper teeth. A few nights ago on the OTHER side, my left eye tooth, lateral incisor and even behind that near the back started hurting, a very piercing pain when I laid on my right side when I went to bed. Then I laid on my back and it went away. I even feel some pain on my bottom teeth. It is very humid in the east and I am wondering if it's my sinuses. Can you feel pain in the eye teeth with sinuses? I just had a cleaning and the dentist said he didn't see any cavities...did not do x-rays as I'm not due for them but I am concerned because either heat or pressure brought on the pain and it wasn't just momentary. I feel no signs of an abscess, I hope it doesn't need a root canal. I almost feel better knowing that it's on both sides, so I tend to think it's my sinuses, this happens so often. Can this humidity outside exacerbate sinus problems, pressure? I have been to neurologists who ruled out trigeminal neuralgia and just don't know why I go through this so often. I also feel it in my temples...could it be originating there in the trigeminal nerve and just traveling down the mandibular and maxillary nerves, causing the pain on both the top and bottom? If anyone can recommend a dentist in NYC who specializes in neuro stuff or who can figure this out, I'd appreciate it. BTW, I am a female (username just picked randomly). ------------------------------------------------------------------------------
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