Oral pain, tooth pain, and injuries

Dentist Steven E. Roth, DMD, answers questions about oral pain, toothaches, and mouth injuries.

Question: I had my teeth cleaned yesterday and when I woke up today, I found a “bubble” inside my gum, on top of my wisdom tooth. Now it has doubled in size. I can only open my mouth about 2 inches and it hurts to swallow. I can’t close my mouth without hurting it. I got an emergency appointment but it’s not for three weeks. What can I do in the meantime?

Answer:All of the symptoms you are experiencing are signs of infection and are a real emergency that can get worse. I would get to a dentist as soon as possible. These types of infections can be quite painful and end up with a hospitalization or worse.

Question: I went to a dentist with pain in my lower right molar. The dentist recommended and performed a root canal. I was OK until the anesthetic wore off, and then pain in the tooth started to increase.

I took amoxicillin and Vicodin  (acetaminophen and hydrocodone)for five days without any real improvement in the pain. When I went back to the dentist the next week, I was told this was normal. Pain wakes me up and makes eating difficult. I'm living on ibuprofen to manage the throbbing pain. I am scheduled to see this dentist again this week to have post and crown put in. I'm not anxious to put in a crown if the pain hasn't subsided. Is it normal for pain to persist for seven to ten days after the root canal?

Answer:Patients react differently to different situations. Some people experience pain while others do not. It sounds like the antibiotics and pain medications are the way to go, but if the pain is severe, I would call the dentist immediately and not proceed with any other work until the pain completely subsides.

Question: I have been up all night in pain from seeing the endodontist at 1:00 p.m. to finish a root canal. I am on Z-Pak antibiotics(Azithromycin)because it became infected. I take Vicodin extra strength, oxycodone, and ibuprofen every few hours. Nothing seems to work. The pain is pulsating, and as soon as the painkiller helps a very little bit, it only lasts for half an hour and I am back to where I started. Other than taking more and more painkillers mixed with ibuprofen (which I do not want to do), what can I do?

Answer:It sounds like the antibiotics and pain medications are the way to go, but if the pain is severe, I would call the dentist immediately and not proceed with any other work until the pain completely subsides. Only the treating dentist knows the exact situation, and communicating with him/her is the best advice I can offer.

Question: I had my 2 left wisdom teeth extracted a week ago. I ended up with a dry socket on the bottom. My oral surgeon went with the clove oil technique -- gauze soaked in clove oil and packed in the cavity -- for 7 days. Is it really safe to leave it in for 7 days? Sounds like an infection waiting to happen.

Answer:Without knowing the exact circumstances, normal treatment is to remove that packing within 48 hours or an infection can ensue. Please contact the oral surgeon as soon as possible to resolve this situation.

Question: I've been dealing with my wisdom teeth rotting for quite awhile. I actually was scheduled to have them extracted last year, but a week before surgery, I found out I was pregnant and couldn't be put under anesthesia. Then I had to switch dental insurance, and now I have a six-month waiting period. My wisdom teeth have come in and started rotting. The side and part of the top is gone on both of them. They go through cycles of hurting and not hurting. I use Orajel and Tylenol for the pain. I'm just wondering, if they don't become infected, will they eventually just finish falling out and the nerve die? Or if the tooth is gone, will the root still hurt?

Answer:It sounds like a deteriorating situation to me. The teeth will not fall out, the remaining teeth or roots can get infected and cause big problems. I would get to an oral surgeon as soon as possible to properly assess the situation and to hopefully prevent major infection and problems.

Question: About 4 years ago I bit into something, and my second from the last lower left broke in half. I had a root canal and a crown. The crown felt - not like my other teeth. Now my tooth (the crown) is in a ton of pain. Not a sharp pain but a constant, nagging, "heavy" pain. Not overwhelming, more like a 2.5 on a 10 scale. For what it is worth, the gum line where the crown meets the gum is black although I was told "that is normal". Basically, it feels like something is rotten below the crown, like there may be an infection under there.

I have now visited 3 different dentists who have told me that it was "impossible" for there to be pain under the crown because there was "no nerve". Well, I can assure you there IS pain, and it is 24 hours a day. I think this is a contributor to a huge amount of stress in my life and even my mind-set to the point that it is driving me crazy. One dentist even X-rayed. Said there was nothing. What could be the problem? Could there be a real pain caused by an

infection.

Answer:There are several possibilities. The bottom line is if there is pain, your body is telling you that something is wrong. Root canals can become re-infected. The tooth could be fractured and infected, or there could be a deteriorating periodontal or bone situation where the housing of the tooth is shrinking away.

It is easy to get overwhelmed by pain because your body wants it to stop. My best advice is to see a dentist who can evaluate the situation with X-rays, visual exam, periodontal probing, tapping the tooth, feeling the tissues around the tooth. When I cannot diagnose the specific problem, I will always refer to a specialist such as an endodontist, oral surgeon, or periodontist for their expert opinion.

Question: I am currently pregnant and having issues with my teeth. My wisdom tooth is coming in, causing a great deal of pain. I am not able to see my ob-gyn for two more weeks, to let me know if I am able to have my wisdom teeth taken out. It is starting to become sickly painful. What can I do until then?

Answer:Removal of a tooth is considered surgery. Even though you are having pain it is important to receive medical clearance from your ob-gyn first. If you are in pain you should be able to get medical clearance from the ob-gyn immediately. Pain and infections are a risk to the fetus and the pregnancy. Get in touch with them immediately or go to your local ER if you can’t.

Question: I've had a four surface filling done three weeks ago and I am still having pain. I've gone back to the dentist a week ago for her to look at it. She shaved it down a bit and told me not to eat with it for 4 to 5 days. So today, a week later, I've tried to eat a pb&j, and it had a stinging pain in the middle, so I took some aspirin.

I am worried as to why it is still hurting. I've waited this long and until the afternoon, since I grind, but have been using a mouth guard. The dentist explained that the grinding may cause some pain since the nerve was over stimulated. I am not sure if I need a root canal or something else. I have an appointment for some more fillings on Monday. Should I wait until then or should I go see her again soon?

Answer:If you are having pain after three weeks it is possible that there is an irreversible pulpitis or an inflamed nerve that will not get better. This may need to be treated with a root canal, or further bite adjustment. I would go back to the dentist before beginning more treatment.

Question: I have been in pain for the last 2 or so weeks. I have scheduled a dentist appointment but it’s not until next week. Lately the pain has gotten so bad that I can't think. All I want to do is cry. Last night I actually woke up panicking because the pain was so bad. It's in the back of my mouth, where I have a very bad looking tooth. But the pain goes to my jaw. I tried using Orajel last night, but it did nothing. One 600mg of ibuprofen did nothing for it either. I am hoping I can make it till next week, but I am really nervous and in a lot of pain. Is there anything I can try?

Answer:If you are in that much pain and the pain is in your jaw it is very likely that you have an infection. Waiting is not an option. See your dentist immediately. If you can't, see another dentist or go to your local hospital’s emergency room. Extreme pain is an EMERGENCY. Emergencies are supposed to be seen immediately because they can get worse.

Question: I had a deep cavity filled 2 weeks ago. It's a tooth-colored filling. It's on the side of my tooth, not the chewing surface. It doesn't hurt to brush my teeth or chew, but it's still sensitive to heat and cold. (It wasn't sensitive before the filling). I can feel that it's there. I wouldn't describe the feeling as "pain", probably not even as

"discomfort".

I'm just aware of it when I think about it. It's more of an annoyance than anything else. The dentist said it would probably hurt for a couple weeks since it was deep. Looking online, I'm seeing people say anything from 1 to 8 weeks. What should I expect?

Answer:It is not unusual to have sensitivity after a deep filling. It could last 8-12 weeks. The most important thing to know is if there is a change for the worse, you may have an irreversibly damaged nerve that can get infected.

This would require root canal therapy to save the tooth. I would carefully monitor your symptoms and get in touch with the dentist if something changes.

 

Oral pain, tooth pain, and injuries

Dentist Steven E. Roth, DMD, answers questions about oral pain, toothaches, and mouth injuries. Question: I had my teeth cleaned yesterday and when I woke up today, I found a bubble inside my gum, on top of my wisdom tooth. Now it has doubled in size. I can only open my mouth about 2 inches and it hurts to swallow. I cant close my mouth without hurting it. I got an emergency appointment but its not for three weeks. What can I do in the meantime? Answer:All of the symptoms you are experiencing are signs of infection and are a real emergency that can get worse. I would get to a dentist as soon as possible. These types of infections can be quite painful and end up with a hospitalization or worse. Question: I went to a dentist with pain in my lower right molar. The dentist recommended and performed a root canal. I was OK until the anesthetic wore off, and then pain in the tooth started to increase. I took amoxicillin and Vicodin (acetaminophen and hydrocodone)for five days without any real improvement in the pain. When I went back to the dentist the next week, I was told this was normal. Pain wakes me up and makes eating difficult. Im living on ibuprofen to manage the throbbing pain. I am scheduled to see this dentist again this week to have post and crown put in. Im not anxious to put in a crown if the pain hasnt subsided. Is it normal for pain to persist for seven to ten days after the root canal? Answer:Patients react differently to different situations. Some people experience pain while others do not. It sounds like the antibiotics and pain medications are the way to go, but if the pain is severe, I would call the dentist immediately and not proceed with any other work until the pain completely subsides. Question: I have been up all night in pain from seeing the endodontist at 1:00 p.m. to finish a root canal. I am on Z-Pak antibiotics(Azithromycin)because it became infected. I take Vicodin extra strength, oxycodone, and ibuprofen every few hours. Nothing seems to work. The pain is pulsating, and as soon as the painkiller helps a very little bit, it only lasts for half an hour and I am back to where I started. Other than taking more and more painkillers mixed with ibuprofen (which I do not want to do), what can I do? Answer:It sounds like the antibiotics and pain medications are the way to go, but if the pain is severe, I would call the dentist immediately and not proceed with any other work until the pain completely subsides. Only the treating dentist knows the exact situation, and communicating with him/her is the best advice I can offer. Question: I had my 2 left wisdom teeth extracted a week ago. I ended up with a dry socket on the bottom. My oral surgeon went with the clove oil technique -- gauze soaked in clove oil and packed in the cavity -- for 7 days. Is it really safe to leave it in for 7 days? Sounds like an infection waiting to happen. Answer:Without knowing the exact circumstances, normal treatment is to remove that packing within 48 hours or an infection can ensue. Please contact the oral surgeon as soon as possible to resolve this situation. Question: Ive been dealing with my wisdom teeth rotting for quite awhile. I actually was scheduled to have them extracted last year, but a week before surgery, I found out I was pregnant and couldnt be put under anesthesia. Then I had to switch dental insurance, and now I have a six-month waiting period. My wisdom teeth have come in and started rotting. The side and part of the top is gone on both of them. They go through cycles of hurting and not hurting. I use Orajel and Tylenol for the pain. Im just wondering, if they dont become infected, will they eventually just finish falling out and the nerve die? Or if the tooth is gone, will the root still hurt? Answer:It sounds like a deteriorating situation to me. The teeth will not fall out, the remaining teeth or roots can get infected and cause big problems. I would get to an oral surgeon as soon as possible to properly assess the situation and to hopefully prevent major infection and problems. Question: About 4 years ago I bit into something, and my second from the last lower left broke in half. I had a root canal and a crown. The crown felt - not like my other teeth. Now my tooth (the crown) is in a ton of pain. Not a sharp pain but a constant, nagging, heavy pain. Not overwhelming, more like a 2.5 on a 10 scale. For what it is worth, the gum line where the crown meets the gum is black although I was told that is normal. Basically, it feels like something is rotten below the crown, like there may be an infection under there. I have now visited 3 different dentists who have told me that it was impossible for there to be pain under the crown because there was no nerve. Well, I can assure you there IS pain, and it is 24 hours a day. I think this is a contributor to a huge amount of stress in my life and even my mind-set to the point that it is driving me crazy. One dentist even X-rayed. Said there was nothing. What could be the problem? Could there be a real pain caused by an infection. Answer:There are several possibilities. The bottom line is if there is pain, your body is telling you that something is wrong. Root canals can become re-infected. The tooth could be fractured and infected, or there could be a deteriorating periodontal or bone situation where the housing of the tooth is shrinking away. It is easy to get overwhelmed by pain because your body wants it to stop. My best advice is to see a dentist who can evaluate the situation with X-rays, visual exam, periodontal probing, tapping the tooth, feeling the tissues around the tooth. When I cannot diagnose the specific problem, I will always refer to a specialist such as an endodontist, oral surgeon, or periodontist for their expert opinion. Question: I am currently pregnant and having issues with my teeth. My wisdom tooth is coming in, causing a great deal of pain. I am not able to see my ob-gyn for two more weeks, to let me know if I am able to have my wisdom teeth taken out. It is starting to become sickly painful. What can I do until then? Answer:Removal of a tooth is considered surgery. Even though you are having pain it is important to receive medical clearance from your ob-gyn first. If you are in pain you should be able to get medical clearance from the ob-gyn immediately. Pain and infections are a risk to the fetus and the pregnancy. Get in touch with them immediately or go to your local ER if you cant. Question: Ive had a four surface filling done three weeks ago and I am still having pain. Ive gone back to the dentist a week ago for her to look at it. She shaved it down a bit and told me not to eat with it for 4 to 5 days. So today, a week later, Ive tried to eat a pbj, and it had a stinging pain in the middle, so I took some aspirin. I am worried as to why it is still hurting. Ive waited this long and until the afternoon, since I grind, but have been using a mouth guard. The dentist explained that the grinding may cause some pain since the nerve was over stimulated. I am not sure if I need a root canal or something else. I have an appointment for some more fillings on Monday. Should I wait until then or should I go see her again soon? Answer:If you are having pain after three weeks it is possible that there is an irreversible pulpitis or an inflamed nerve that will not get better. This may need to be treated with a root canal, or further bite adjustment. I would go back to the dentist before beginning more treatment. Question: I have been in pain for the last 2 or so weeks. I have scheduled a dentist appointment but its not until next week. Lately the pain has gotten so bad that I cant think. All I want to do is cry. Last night I actually woke up panicking because the pain was so bad. Its in the back of my mouth, where I have a very bad looking tooth. But the pain goes to my jaw. I tried using Orajel last night, but it did nothing. One 600mg of ibuprofen did nothing for it either. I am hoping I can make it till next week, but I am really nervous and in a lot of pain. Is there anything I can try? Answer:If you are in that much pain and the pain is in your jaw it is very likely that you have an infection. Waiting is not an option. See your dentist immediately. If you cant, see another dentist or go to your local hospitals emergency room. Extreme pain is an EMERGENCY. Emergencies are supposed to be seen immediately because they can get worse. Question: I had a deep cavity filled 2 weeks ago. Its a tooth-colored filling. Its on the side of my tooth, not the chewing surface. It doesnt hurt to brush my teeth or chew, but its still sensitive to heat and cold. (It wasnt sensitive before the filling). I can feel that its there. I wouldnt describe the feeling as pain, probably not even as discomfort. Im just aware of it when I think about it. Its more of an annoyance than anything else. The dentist said it would probably hurt for a couple weeks since it was deep. Looking online, Im seeing people say anything from 1 to 8 weeks. What should I expect? Answer:It is not unusual to have sensitivity after a deep filling. It could last 8-12 weeks. The most important thing to know is if there is a change for the worse, you may have an irreversibly damaged nerve that can get infected. This would require root canal therapy to save the tooth. I would carefully monitor your symptoms and get in touch with the dentist if something changes.