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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 2034
Experience:  Dentist and Anesthesiologist for 34 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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I have lower and upper teeth pain on the left side. Comes

Customer Question

I have lower and upper teeth pain on the left side. Comes and goes, throbbing and last for 10 minutes or more. been to two root canal specialist, a dentist and ENT and they do not know what is wrong. xray shows nothing, tapping on teeth and no cold sensitivity when drs do it. but i will have triggers from cold and hot. been on 2 antibiotics and even pain meds do not help subside the pain when the flare up hits. been doing good the past week but i did exercise yesterday and i have had about 10 flare up since yesterday evening. i have been dealing with this for over 2 months. today has really taken a toll on me. the pain is on one tooth that already has a root canal #18 so the 2 behind that is what they keep looking at but nothing shows for it to be a root canal or a cracked tooth. but what bothers me is sometimes the pain will start at the top left and then my whole side of my face will hurt. do i need to see the root canal specialist or the ENT again and get a cat scan or do i need to see a neurologist? desperate.... have no clue of what to do next
Submitted: 2 years ago.
Category: Dental
Expert:  Dr. Katz replied 2 years ago.

hoteego1 :

Do you have any missing teeth or spaces in your mouth?

Customer :

no there is a crown on the tooth behind the one that has a root canal so the xray will not tell the whole truth without going in and opening up the tooth. so neither root canal specialist will touch it cause they dont know which tooth

hoteego1 :

Has your dentist checked your bite? Do you grind your teeth either in daytime or at night?

Customer :

the one root canal dr said that was a possibility so he suggested aleve and exercise at night and warm washcloths on face but really no difference. i do not know if i grind at night but i do not in the day. that dr was about 40%leaning towards grinding but the other 60% he felt was probably the tooth behind the root canal

hoteego1 :

Ok tooth #18 has been root canaled already from your post..that leaves only one tooth behind it ,#17 which is your wisdom tooth.Which tooth is actually hurting?

Customer :

ok my numbers are wrong.... no wisdom tooth, then the two molars and then the next one up is the one that is sensitive which is the one with the root canal...sorry about that. the dr does not know which of the 2 back teeth to pick from cause it is all on the same nerve that goes to the one that is the root canal

Customer :

18 and 19 and the root canal is 20

hoteego1 :

Do you have any pain just in front of your ear on the left side?

Customer :

i feel tightness but not pain ...each time i have a flare up my ear does not hurt but all the way up to above my eye i can feel the pain

hoteego1 :

Can you reproduce the pain when you clench or grind your teeth?

Customer :

no

hoteego1 :

So the pain on the lower is centered around the lower bicuspid tooth..#20 and on the top..it is above your eye? no teeth on the top hurt?

Customer :

yes my teeth will start hurting on the top and spread to the bottom or it will start hurting on the bottom and spread to the top ....i cannot pinpoint that pain when it starts. i feel it just start hurting anywhere on top or bottom but only on left side and spread and hurt for about 10 minutes or so and then i can feel it just go away

Customer :

in december it was on both sides of my mouth but it has all gone to the left side now

hoteego1 :

But the pain is generalized and not isolated to one tooth? Have you had any history of any sinus difficulties or ever had any trauma to your face?

Customer :

if i floss around 20 and 21 it does not feel good and i can tell the cold hot sensitivity triggers on that tooth sometimes not all the time. have had sinus issues before but went to ENT last week and basically he said i had nothing wrong and said if i wanted to do a cat scan i could....no trauma to the face

hoteego1 :

Ok so your sinuses are clear.Is the pain that you get a dull throbbing lasting pain or is it sharp and quick?

Customer :

dull trobbing lasting pain and it makes me stop everything and just pray for the pain to go away. i have had infected teeth before and its not that kind of pain. but it is starting to get close but the only problem is i feel i have to put pressure all on the side of my face and side of mouth because i cannot put my finger on any one tooth

Customer :

when the pain hits i feel it in my cheek bone as well. everything seems to hurt when it happens

hoteego1 :

Do you feel like the pain is always coming between tooth #20 and # XX?

Customer :

no

hoteego1 :

Ok You realize that I am limited without xrays and actually seeing you but from what you are telling me...The first thing that I would do is have your dentist check your bite and make sure that you are not striking one side before the other..Teeth that react to cold and hot usually suggest a bite problem.My concern is that it effects the entire left side and cheek ..and continues around your eye. The trigemminal nerve innervates these areas and trigemminal neuralgia is certainly something that I cannot rule out.The pain when you are flossing seems gum related but that would not give you the intense pain to the eye and upper jaw. You have not given me any indication of any swelling and infection does not seem to be the problem.If your dentist adjusts the teeth and you still have no resolution..I would consider a neurology consult to examine the possibility of trigemminal neuralgia..

Customer :

they really have already looked at my bite and they do not feel that is what is wrong either. there is no swelling that we can see and when flossing the pain is not in the gum but the tooth itself which is the one with the root canal.... would a cat scan from the ENT help us see anything or should i skip everything and just go see the neurologist?

hoteego1 :

From the information that you are giving me ..a CAT scan may not really show much unless there was some growth or tumor.That bicuspid tooth that has been root canaled does sit many times very close to the mental nerve in that region and it is possible that ther may be some irritation there..but I take it that the root canal was probably done some time ago and the xrays I take it have been negative.Either the ENT or or a neurologist can order a CAT scan...My feeling because you have been through the most likely scenarios is that a Neurology consultation..at this point..might be your best bet.Two months is a long time to have debilitating pain.

Customer :

the root canal was done in april of 2011....yes i am tired and i am now at the end of my rope... im starting to get scared cause no one can really give me an answer of any kind

Customer :

what also bothers me is that when im driving the pain will hit or just watching tv or i could be eating but i cannot tell you any particular activity that starts up the pain

hoteego1 :

It is the fact that you have pain only on the left side..up to your eye with no real connection to a particular tooth..and the pain is in the cheek and on the upper and lower jaws that puzzles me. Do you have sensory pain in the skin at all around your lip or nose or cheek that feels like pins and needles?

Customer :

no

hoteego1 :

I am still leaning towards the neurology consultation.. sometimes the 7th or facial nerve will cause pain but it would be more superficial.

Customer :

ok thank you for your time. i will try to get an appt with someone tomorrow and see what happens. there is really no need in going to the root canal specialist again? i know you dont have xrays but after hearing everything would you lean towards a bad tooth or a cracked tooth. Another symptom was very very bad breath according to my husband... i did not realize it though and i started using a nasal spray and the bad breath went away

hoteego1 :

Sinus drainage can cause an odor on the breath..as well as gum disease,gastric reflux and an abcessed tooth. If you had a cracked tooth..you would probably be able to put your finger on that tooth and identify it without much of a problem.One tooth would probably not cause the widespread pain that you are having especially because it is on the upper and lower at the same time.I wish that I could help you more but i am kind of limited online.I would sure be interested in what they find out...and I hope they can get it resolved quickly for you.

Customer :

thank you again for your time..i just keep stumping everyone, i just hope and pray that someone will give me an answer soon... or better prayer is that it just goes away.

hoteego1 :

Good luck and please write back or leave a message to let me know what the final diagnosis is ..Have a good night

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