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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5990
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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Dr Bornfeld Are there any studies showing how neck pain can

Customer Question

Dr Bornfeld
Are there any studies showing how neck pain can be caused by nerve pain from deep pockets or weak teeth in the elderly or large cavities? Possibly the dental issues would not be appearing as decay or infection on xrays.
Is that possible to have pain without anything showing up on dental or jaw xrays but after doing a tooth or molar extraction the pain in the neck dissapears?
Submitted: 6 months ago.
Category: Dental
Expert:  Camille-Mod replied 6 months ago.
Hello,I'm Camille, and I’m a moderator for this topic. I sent your requested Expert a message to follow up with you here, when they are back online.
If I can help further, please let me know. Thank you for your continued patience.
Best,
Camille
Customer: replied 6 months ago.
Does that particular expert regularly answer on the site? How frequently?
Expert:  Camille-Mod replied 6 months ago.
HI Yes he does, but I can't predict how soon it would be. I can open your question to other Experts if you'd like?
Customer: replied 6 months ago.

I would like to take a chance on asking someone else. But if I am not satisfied with their answer, can i still request that dr Bornfeld answers me as well?

Expert:  Dr. Rick, MD replied 6 months ago.

Hi. My name is***** and I am online and available to help you today. Thank you for your patience.

Question and answer is just one of the services I offer. I can also provide you with premium services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested.

When were you last examined by your DDS?

What did she find?

How long have you had this pain?

Do you have any other medical problems or take any medications?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

Customer: replied 6 months ago.

examined Oct 2015,

Customer: replied 6 months ago.

The panorax show a small white spot on the bottom right jaw... If that is a piece of left over dental ligament, Ive read that it could be causing some slow infection.. Perhaps that is not appearing in the pan xray yet radiating to the side of his neck?

Expert:  Dr. Rick, MD replied 6 months ago.

Thank you for that additional information and xrays.

I do not see anything here that would cause neck pain.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you can please give me the top rating in all areas. It has been a pleasure to assist you today.

Thanks in advance,

Dr. Rick MD FACS

Customer: replied 6 months ago.

Why does the Dentist want to remove the teeth? What about the tooth that is imbedded in the gum. Are you a dentist?

Customer: replied 6 months ago.

Why does the Dentist want to remove the teeth? What about the tooth that is broken at the gum line. Are you a dentist?

Expert:  Dr. Rick, MD replied 6 months ago.

My entire family are DDS. I am a surgeon.

The best way to find out why your DDS wants to remove the tooth embedded in your gum is to ask her.

Make sense to you?

I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the excellent feedback button for this encounter. And, don’t forget, I work for tips. I would also be happy to continue to answer any more questions you have until we have resolved your concern.

Dr. Rick MD FACS

Customer: replied 6 months ago.

She was out of the office yesturday and today..... Her assistant said to keep it and she said to remove it.

Expert:  Dr. Rick, MD replied 6 months ago.

Then you should gather up these records and consult with a different DDS. After examining you and reviewing your documents and, possibly, doing xrays of her own, she will give you her professional opinion.

Make sense?

Time to rate :)

Thanks.

Customer: replied 6 months ago.
The reason I'm posting on Just answer is because I can't get any appt until next Wed anywhere and I'm trying to determine if my dads neck ache is from his tooth somehow. Everything else has been ruled out. The dentist said it could very well be. But the other partner/assistant said there's nothing on the X-ray to suggest any infection.
That's why I'm asking an expert here to see if with your history and experience, if you have come across a connection .
Theres articles suggesting this connection but I wanted to know what a dentist on justanswer thinks after looking at the images and documents.
You can opt out and hopefully dr Bornfeld can answer
Expert:  Dr. Rick, MD replied 6 months ago.

From what you have posted, in my professional opinion, I do not see anything that would cause the neck ache.

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Dr. Rick MD FACS

Customer: replied 6 months ago.

Hi there... I'll get another question to you and make up for this... But can you please release the question back to Dr Bornfeld.....? I began to use a water pic with peroxide on my teeth and non specific facial pain went away. Xrays found nothing wrong on any of my teeth.

Expert:  Camille-Mod replied 6 months ago.
Hello,I'm Camille, and I’m a moderator for this topic. I sent your requested Expert a message to follow up with you here, when they are back online.
If I can help further, please let me know. Thank you for your continued patience.
Best,
Camille
Expert:  Mark Bornfeld, DDS replied 6 months ago.

Please accept my apologies for the delay in aswering-- my academic commitments prevent me from attending to questions here on JustAnswer as frequently as in the past.

First: I agree that dental infection only rarely serves as a source of neck pain, and when it does, it is due to a very acute and severe dental infection (e.g., Ludwig's angina) spreading to the connective tissue spaces in the neck. In these cases, there is little ambiguity of the source of the pain because the dental infection is so severe. This type of infection is not what appears in the radiographs you've provided; what shows here is more of an indolent, chronic infection which would not be expected to have any causal relationship to the neck pain. Likewise, the small white dot on the right side of the panoramic radiograph (actually on the LEFT side of the lower jaw) would not have any connection with neck pain, as the appearance of the bone immediately surrounding it shows no abnormality. This white spot is not a remnant of any periodontal ligament, but is either an artifact-- a false radiographic finding due to some deficiency in the photographic emulsion or the reproduction of the image-- or it is a metallic fragment-- perhaps a piece of filling material that was in the mouth at the time the x-ray was taken.

Although it is tempting to draw conclusions regarding causation if the neck pain resolved after tooth extraction, the time relationship between those two events was almost certainly just coincidence. Different types of pain-- particularly musculoskeletal, myofascial, or neuropathic-- generally present in intermittent episodes by their very nature.

If there is anything at all in your photos of any interest beyond the conspicuous tooth decay and periodontal disease, it is the somewhat longer than average styloid processes evident in your panoramic radiograph. However, despite this finding, a so-called Eagle syndrome (which can manifest as neck pain on turning of the head) is rather rare, even with styloid processes much longer than these.

I believe a proper evaluation of the neck pain resides squarely in the medical domain, and there is little reason to suspect any connection between it and the dental issues displayed in your case.

Hope this helps...

Customer: replied 6 months ago.

I took him to the dentist yesterday and he pulled the last molar on the left on the Panx.... the dentist said it came out easy. He said there was gum that might be the cause. We shall see. And then i had a consult with someone eles that said it can be TMJ.. is that what you mean by styloid processes? She said that an upper denture could resolve the pain because his having no bite is causing strain on his jaw...(she said something like that.. ) Is that possible?

Expert:  Mark Bornfeld, DDS replied 6 months ago.

"And then i had a consult with someone eles that said it can be TMJ"

Temporomandibular dysfunction is occasionally associated with more far-ranging myofascial pain. However, if there is temporomandibular dysfunction, there are always conspicuous symptoms relating to jaw motion-- e.g., pain on jaw movement, limitation of jaw movement, temporomandibular joint noise and/or locking, etc. In the absence of these symptoms, positing a diagnosis of temporomandibular dysfunction is not all that plausible.

"is that what you mean by styloid processes?"

No-- the styloid processes are separate and unrelated to the temporomandibular joints. Functionally, they may contribute to jaw dysfunction, because they serve as origins for ligaments that attach to the jaw. However, the symptoms of Eagle syndrome, which is a relatively rare disorder, are easily distinguished from the symptoms of temporomandibular dysfunction. In any case, the x-rays you supplied do not suggest Eagle syndrome, as the styloid processes are not greatly enlarged.

"She said that an upper denture could resolve the pain because his having no bite is causing strain on his jaw...(she said something like that.. ) Is that possible?"

Possible? Yes-- but it is highly unlikely to confer any benefit in neck pain that is not associated with the other symptoms of temporomandibular dysfunction I mentioned above.

Hope this helps...

Customer: replied 6 months ago.

I forgot to add that we had the metal fillings removed last fall so I am now attaching the current status of his teeth in these xrays taken a few days ago by an endodontist where I went independently to ask about doing a root canal on the tip # ***** and add a small build up in the hope that it makes my dad have more biting power. The endo dr showed me that my dads bite does not allow his upper gum and his lower teeth to meet up. I was assuming that these few teeth were helping my dad chew. But a hygienist I know from many years ago suggested, (with only looking at the images, that if he pulled out all his bottom teeth, that both upper and lower gums would meet and his biting power would be more efficient at breaking down food than just keeping the lower teeth alone. The bite would then be more natural and less strain because his upper gums and bottom gum would meet. If he got all his remaining teeth pulled, I am back to having concern for his emotions and weighing where he is at psychologically.

Do you think there is periodontal disease in the current xray? The dental hygiene yesterday said he did not have that much tarter.

Expert:  Mark Bornfeld, DDS replied 6 months ago.

No x-ray was submitted with your latest post.

Customer: replied 6 months ago.

OK, here are some more images. The charts are from Oct 2015 and the xrays are just a few days ago. The dentist that extracted the tooth number 19 had not done an updated xray and I am curious if my dads tooth had gotten better once it was filled and that dark image at the roots had cleared up as per the recent xrays compared to the panorex done in aug 2015.

Expert:  Mark Bornfeld, DDS replied 6 months ago.

"I went independently to ask about doing a root canal on the tip # ***** and add a small build up in the hope that it makes my dad have more biting power. "

It is unlikely that this tooth would add any functionality-- either on its own, or in the context of a lower partial denture. The tooth is not only structurally deficient, but it also has too short a root to contribute to bite or denture stability.

"The endo dr showed me that my dads bite does not allow his upper gum and his lower teeth to meet up."

Teeth do not "meet up" when they only occlude against a toothless arch. If the intent is to create a functional occlusion, your dad will need an upper prosthesis; anything short of that will not create a workable bite. I am skeptical whether the removal of the lower teeth will either add or detract from functionality, and I would be inclined to recommend the retention of any lower teeth whose status merits the effort unless those teeth are inflicting mechanical injury on the upper gum-- especially if the fabrication of a lower partial denture is fabricated. That presumes that the teeth can be properly restored and the decay eliminated.

"If he got all his remaining teeth pulled, I am back to having concern for his emotions and weighing where he is at psychologically."

I am unqualified to comment.

"Do you think there is periodontal disease in the current xray? The dental hygiene yesterday said he did not have that much tarter."

A diagnosis of periodontitis is made using multiple criteria-- some of which are unavailable here (presence of tartar is not one of them). Except for the bone loss in the bifurcation (the area between the roots of tooth #19), there is little evidence of active disease. There is one 4 mm pocket on the distolingual of tooth #29, but that barely qualifies on its own as meeting the diagnostic criteria of periodontitis.

"I am curious if my dads tooth had gotten better once it was filled and that dark image at the roots had cleared up as per the recent xrays compared to the panorex done in aug 2015."

I assume you're referring to tooth #19. No, it did not get better, and the placement of a restoration on a tooth with active endodontic infection would not have been expected to "clear up" a loss of bone in the root bifurcation area.

Hope this helps...