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Dr. Behere
Dr. Behere, Dentist
Category: Dental
Satisfied Customers: 2785
Experience:  Masters degree, years of experience with all kinds of dental problems.
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I have been pn this site several times in reference to my

Customer Question

I have been pn this site several times in reference to my situation. It is an edodonist question. I have trigeminal neuroglia. I had an injury to m front tooth 3 years ago, off and on it has been uncomfortable to me. I saw an edondontist 1 ago several times and he saw nothing wrong with it. I have been to my dentist in the last 3 months 2x each time he x-ray it there was no signs of a problem. I am unable to have it temparture tested because any movement to my jaw or teeth will cause me excuritating trigmenial pain. I feel as though the pain has changed and it is my gum more than my tooth at times. The thought of a root canal is unimaginable to me, given my condition. I have been told several different suggestions on this site before. I am looking for more guidance as to what an opinion there might be. I am overwhelmed by panic and fright. Please help.
Submitted: 7 months ago.
Category: Dental
Expert:  Dr. Behere replied 7 months ago.

Hello,

Thanks for putting up your question on Just Answer.

So as I understand , a dentist and an Endodontist have both given you a clean bill of health for the front tooth in question.

Do you have access to the latest X rays of that tooth? Can you upload them here?

For the moment, let us assume that they are right, and the tooth is normal. Then there must be another explanation for your pain.

There is a grey area of orofacial pain , what we term as Atypical Facial Pain or Atypical Odontalgia, which does not respond to any therapy, and for which no cause can be found.There is nothing wrong with the teeth or gums. This type of pain is common at your age and gender. It can be provoked by dental treatment, underlying systemic disease or it may be brought on by stressful life events.

These different types of pain do no not respond to conventional treatment, like antibiotics and steroids. They require non conventional treatment like sedatives, anxiolytics, antidepressants, physical self regulation, cognitive behavior therapy etc.

I suggest you visit the Orofacial Pain/Oral Medicine department of the dental school nearest to you. A full assessment is required to eliminate any underlying cause. Screening tests should be carried out to exclude hematinic (blood) deficiencies and to rule out diabetes. If all this is negative, there might be an underlying psychogenic cause(anxiety).

I also urge you to try alternative pain relief methods like acupuncture and Cognitive Behaviour Therapy- includes relaxation and breathing techniques and positive re-enforcement of thought.

Hope this answers your question. Feel free to contact me again for more information. Please leave a positive rating for me if this answer has helped you. I do not get credit for it otherwise.

Good Luck !

Regards,
Dr. Behere

Customer: replied 7 months ago.
Thank you for your response. I appreciate your input, I am certainly not looking for a problem, but is there a possibility that the tooth could go "bad" after an injury, and if no absess exist is there any other reason that would cause a necessary root canal to be done? I do have a recent ex-ray that can be sent over. If the visit to the endonist was a year ago is that sufficient to know that there is nothing wrong? My dentist has seen me more frequently and looked at the e-ray. My concern is since the pain has changed would that mean the tooth is getting worse or is it a case of the items that you had mentioned? Thank you
Expert:  Dr. Behere replied 7 months ago.

Hello,

A tooth can turn "bad" or non-vital following injury. However, there is a wide variation of possibilities that can happen. The tooth can slowly turn dark or not, it can just "die" , or it can get infected.

Even if there is no active abscess, a tooth that has undergone trauma may need a root canal for aesthetic reasons.

I happen to specialize in Dental Radiology and I would really like to see your most recent X ray. And yes a lot can happen to the tooth in one year, we really shouldn't count on the Endodontist's opinion if it is a year old.

You can refer to these step-by-step instructions to upload your Xray: http://ww2.justanswer.com/how-do-i-send-photo-or-file-expert

Alternatively, you can just use an external photo sharing site like www.imgur.com and copy-paste the URL of the image here.

Regards,
Dr. Behere

Customer: replied 7 months ago.
I will upload the x-ray after the dr sends it tome, also did you mean a picture of my tooth> I do have a veneer so would I really see it if it turned black?
Expert:  Dr. Behere replied 7 months ago.
No, I meant the X ray. But yes sure a photo of the tooth would also be useful maybe.
Customer: replied 7 months ago.
I am still waiting for the copy of the x-ray. I will send this to you
Customer: replied 7 months ago.
here are the x-rays
Expert:  Dr. Behere replied 7 months ago.
I haven't received any images.
Customer: replied 7 months ago.
I having trouble sending them to you
Expert:  Dr. Behere replied 7 months ago.
Are you trying to upload them to www.imgur.com? That would be the easiest way.
Expert:  Dr. Behere replied 7 months ago.
I've just got your X rays via just answer support by email. There are a lot of them, so I'll see them all carefully and then respond.Thanks for your patience.Regards, *****
Expert:  Dr. Behere replied 7 months ago.

Hello Meghan,

Ive see your X rays and there is nothing wrong with the front tooth on the X rays.

Hope this answers your question. Feel free to contact me again for more information. Please leave a positive rating for me if this answer has helped you. I do not get credit for it otherwise.

Good Luck !

Regards,
Dr. Behere

Customer: replied 7 months ago.
TThank you, ***** ***** para rax and the just the x-ray look ok, thank you fo retelling me that. I just can t understand why the pain is there in the gum and the tooth it is completely unnerving
Expert:  Dr. Behere replied 7 months ago.
Hello Meghan,Please explore the Atypical Pain option as suggested by me in my first couple of responses.Hope this concludes our conversation. Please leave a positive rating if my answer has helped you.I do not get credit for it otherwise!Regards, *****
Expert:  Dr. Behere replied 7 months ago.

Hello,

Im just following up ! Did my answer help? If yes, please leave a positive rating for me. I do not get credit for it otherwise !

If you have any further question, do write back!

Regards,
Dr. Behere

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