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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 6017
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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I have starting to have throbbbing pain around my gums and

Customer Question

I have starting to have throbbbing pain around my gums and my teeth on my left side. It starts right below the ear and goes to mostly to the botton row of my teeth. There is some pain on the top row but not like there is on the lower row. Norco does not help relieve the pain. I also tried oral jel but that did not phase it at all. Wet heat seems to relieve it somewhat and it helps to chew gum on that side. I haven't noticed the pain very much during the daytime but it starts once I lay my head down at night. I am able to eat and chew on that side.
Submitted: 5 years ago.
Category: Dental
Expert:  Dr. Mariana replied 5 years ago.
Hi, I am here to help you,
The symptoms you are describing are very likely related to an inflammation of a tooth nerve, probably due to a cavity or to a tooth filling that is cracked. This inflammation is called pulpitis. There is no home remedy for this problem.
Pulpitis is an inflammation of the dental pulp. Dental pulp is the portion of your tooth that has blood vessels and nerves in it. When the dental pulp gets irritated, our body responds by sending extra blood and defense cells to the pulp. When inflammation occurs on any other part of our body, there is room for expansion. Unfortunately, the tooth is an enclosed space and expansion is not a possibility. the compression of the nerve inside the tooth produces pain. When this inflammation is mild, the process is called reversible pulpitis. The symptoms can range from nothing at all to a sharp pain when they are stimulated by things that otherwise wouldn't cause pain to your teeth. Usually cold will be one of the first symptoms to appear. Sometimes this can be taken care of by removing the cause, like a filling that has cracked of a filtration. The pulp will heal and the symptoms disappear. Other times it will lead to Irreversible pulpits , which is a severe inflammation of the dental pulp. It can also happen when a dentist needs to remove lots of dentin due to big cavities and gets really close to the pulp.
Once you have irreversible pulpitis, there's no cure. The only way to fix it is to have a root canal treatment performed (where the dentist or endodontist removes the dead pulp and fills it up with a rubber material) or to have the tooth extracted.
My advice is to go to the dentist as soon as possible to have your tooth examined and determine the best course of action.
I hope this helps!
Dr Mariana Levy
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Expert:  Mark Bornfeld, DDS replied 5 years ago.
Welcome to JustAnswer, and thank you for putting your trust in me!

I would like to present a dissenting opinion. Although the nocturnal presentation of pain is a characteristic of pulp infection, everything else about your narrative would tend to exclude either pulp or periodontal disease. For example, pulp infection almost always causes an increase in tooth sensitivity to chewing pressure, to exposure to heat, or to exposure to cold. Not only are these characteristic signs absent in your case, but you claim that your pain is actually relieved by chewing, which is absolutely not suggestive of any dental disease, including temporomandibular joint dysfunction.

On the other hand, the onset of symptoms when your body is in a recumbent position is characteristic of inflammation-- particularly vascular inflammation. The initialization of pain in a location directly beneath the ear is further suggestive of a vascular issue, because it is here that the main arteries of the face branch away from the external carotid artery.

Therefore, although a thorough dental examination is a logical first step whenever jaw pain occurs, I suspect that this would be done primarily to cover all the diagnostic bases and leave no stone unturned. However, you will probably need to consult with your primary care medical doctor as well, to investigate other potential issues that can manifest as jaw claudication, such as an autoimmune vasculitis or even referred cardiac pain.

Hope this helps...