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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 6021
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA, American Academy of Oral Medicine
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Have pain in upper right back molar(wisdom0 on biting

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Have pain in upper right back molar(wisdom0 on biting down-goes away on release of bite, although a very dull throb/pain lingers.. Pain can be generated by pushing up on tooth with tongue/finger. No sensitivity to cold drink. On gum above the tooth is a 'ridge'(not bump or cyst) that runs forward on gum over another 1-2 teeth, growing smaller as it does. It is not very big-more noticeable by comparison to flat/smooth gum line over other molars than by its own mass-and it is not painful to touch. Also, have a cold/upper respiratory/sinus(?) infection that has come on in past day or two-tooth pain first noticed in past 18 or so hours. Have some oil of oregano-see it recommended(diluted w/olive oil) to treat pain.
Welcome, and thank you for putting your trust in me!

I presume the intent of your question is to inquire as to the next most appropriate step; please clarify if I'm mistaken.

It is actually quite common for upper molar pain to be confused with sinus pain and vice versa, because the roots of the upper molar teeth are situated very closely to the floor of the sinus. Sometimes there is no bone separating the molar roots and the sinus membrane, and that is why pressure on such a tooth in the presence of sinus inflammation can provoke tenderness.

However, although the recent onset of sinus infection does suggest that it is causally related to your tooth pain, you should know that the symptom of tenderness of a tooth to pressure-- technically referred to as "pericementitis"-- is a non-specific symptom of several potential issues. Therefore, if management of your sinus infection does not bring about resolution of your tooth pain, you will need to seek a formal diagnostic assessment of your dentist to rule out several dental issues, including:

--pulpitis or dentoalveolar infection
--excessive chewing force exposure ("occlusal trauma")
--tooth fracture

Until you can arrange for professional attention, an effective pain relief regimen utilizes alternating every 3-4 hours between 1000 milligrams of acetaminophen (2 Extra-Strength Tylenol tablets) and 400 milligrams of ibuprofen (2 tabs of Advil). This combination has been shown to provide pain relief equivalent to prescription strength opiate medication. Keep in mind that this regimen is not appropriate if you have a history of liver or peptic ulcer disease; do not exceed 4000 milligrams acetaminophen (8 Extra Strength Tylenol tablets) per day.

Hope this helps...
Customer: replied 5 years ago.

Thanks for initial response-should I give it say, 3-5 days to see if cold/upper respiratory

situation clears up & the pain goes away? Pain is moderate, more nagging than intense & really apparent just on chewing/bite. Thoughts on using the oil of oregano? Also have read that applying fresh cut garlic to affected area is also helpful. Finally, gum line ' above this tooth 'feels' to have receded somewhat-periodontis?

The amount of time you allow until seeking professional care would depend on the severity of your symptoms, and your prior experience with similar pain episodes. In the context of your narrative, it appeared that the presence of upper respiratory infection was established, and there was no uncertainty as to the presence of sinusitis. If this is not the case, or if your symptoms are not consistent with previous experience, this would merit more caution, and more prompt attention. Likewise, if you're not current with your dental check-ups, this would also suggest that the absence of contributory dental disease cannot be assumed, and would call for more rapid professional management. Until a diagnosis is confirmed, any delay entails some risk of onset of more severe symptoms.

Because a presumptive diagnosis of sinusitis exists, the application of topical agents, whether garlic or oil of oregano, is unlikely to have any effect on the symptoms, as they would not penetrate to the affected tissues. As for gum recession-- it could be associated with periodontitis, but because it can also result from other issues, such as poor tooth position or over-zealous toothbrushing, it is insufficient in itself to imply periodontitis without correlation with other diagnostic criteria. Your dentist would be able to assess your gums for inflammatory gum disease in the course of a routine formal diagnostic session.

Hope this helps...
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