Unexplained tooth pain

queasyrider_2

Up until a year or so ago I suffered with sensitivity in my upper teeth when drinking anything hot or cold.

I visit the dentist every 6 months and i always pointed this out to him and he would tell me to use a sensitive toothpaste and to brush carefully. After a while of doing this the sensitivity would wear off for and all would be fine until it started again. This hasn't happened for ages now.

Earlier this year i started getting a different type of pain in my upper teeth, Mostly on the left but sometimes on the right or the front ones. This was a sharp stab of pain that was intermittent and quite bad but was controllable with ibruprofen and paracetamol & codeine until such time as i could get an appointment with the dentist. 0n every occasion he'd test them for sensitivity by applying a cold spray to the teeth and tapping it with the end of one of his instruments but there was no sensitivity so i'd go back to the pain killers and after a while the pain subsided and i'd stop taking the painkillers.

In June this year i flew to Spain for a 2 week holiday and home again without any problem. In July the pain started again worse than ever, I went to see my dentist again, and again he could find nothing wrong and this time he actually took an x-ray of my left hand upper teeth which showed no damage.

After a while of taking painkillers again the pain wore off and all was well again.

On 3rd September I flew to Spain again for 4 weeks as a retirement present for myself and all was well until the plane started to climb at which time my teeth started hurting worse than ever, It literally felt like they were going to explode. I'm presuming that it was due to the pressurization of the cabin which caused it but whatever caused it, It was agony and i resigned myself to spending a month in the sun with a diet of paracetamol & codeine alternated with Ibuprofen surely it can't get any worse than this? That is of course until I went to the local Farmacia to stock up on paracetamol & codeine only to be told that they don't sell them without a prescription. After a week of this there was no improvement so i decided there was no option but to find an English speaking dentist and get checked out. This turned out to be more complicated than i thought but i did eventually get an appointment.

Dr Mark Rosasco is an English speaking Danish dentist practising in Spain, He had a good look around, Took an x-ray and confirmed that i had no cavities or work needed and suggested it'd be a good idea to visit the hygenist for a good clean.

A few days Iater i went to the hygenist who spent at least half an hour Poking, Scraping, Cleaning and polishing, none of which started them hurting. I now have nice clean gnashers but still have the pain.

I was dreading flying home on 1st October and even considered travelling back by train but was put off by the fact it would cost over £400, and as part of it is between Malaga and Madrid which takes 2 hours and travels at almost 300 mph i'd imagine that there will be some kind of pressurisation of the carriage which will probably be just as bad.

I made it home and made an appointment with my doctors surgery but to be honest I don't think they have a clue what to make of it but put me on 2 weeks of antibiotics (doxycycline) and after taking them for a week the only effect they have had is to make me even more familiar with the smallest room in my flat. I am concerned that whereas in the past the pain has gradually disappeared after a week or two at most and the painkillers have been gradually reduced and eventually stopped completely this time it hasn't gone after 6 weeks and i'm more than a little worried about the effect that taking the maximum allowed dose of both Ibuprofen and Paracetamol and codeine will be doing to my system and also that they are not very effective.

What I can't understand is that previously the pain seemed to come on for no apparent reason and after a week or two of pain killers it gradually stopped. When I left home on 3rd September i had no pain whatsoever but it started hurting worse than ever when the plane took off and it took longer than usual to stop (4 weeks) but when i left Spain to return home i was once again virtually pain free but i knew that i wouldn't be by the time i got in the air and this proved to be the case.

Since I returned home on 1st October i've visited my dentist who doesn't have any idea what is causing the pain. I've also seen my doctor 3 times who has tried one course of antibiotics, One course of steroidal nose drops and 2 different anti depresant tablets( Amitrityline & Duloxatine). I tried one of each of these and they made me feel far worse than the toothache. I'm currently waiting for an appointment at the ENT department of the Queen Alexandra Hospital Portsmouth. The earliest appointment i could get is December 31st. To be honest i don't have any great expectations as it would seem that we're just going through the motions. Surely there must be someone who can tell me whats wrong and get it sorted out.

Regards

Culpepper

Toothsmith

I'm sure there is, Culpepper, and I'm sure they will find out the problem and sort it out.

But to do that, you need to go through the process of eliminating things, checking things and tests.

It would seem that the people that have seem you have done the right things, and have referred you appropriately. Maybe the blind prescription of antibiotics the second time was a bit of a shot in the dark, but the doxycyclin was prescribed as the problem could have been a sinus one.

From the different people you've seen already, I am sure that the solution is not blindingly obvious! It may well be something simple in the end - but you need to find out what it is. And sometimes, that just takes time.

busiscoming2

I have PM'd you queasyrider.

beckstar1975

I am going mad with this and am seeing a third ENT this afternoon, as Dentist sure it's sinus related - even had 2 lots of root canal on a tooth and still have pain.

Mine was/is put down to allergy induced sinusitis, but may all change later on

I find the doxycycline helps whilst I'm on it but effects wear off a matter of days after it's finished

Good luck, and please do keep us posted

b*

queasyrider_2

Thanks for the reply Toothsmith, I'm happy with the treatment i've had both here and in Spain the only thing that worries me is that both the doctor and dentists have as good as said that they're stumped.
I only had the one lot of antibiotics, The second time I went to the doctor he gave steroid nasal drops which i'm still taking but to no apparent effect.
Flying definitely made it far worse. It literally felt like they were going to explode and it to 6 weeks to die down when normally it takes about a week before coming back again. I still find it strange that it comes and then goes.
I'm also convinced now that the very back tooth on the upper left side is actually a tooth problem even though nothing showed on the x-ray as it's a different type of pain. I have an appointment with my dentist for a checkup on the 27th Nov but can't get ENT appointment until New Years Eve so i feel that there's a few sleepless nights before then. It's not that the pain is particularly bad, it's more of a sharp twinge followed by an ache. It has never woken me up but does stop me getting to sleep. I also find that i can't wear my sleep Apnea mask as it encloses my face which raises my pulse which in turn sets the teeth off again. I'm actually not convince that it's not the CPAP mask that caused it because i don't recall it happening before May this year when I was diagnosed with Sleep Apnea, It's also relevant that the same teeth used to be sensitive to hot and cold and also that since 2005 i've flown to Spain and back twice a yearwith no problems and also in June this year without problem so although it seems to me to have been a problem for ages i imagine that it must have only become a problem since June this year. Cheers Derek

queasyrider_2

beckstar1975 wrote: »

I am going mad with this and am seeing a third ENT this afternoon, as Dentist sure it's sinus related - even had 2 lots of root canal on a tooth and still have pain.

Mine was/is put down to allergy induced sinusitis, but may all change later on

I find the doxycycline helps whilst I'm on it but effects wear off a matter of days after it's finished

Good luck, and please do keep us posted


b*

Thanks for the reply i certainly will keep the board updated. Cheers Derek

lessonlearned

I had this.

I have a wonderful dentist and after all the usual investigations she referred me to a Maxilofacial Consultant.

His diagnosis was barodontalgia - a condition which is linked to flying. Although quite common among WWII pilots it is now extremely rare because modern cabin pressures should be at the optimum level to stop this. My consultant told me I was only his second patient to present with this in his 30 year career.

He explained that in my case it might have been caused because my teeth had become hypersensitve and there was some inflammation going on.

He felt that this was because I had had such a lot of dental work done (I have the worlds worst teeth and my dentist has had to work hard to save them ie crowns, bridges etc).

Although my gums were healthy and my teeth were ok he thought that there might be some long term inflammation going on.

He prescribed 10mg of Amitryptaline to calm down the nerve endings and to just "settle things down".

Once things had settle down and I was pain free he advised me to just take amitryptaline for 2 weeks before flying. It worked and I was ok flying again.

The only problem is, like you, amitryptaline does cause me to suffer stomach problems.

mda99das

Without examining you has anyone tested or looked for cracks in the tooth? These are so hard to find and diagnose but sometimes the crack can lead to the pulp and cause the symtoms u described. Rct & crown or xLA may be in order

brook2jack

There are about fifty different possible diagnoses I can think of off the top of my head.

Diagnosing pain in the head area is both an art and a science as there are around fifty times more nerve endings in this area than any other part of the body.

This can make the right diagnosis a difficult and painstaking process sometimes, unfortunately that means sometimes it takes time and a few specialists to pin down the right diagnosis and treatment.

Toothsmith

This is a useful article to read.

http://www.bbc.co.uk/news/health-24932880

I'm not saying your problem is trigeminal neuralgia - it probably isn't. But it just shows the importance of obtaining a proper diagnosis and not just going with what the patient thinks is the problem.

queasyrider_2

Hi, I've come across this many times but I also don't think it's this because it's normally described as the worst pain known to man and while mine is quite bad some times I don't think it's that bad even though I've had it on and off for a couple of years. I've become convinced that the tooth at the very left end on the top is definitely toothache as it has becoming a throbbing ache that builds up to a shooting pain and sometimes shoots up my face. The only thing that leaves me a bit unsure is that nothing showed on the x-ray but it's certainly different (and worse) than the other teeth.

Toothsmith wrote: »

This is a useful article to read.


I'm not saying your problem is trigeminal neuralgia - it probably isn't. But it just shows the importance of obtaining a proper diagnosis and not just going with what the patient thinks is the problem.