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New crown, experiencing pain and no answers

  • Thread starter Thread starter Kovan
  • Start date Start date
@sudzs

Thank you for sharing. I will take a look at that book.

My challenge is that I have not been given a very clear diagnosis. Or so it seems to me.
2 dentists and 3 endodontists have been pretty certain that there are not any fractured teeth, nor infections but all have indicated that hidden fractures are “ possible”. My appointment with the TMJ/ofp specialist added more “possible” diagnosis of muscular issues due to my previous month of dental work and evaluations each week that possibly triggered some nerve issues. And that “possibly” a tooth may still need a RC.
I had a week of relief for the most part after the endo appointment and the specialist and then in that appointment the pains were not there and my explanation of the source of pains were questioned because I wan not able to describe it “well enough”. I was prescribed 1 stretching exercise and told to keep wearing the mouth guard at night and come back in a month with the guard to take another look.

So, this past week has been the most uncomfortable so far, with each day since that appointment leading to yesterday where I needed ibuprofen 2 times and my mental going to all the things it could be and not really knowing what to do to calm the pain.
I am tracking it day to day and while there are 2 sources of consistency, the tooth behind the crown is where the prickly, tingly, burning comes from that spreads ache and sensitivity to the teeth from the crown back, and a consistent ache stemming from the 2 year old RC below that has also seemed to now have the same sensations stretch to the teeth and gums around it.
So worry that the popcorn kernels that I recall on the RC weeks before the fractured tooth and crown on top were done make me worry the RC tooth is cracked beneath the crown.

In short the pain is leading to worry, stress and not knowing what to do..Google is not helping not helping, as I try to avoid it, but sometimes in the worst pain I seek an answer only to realize info overload is not helping.

I am desperate for some more clear answers as to what the issue is, or aven some clear remedies to try so we can better rule out some things. The wait and see approach is mentally taxing, taking a toll on my physical health and with holidays now, fear that if the pain reaches “emergency” that I won’t be able to get in and be helped.
 
Oh that all sounds very frustrating for you. I hope you can find some solutions to your pain soon.
 
@sudzs Thank you! And same to you. It appears you have gone through much with it all.
 
Thanks, yes, I've had a year of pain due to the dentist leaving decay under a filling I had done last January. Put Sensodyne on the tooth she said! And then it died!! She also didn't do a great root canal treatment so having that done again tomorrow by an endodontist. I'm so depressed and stressed by the thoughts of tomorrow.
 
@sudzs
I wish you the best and hopefully the re do will help a lot tomorrow.
 
@Gordon

I am coming up on a dead end and getting a bit desperate. Perhaps you may have a suggestion or 2. I am, trying to connect with the endodontist and specialist as the pain and irritation hit a high level over the weekend. I am not having much luck and am starting to perceive it is because no one can see an issue, in spite of me knowing there is one. I do not think it is in my head and there is a pattern even if there are other symptoms moving around.

The tooth behind the crown put on a month ago is the source of the “pain”, although the tooth itself does not seem to be in pain. If touched or pressure hits it, it starts to radiate a prickly, burning sensation in the gums and above the top teeth. The other constant is the root canal below that tooth, having a dull ache off and on when the top becomes uncomfortable. It is a bit tender if any little bit of pressure comes across it. The levels of pain and discomfort vary throughout the day. Sleep seems to be my best reprieve from the pain and mental awareness of it all.

Right now after the TMJ/ofp specialist my only recommendations for it all, is continue wearing the night guard, a stretch for the jaw and come back in a month. I am starting to wonder if the guard is creating other issues as my whole top set of teeth feel weird when I take it off.

I am desperate for some answers or even a plan that can narrow down to what it may be. And perhaps more importantly, some remedies to manage the pain. I am guessing at everything and not sure if it makes it better or worse.

I don’t even know where to start, whether it be yet another opinion from another dentist, endo or doctor. I would like to have a professional opinion that can help stay part of this without starting over with a stranger when something obvious is not found.

Very stressed about it all and my physical and mental health is starting to go down and I am not sure if that adds to it all.
 
Unfortunately there's not much I can suggest without examining you.
It's possible that the night guard is contributing, so it might be worth asking someone (either the TMJ guy or a general dentist) to look at it sooner if you can get in. Who made it BTW?
 
@Gordon

Thank you. In my mind I know you can only share general thoughts from your professional experience.
Your support and knowledge is helpful.

My dentist made the night guard.

I am still trying to connect with the endo and specialist to see if they can get me in for another look. I believe they are doing the best they can and I know they have a lot of patients, so the ongoing challenges I am going through has me wanting to get in any where for someone to look and help. But I don’t want to keep starting over and waiting, and I would like some sort of plan other than wait and see approach or at least some pain management options other than over the counter ibuprofen.

I am not sure if me trying to keep track of each day is helping or making me worry more, as trends and triggers seem to be all over the place.

Thank you though. Your regular check ins and straight to the point ideas are helpful and supportive even if you are not able to diagnose. I know you have helped a lot of people through the years.
 
I would like some sort of plan other than wait and see approach or at least some pain management options other than over the counter ibuprofen.
Can you take Aspirin? Much better dental pain relief than from Ibuprofen.

I'd suggest alternating meds, take Ibuprofen every 6 hrs or so and then alternate with Aspirin (or Paracetamol if you can't take Aspirin) every 6 hrs but with a 3 hr gap between doses during the day, this way there's a constant level of pain relief in your bloodstream which might settle things down a bit better for you. Do it for a few days in a row and see if that helps any.
Say 09:00 Ibu, 12:00 Asp, 15:00 Ibu, 18:00 Asp, 21:00 Ibu and last Aspirin at 23:00 or so, adjust the timings to suit your day!
 
Thank you @Gordon

I will try that out.

The roller coaster continues. Yesterday just before mid day the pain and agitation all but stopped.
Today started okay, and then gradually the discomfort returned.
I am still trying to get in to the TMJ specialist if a cancelation comes. I need a plan and an idea if things are “healing”
Yesterday was a moment of calm and peace and I hope to have more days like that in a row sooner than later.
 
Update-

The TMJ/OFP specialist got me in early Thursday morning. Again my mouth/teeth were feeling better, but I was able to feel some of the discomfort. He took the time to ask many questions and see if we could narrow down things.

The two constants are the tooth behind the new crown. And the RC molar below.

The tooth behind the crown, is not really in pain in the tooth itself, but is the location and source of the “raw” prickly/heat/agitation that seems to start everything off. And it is more on the side of that tooth and the molar behind it than by the new crown. But the discomfort when bad seems to radiate from the new crown back to the last molar at its worst. And at its best, just between that tooth and the second molar. He asked lots of questions to narrow down the description of what exactly the pain feels like.

The RC molar below was a bigger challenge to describe. At its worst, it is tender when chewing. (But pushing on it causes a faint ache) and then throughout the day a faint dull ache. And at its best I can “notice” it but no real pain or discomfort.

The specialist is pretty certain it is a muscular issue triggering nerves and the RC molar could be strained from grinding, or still healing from the popcorn kernel.

In the visit he sprayed some cold stuff along my jaw joint on both sides, pulled up and down on my top and lower jaw while I exhaled several times, and then the “pain” in the top tooth would subside for 5 minutes or so before I would start to notice it a bit again. He did this several times with the same results.

He reviewed my bite and night guard and identified that my bite was off, coming down more on the left side (where I have no pain). He did some side to side movements of my jaw and then tested and it started to line up more.

He said my night guard is a very well done appliance for grinding, but is saying a different guard is needed for the bite and jaw alignment that he is diagnosing as the issue.
A quick splint was made which covers my top front teeth, an appointment for another guard was made.

He provided a packet for home “remedies” for stretches, heat therapy and said I should not need over the counter pain meds, but if I do, Tylenol is best and to let him know if I get to that point.

I am documenting what I understood, but am certain there is a bit more “technical” diagnosis and information that I did not absorb.

That day and yesterday, I kept the quick splint in, stretched the jaw, used heat and no meds needed.
The “pain”. Is staying more localized when it flares up , the duration was longest as I lay down for the evening, and shortest when I am talking and or eating. Comes and goes.

I am taking this as an improvement and fighting the mental challenges at the points where I have felt pretty good for a stretch, but then the reminder of this all when it flares a bit. And the. I worry about all the things it could be in spite of dentists and endo’s saying my teeth look fine and healthy.

If I had a question that I did not ask the specialist, it would be, How long would I expect to be going through all this before I start to feel “normal” and have days where I do not feel this and my mouth and teeth feel as they should? Or am I going to have to deal with this everyday forever?

As I look through the forums, it seems folks with similar issues share similar things that I am experiencing, but then disappear, so curious if they found some permanent relief or had to give in to this not going away…or if it turns out to be an actual tooth/teeth or other issues.
 
Thanks for the update. It does sound as though you've got a working diagnosis and things are being dealt with.
If it's a TMJ issue then it can basically come and go almost at random, you need to keep this in mind and try not to get disheartened when you have a bad day, it will get better at some point.
 
I had planned to share an update a little over a week ago as it seemed that I was healing up a bit and things were feeling better.

I met with the TMJ/oral facial pain specialist and a digitial scan of my teeth and an CT scan were both done. I reported that I had been doing the stretches/exercises and things seemed to be improving.
The digital scan seemed to show my bite was normal and the CT scan showed my jaw was also normal and other than some mucus in my nasal area (he said was normal for allergy season) and some arthritis in my neck (he did not expand on that) things looked okay.
He then set an appointment for me to return for the splint for the bite he said was an issue back in December and then said it could still possibly be the tooth. I asked him if it could be a nerve as I had noticed over the last couple of weeks that if I stretched my neck to the right and or left that it felt like it alleviated the onset of the agitation in the tooth behind the crown. He said that could be possible.

I saw my dentist several days later for my 6 month check up and he took a look and said everything looks good as far as my teeth go. I shared that I was seeing the specialist as the pain had persisted and that he was looking at possible muscle issues affecting my jaw and bite. And my dentist made a somewhat sarcastic remark that he hoped it all works out if I choose to go on that journey but my bite and teeth all look good.

The following days after the dentist visit the agitation and discomfort started to increase and that led to the weekend when it got so intense tat I took ibuprofen and tylenol several times because the neck stretches and exercises did not seem to alleviate the issue. It was a rouh day and has sent my mental state back quite a bit. The following day was difficult, but I avoided taking pain meds and put the night guard in for a good part of the day to calm it down. Today has been a bit less than yesterday, but it just feels like my mouth has become a mine field and I am worried what will trigger it and set it off.
It has been 3 months since this all started and I do not feel like I have an answer to what the issue is and every time I think I have narrowed down what triggers it, and what alleviates it it changes.
I am tracking daily, desperate for a diagnosis with a remedy and each time I see someone it seems that it is guess work and wait another month to come back.

At this point I gather, that the teeth are ot the issue. Based on the dentists and endos that have looked. I believe this, because it has not gotten worse in a tooth and sleeping is the one constant in being free of the agitation that leads to the pain.

I gather that it is not TMJ issues as I don't seem to have the clicking, tightness, pain in the jaw and the scans showed everything in place. I asked about it being nerves, and the answer was "maybe".

The agitation in my mouth has a constant of the "Hot spot" being the tooth behind the new crown. But my explanations of this agitation/pain does not seem to register when I try to explain it to the specialist. But when it flares up long enough, the teeth surrounding it start to feel achy and sensitive. Then the teeth below do as well with the root canal feeling like the central point. At this point, my mouth has so many sensations and agitations now that it is hard to tell what is going on. I am desperate just to have no awareness and or sensations in my mouth as it is driving me insane and messing with my ability to be productive each day. Even when it feels almost "normal" my mind starts to wonder for how long will the calm last before it flares up again.

If it is not the tooth or teeth, and my TMJ seems to be in good shape, what is it? I know you have mentioned atypical trigeminal neuralgia as a rare but possible thing, Gordon. Who should I see to diagnose if that is the issue. I started to look for info on that, but that is a rabbit hole, and I saw that diagnosing that seems to take a long time because so few know what to look for.

My questions-
Should I be seeking help with a different type of medical/dental professional?
Are there different questions that I should be asking to help get to the bottom of this?
If this goes much longer, can it cause more issues?
Am I crazy and is this all in my head?
I am just not sure where to look, or what info to trust (I do not Google about this any longer) Someone has to be able to guide and diagnose the cause.
I never would have thought a fractured tooth needing a crown would turn out this bad.
Could it be the crowned tooth causing the issue?

I keep your comment, Gordon, in mind to try and remember it will get better at some point. I think the doubt creeps in after my visit and less than confident response form the specialist as to what is the actual issue.

Desperate for answers/diagnosis and a treatment plan to manage the discomfort.
 
If the night guard is helping then that would point to it still being some kind occlusal thing going on. Is the specialist still going ahead with making a new splint? I might have missed that someplace?

If you're going down the atypical facial pain/neuralgia route then you probably need a neurologist input.
Physiotherapists can be very helpful with ultrasound and exercises if you've found stretching etc has helped.
 
@Gordon
Good morning. Yes, the dental splint is still part of the current plan. The digital scan was done for that purpose and I have an appointment to have that delivered toward the end of February. When I saw him last week and I reported things were feeling better, I was asked if I still wanted it. I responded that I think so, because that was the suggestion and while feeling better I still have not reached a point that I felt “healed”.

Can you expand on “occlusal” thing. I am not sure what that means.

I pray it’s not an atypical neuralgia thing and when I dipped my toe I that Google rabbit hole I am not sure what to think.
The specialist did mention maybe a physiotherapist, but he tosses so many things out I just catch some bits and prices and try and hope for the best and do what he suggests.
 
Can you expand on “occlusal” thing. I am not sure what that means.
Sorry, fell into the trap of using jargon. It means an issue with your bite. The posh name for teeth coming together is "occluding", the study of which is "occlusion".

Definitely ask about a Physio referral if one is available to you.
 
@Gordon
Okay, that makes sense. Probably why the specialist recommended the splint. I will ask him about a referral. I know he mentioned that as a possibility early on. I am trying to get back in soon. It is crazy how hard it is to get into see someone these days and then not have to wait weeks for the next steps.
 
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