pain when biting down

[krystal]

salut! i was advised to post here by some very very woundeful people from the support forum (and i swear i'm not shaking or crying this time when i post this).

i understand that dentistry is as much an art as a science, and it isn't always an exact art or science.

if you appear at a dentist and he's trying to solve a problem for you: pain when biting down. he gives you an exam (IV sedate because you won't let anyone near you otherwise) and takes x-rays and the area is clear of infection/cavities in the tooth/teeth (two next to one another) in the upper right jaw. but it hurts to bite down.

so he says "i'm not exactly sure what's causing your pain because there are a lot of different things going on". you understand that, this is your dental first. he first think it might be your wisdom teeth (impacted teeth) coming in causing pressure on your upper rack teeth. fills six other teeth (refered pain).

(ok, let me say that this dentist is awesome amazing -- it's quite funny, really, there i am with my shock white mohawk and studs and piercings and chains and he's being so super supportive and accomadating and nice. he let me bring my friend -- with vest-- into the xrays, always sedated me so i wouldn't feel fear ...so i have nothing but a million good things to say about him)

anyway, i have the impacted wisdom teeth out and the fillings done. it's such a messed up experience and i survive...and still manage to come back again....because there us still no progress on the pain in the upper rack of my teeth.

he then suggests -- because i'm an intense person -- that maybe i'm bearing down too hard on my teeth at night, so he makes me a mouth guard.

pain resolves itself slightly (maybe placebo affect, but i swear i'm not having psychosomatic symptoms -- i swear, the pain is eased with numbing gel) but it is still there. and even tho there is nothing on the xray to prove anything, it hurts when you bite down and you know it.

at any rate, at what point is there just no answer to your problem and you just submit yourself to not chewing on that side anymore because the problem is seemingly unsolvable. i'm feeling pressed to return to his practice again -- not because he's a wonderful doctor or anything -- but i just don't want to submit myself to more treatment.

do dentist's ever come to a point when they have no answer to the problem because they don't know (i'm not making a slight at him, he did all he could) how to solve it, so you just let it be and stop going/trying?

i don't think i really want to go thru another set of attemptive treatments when it's easier at this point to just admit your teeth are messed up (your fault, you never went to a dentist) and you'll just have to live with it.

again, i don't fault the dentist at all, he's awesome, i just think my teeth must be too messed up to fix. being someone who is so scared, it's really hard to keep coming back and back again. every time i go, it's like he finds something else that is wrong (more fillings after a year) and it seems like a never ending cycle of bad news. and it's all these other problems he's finding and fixing, and i'm greatful, but my original complaint about not being able to bite down is still there.

 

[letsconnect]

Re: unknown problem

Hi Krystal, I'm only a layperson (I'm sure Gordon will chip in later), but it might be cracked tooth syndrome (which can be notoriously difficult to diagnose, as it often won't show up on x-rays).
Does the pain only occur upon biting? And could you describe the pain some more?

 

[melodyl]

Re: unknown problem

I have had the exact same problem with my bottom right back tooth for over 11 years. it was filled in 1995 and since then, I can not bit down hard on it.
I've been to the doctors and they have taken x-rays and found absolutely nothing. I just can't bit down, the pain goes through my head. One guy said "maybe the filling was too close to the nerve". Another guy said "might be inflamation". One guy said "well, you have TMJ, and that can manifest itself in tooth pain".
11 years and no answers.
Since I am phobic and I recently found my phobia dentist, during treatment I asked him about this tooth. he had taken x-rays and found nothing. he said "well, I really don't know, it might be inflammation".

so if anybody knows why a person can't bite down on a tooth (really hard) for 11 years, but the tooth gives them no problems whatsoever on any other ocasion, I'd love to hear it.

melody

 

[krystal]

Re: unknown problem

salut let's connect!

I spent a good deal of time this morning trying to really consider and isolate what symptoms i'm experiencing. i hope this will make this more clear -- of course it also freaks me out because i'd rather be in denial about the problem (no symptoms to discuss 'cuz there is no problem).

i have to say i really like denial (tho it doesn't make for very good or helpful conversations) because i know it's not rational.

so yes, trying to isolate the problem.

if i'm munching on nacho (corn) chips, when i bite down i'll get a sharp pain like someone jamming a knitting needle up into my jaw. it doesn't happen all the time but i try not to chew on that side of my mouth.

or if i wake up from laying realy hard on my pillow so like all the weight of my big fat head is concentrated on a pressure point of my cheekbone, the same teeth will ache, too. or it will ache during the day is i'm really stressed (or maybe only because i'm worrying about my teeth)

i can use numbing gel and it eases the pain. or i try not to sleep on that side of my face anymore - -sometimes it doesn't work out 'cuz you can't control your body when you're asleep.

i guess it's most bothering when eating -- because you anticipate that the next bite is going to hurt or you only chew on the other side of your mouth. of course, then you worry that the other side of your mouth will break down and then you're really in trouble.

i used to always tell people when i flinched that "i just bit my tongue" but that excuse got thin from using it so often. when i was 16, i was sleeping on my friend's couch and really struggling at dinner and my friend's mom was like "why don't i take you to the dentist" and i was so embarassed at being outed because i thot it exposed that i couldn't take care of myself.

it's always been really important that i'm independant and look like i don't need other people's help. so for years i was coping with only using my left side to chew on.

i became more and more lousy in regardes to hiding the pain and i was driving my friend's crazy with all the fake macho bravado and then suffering in front of them. and a lot of what i'm feeling right now -- and i don't mean to disrespect anyone or sound like a cocky idiot -- is around just slipping back into that tough-as-nails denail state and return to just my usual way of coping.

part of me thinks that would be so easy and i'll just keep avoiding what causes me pain and pray that the other sde of my mouth doesn't break down. my dentist keeps trying to remind me to stay strong, and i guess i feel bad that i'm letting him down by bolting from this.

and i know i should be proud of myself for getting this far from where i was when i began -- and then dentist took me under his wing no matter how punk-rock i looked. and he talks to me (but also understands that some times i'm too upset to talk or listen, so he respectful deflects to a friend and says, "i know krystal can't hear me right now, but tell her...")

i remember, too, how he sat down with at the end of one appointment, after talking to my friends who had told him that i was really trying to get my life together, he was like "i hear that you've quit drugs, you're going to school and you got a place to stay and, but now that you have a sink and a frigde, you need to start brushing and flossing consistently and we're also gonna work on your diet"

i was really floored, i guess more than anything because he was treating me like a real person. he wasn't mad that my life was messed up and i could tell he just wanted to help. and he wasn't mad that i was trying to manage my own pain (my wisdom teeth were jammed into the back of my mouth and it was starting to really bother me).

since i was at his office so damn often at the begining because i was in pain -- and not always doing what he suggested -- he said this would be a good experience for me to normalize myself to being around the dentist.

and the other staff got to know me, too, and because i didn't want to freak out in the waiting area (there are kids there and it's not fair to look angry or scared in front of them, you always gotta keep it together when kids are around), someone would always let me chill in their office. and none of them got mad when i cried or i needed them to stop what work they were doing on me.

i was suppose to be coming in every two weeks while he adjusted the mouth guard he made for me so it would fit and to fix some holes in my teeth, but then i got overwhelmed and frustrated and i stopped coming -- which i know, that's the rudest most disrespecful thing i could have done.

i got a few calls from the staff at first which i ducked, and one call from him saying i shouldn't let myself down by quitting. the calls finally stopped and i was greatful because i could just slip back into the denial thing. i lied to my friend's and told them everything was fine and fixed.

of course, then, the whole "don't worry, i just bit my tongue" excuses started to arise again and my friend's weren't buying it anymore. they called me on it, that i didn't go/stop going. so now they're unhappy with me, too. mon dieu, my cowardess has made a big mess of everything!

 

[Gordon]

Re: unknown problem

A cracked cusp on a tooth sounds a likely suspect. But it's really just a guess without examining you and seeing x-rays.

 

[letsconnect]

Re: unknown problem

Forgive me if I'm wrong, but what was jumping out at me between the lines was that, in the "dental situation", you are taking on the role of a help-seeking child - a role that you despise (for example in the incident with your friend's mum, and as you said, you always wanted to be independent more generally speaking). So seeking help might be a bit of a throwback to the "bad old days"?

 

[krystal]

Re: unknown problem

let's connect:

i feel like when i need help, then i've lost control over things. you get so anxious at the anticipation that you're gonna have to hand over control and then people might hurt you.

while i can deal with 'help' more effectively when it's just a talking relationship, but when you have to hand over control of your body to like a doctor or dentist, it's so frightening and i feel so helpless because all you're allowed to do is like lay there and let someone man-handle you and you can't do nothing about -- especially when someone is hurting you with an instrument.

i remember i got punched in the gob once and i had to go to the hospital (oh course, i got punhed IN THE MOUTH, the worst possible place!) and the emerg. doc was looking inside my mouth and he was hurting me and i told him to stop and he didn't, he was stalling at my request to stop so he could finish what he was doing. that sucked. it really sucked.

i think the way i feel/fear is why the dentist likes to put me under IV sedation, because i can't handle being man-handled otherwise. and i think the sedation helps a lot ... actually, i wish they could sedate me at home so i'm not aware of anything.

i remember joking with a friend i wish dentis's had tranquilier darts so they could just put you out when you least expect it (so there is 0 anxiety of the anticipation) and then you just later all fixed up. 'cuz it's the anticipation of hurt and loss of control that i hate, even tho i try and remind myself that he's only trying to help.

***

also, if my tooth was broken or cracked, they'd be able to see that on an xray or in person, right, cuz it's be like cracked pavement, there'd be a line?

 

[letsconnect]

Re: unknown problem

you get so anxious at the anticipation that you're gonna have to hand over control and then people might hurt you.

while i can deal with 'help' more effectively when it's just a talking relationship, but when you have to hand over control of your body to like a doctor or dentist, it's so frightening and i feel so helpless because all you're allowed to do is like lay there and let someone man-handle you and you can't do nothing about -- especially when someone is hurting you with an instrument.

That feeling of loss of control is an issue for many people. It's usually down to incidents (usually at an age when you can't give informed consent) like the one you described, where the emergency doc didn't stop. The thing is though, now that you're an adult, doing something without your consent would be illegal.

Can I run a couple of quotes past you, they're not on the website at the moment because I'm in the middle of restructuring it, but they might be relevant to your own situation?

 

[krystal]

Re: unknown problem

well, something kinda really bad happened at my house when i was a kid and it was so bad to the point where i couldn't stay there no more, so i had to leave. now i really don't like/hyper sensitive to when people hurt you, especially in a way that makes you feel really scared. and now i guess i'm scared of being touched or man handled by people because i get really scared and afraid they're gonna hurt me, too.
and i don't like to not be in control of what's going on with me for the same reason.

like even with the emerg. room doc, it was hard to convince myself he was only trying to help. i must be screwed up or something.

the quotes would be nice whenever you get the time, i know you must be busy, so no stress. you're help already has been awesome.

 

[letsconnect]

Re: unknown problem

I'm kinda busy right ATM, but I'll definitely drop you a PM either tonight or tomorrow morning !

 

[Parsnip]

Re: unknown problem

Hej Krystal, first of all, you sound like a lovely person with an equally lovely and caring dentist. You are lucky to have found such a professional, so do your best to preserve that relationship.

Cracked cusps are notoriously difficult to find. Typically the pain is severe when biting down - really sharp. That's because tooth enamel is like crystal and can develop wee fracture lines within it. When you bite then, the fracture line can open up a bit and expose the nerve - hence the pain. When you take the pressure off the tooth the fracture line closes again and the pain stops almost immediately. If it's a back tooth there are four or more cusps, any one of these could be the one with the fracture. That's why then, you don't always get pain when you bite on the tooth - because you're not biting in a particular way that puts pressure on the fracture.

The fracture line really is microscopic and won't show on an x-ray. You're dentist might have a wee stick thing which he can get you to bite on individual cusps to identify which one is the problem. However you can't be sedated for that obviously - you need to be able to give him some feedback.

Sometimes it's a matter of waiting until the fracture propagates fully and the cusp just drops off. That's actually a good thing, because the pain usually stops immediately, and it's even obvious to a thick Irish dentist like me where the problem is and a simple filling will fix it.

These fractures are often caused by people grinding their teeth - either consciously or ortherwise. I know I've been guitly of grinding during the night lately - in the morning when I wake up my teeth are aching! Ouch. The bite-guard is probably a good idea then.

Sorry about waffling on about fractured teeth so much! But I hope that helps you in some way.

Take care.

Pars