What specialist helps diagnose chronic dental pain?

[Kns]

For the past two years I have had chronic dental pain on one half of my mouth/face. The teeth on that side have large old amalgam fillings, so my dentist has had me on a plan to crown them. I have had one crown (two more scheduled this summer) and four root canals to address the pain. All of the root canals took away cold pain and do not react to endo ice, but I still have chronic tooth pain. None of the teeth were infected, only inflamed. One of the teeth had a nerve that looked “pinched” according to the endodontist. No cracks or fractures have been found and I have had several CBCT scans and xrays. The teeth are pressure sensitive if tapped on the side and my gums feel like they are burning. The pain radiates to my ear and I have numbness and sensory issues on and off in my cheek on that side when the pain is high. Sometimes the pain reminds me of how it felt when I was little with a loose tooth, although my teeth are not loose. My bite is now off and I only hit on my back second molars. Eating is more difficult. Occasionally I taste blood, but can’t find a source of bleeding. The dentists say my gums look healthy. I wear a custom nightguard. I’m unsure whether I should get the crowns, get any more root canals or just start extracting. I have been to my dentist and endodontist a lot, but am not getting any relief, even with work done. Would an oral surgeon be the right dentist to diagnose what’s going on or should my regular dentist be enough? I feel like I’m going crazy at this point and while some days or hours I feel fine, most of the time the pain is chronic. I realize no one can diagnose me over the Internet - I am mainly wondering what type of dentist I should be seeing - if these issues seem like common ones that a second opinion from a family dentist could help me with or if a different specialist is needed. It’s getting expensive, so I’m wanting to make wise decisions. Thanks!

 

[comfortdentist]

In general your bite should be very even from left to right side. I try my best to ensure that is true before a patient leaves my office. This is something to be expected by all. I would have it adjusted and if your dentist can't get it right then you will have to see another general dentist. This is not specialist care just basic dentistry. If your bite is really off then it will take some time for the dentist to grind it in place but it must be done regardless of what happens to the offending crown.

 

[Judythecat]

Hi, I have atypical facial pain, which essentially translates to toothache, and a burning sensation in my gums. It’s caused by the nerves in my face and mouth mis-firing. My teeth and gums are completely healthy, but I am on three-month checkups because the pain moves around, and I constantly worry that a tooth has gone bad. I was diagnosed by maxillo-facial, after months of trailing back and forth to my own dentist, who referred me. The treatment I was offered was an antidepressant which blunts the nerves, but I would rather just manage the condition than deal with the side effects of the drug. (I don’t have issues with my bite, but I do wear a custom night guard for teeth clenching.)

 

[Kns]

Thank you! Would malocclusion cause the kind of symptoms I am having?

 

[Judythecat]

Mine are definitely nothing to do with malocclusion. The trigger for me was starting to clench my teeth due to stress, which caused me to crack a filling in a lower molar - the clenching had probably been going on for months before I realised. The lower molar was re-filled, never settled, had root canal, never settled, and was eventually extracted, and I think that was the start of a whole nightmare chain of events. I now wear a night guard, and have to constantly remind myself that the pain is nerves, not teeth, but diagnosis took a long time and months of worry.

 

[comfortdentist]

Thank you! Would malocclusion cause the kind of symptoms I am having?

Your complaint would include occulsion as part of the cause

 

[comfortdentist]

"My bite is now off and I only hit on my back second molars. "
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