Why every dentist take CT scan at their office even though we had a copy.

[Useruser]

This is the spot where it hurts for me. And small lump spots.
This is the attached cbct screenshot which is taken before my root canal. Could you please check if you could see anything like tooth root fracture.
Whether a tooth issue cause pain in the lower jaw under ear and neck doctor? @drhirst

 

[Acheygirl]

I just wanted to offer some support so you don't feel alone in this. I had #12 and #13 root canaled. We were chasing a pain we could not pinpoint. The procedures like yours, did not help. Now between #12 and 13 I get pain when eating hot foods. Biting on occasion is off on those teeth but some days it is ok. Debating just pulling out #12. All of my root canal teeth feel odd with taping but all my scans are normal. Sending you positive vibes.

@

Got a question here @drhirst.
As you said, it's very frustrating for me to going around doctors and the specialists for 10 months now. This pain started as lower jaw pain under ear, ear pain. I went to ENT and no infection in ear. Went to dentist to check that. He tested all teeth that side by tapping. This tooth hurts for tapping and biting on it. Then he said it might be a tooth root fracture. Then he told me to extract immediately.
I went to first Endo and he couldn't see anything. He said I have tapping and biting pain. So did root canal. And still same symptoms. No changes in my symptoms even after the root canal. Now the dentist say that this Tooth is the cause for my pain for so long. The dentist want me to do extraction.

The new Endodontist whom I have visited couldn't answer that. Why I have the tapping and biting pain on that Tooth.
What does it mean when it indicates if tooth hurts for tapping and biting?
Tmj specialist mouth appliance is very expensive. I really don't know if I should get normal dentist mouth guard( which is $700) or the tmj specialist day and night mouth guard( $4k to 5k). Since it's an expensive treatment, I am just trying to understand or rule out if it's not completely tooth issue.
I am not able to bite on that Tooth at all. My bite is so hard that side and I am not chewing anything. I have sore pain on that Tooth on and off along with tapping and biting pain. But the constant pain is the burning or sore pain in the lower jaw under ear and side of the neck.
I have 2 lump spots. One in lower jaw under ear and one in side of the neck which is small and very hard and same size since June. Had CT neck scan to check lump spots and normal results.

Don't know if it's tooth issue and causing all these symptoms. Does a tooth which shows tapping and biting pain has to be extracted?

 

[Useruser]

I am just back from the dentist office. I went to smoothen my crown since it has some coarse ends. I had some crown adjustment from the second Endodontist. So I went back to dentist to smoothen it up.
He wanted to check my bite and the right side was hitting hard and my upper molars are so hard and tight. This hard and stiff molars I have since the beginning.
So, the dentist was keep adjusting the first and second molars upper and lower since it shows high spots. He said I can't keep on adjusting these and this is not good.
Now that crown is not in occlusion bite at all. He shaved it down a lot.
He said I might need orthodontist treatment to get the stable occlusion. He said he have an orthodontist in his practice. He will talk to him and let me know if I need a braces or something lie invisalign will work.
He said to hold on with tmj specialist treatment before he let me know if I need braces or invisalign. He said my pain could be from this misaligned bite or occlusion.
I don't know if he comes up with different things. I didn't fight with him as he is the one who said I might have a fracture and asked me to do RCT. I did that and he told me to extract it now as I have the same symptoms still.

Yesterday he said I don't think it's your fracture.he said, I don't think a fracture will cause symptoms for so long the same way. He said I am taking fracture thing out now. So have to think about other things. So this means I had unnecessary root canal. The second Endodontist said the same why did you have the root canal in the first place.
Do I need to fight or argue with him why he proposed an unnecessary treatment?
I didn't say anything about it though. I was totally tired and frustrated. I have been to multiple doctors and specialists and still with no answers or proper diagnosis. The things which are more frustrating is, I have done some unnecessary treatment plans like upper Wisdom tooth extraction and lower molar root canal. So, I did both dental work suspecting that it could be the reason.

Now they want me to do either tmj treatment (which is very expensive) and PT or the orthodontist braces( which is very expensive and permanent bite changes). I don't know if that's how it works in dental field by trying out different procedures?
Please let me know if you have any inputs.

 

[Useruser]

I just wanted to offer some support so you don't feel alone in this. I had #12 and #13 root canaled. We were chasing a pain we could not pinpoint. The procedures like yours, did not help. Now between #12 and 13 I get pain when eating hot foods. Biting on occasion is off on those teeth but some days it is ok. Debating just pulling out #12. All of my root canal teeth feel odd with taping but all my scans are normal. Sending you positive vibes.

Thank you.
So, what's your diagnosis? What's the cause for your pain? Do you have pain for tapping and biting?
I did ask my Endodontist why I have the pain and the answer is nothing. Don't know the reason yet.

 

[Acheygirl]

No diagnosis. Scans and x-rays appear normal. One thought is a neighboring tooth causing the heat sensitivity. But that tooth shows no clear path to perform a RCT on yet. And does not explain why the RCT teeth have pain upon biting and tapping. All 3 of them. Wishing you the best of luck. I keep praying that they just need to settle. Told that when doing a root canal they cannot remove 100% of the bacterial and sometimes it takes time to die off - my guess for me is, an inflammatory response to the dead tooth. Nobody agree's though but there is no other explanation.

 

[Useruser]

No diagnosis. Scans and x-rays appear normal. One thought is a neighboring tooth causing the heat sensitivity. But that tooth shows no clear path to perform a RCT on yet. And does not explain why the RCT teeth have pain upon biting and tapping. All 3 of them. Wishing you the best of luck. I keep praying that they just need to settle. Told that when doing a root canal they cannot remove 100% of the bacterial and sometimes it takes time to die off - my guess for me is, an inflammatory response to the dead tooth. Nobody agree's though but there is no other explanation.

Good luck!!
Mine doesn't have any cavity. I don't have any cavity or infection on that tooth. It was a healthy tooth and I had root canal suspecting a root fracture. That Tooth was sensitive to cold and had some crack lines in the cusp. So did root canal. The second endo whom I visited was shocked why did I do the root canal in the first place when I have jaw and neck pain.

 

[Useruser]

If he can see evidence in your mouth that you are grinding or clenching at night, then it is definitely worth trying a nightguard before extracting the tooth. This is could well be cause of the tenderness.

@drhirst,
I have been told to check the occlusion equilibrium and also tmj treatment for grinding and clenching.
Do we need to get the occlusion equilibrium stable before treating the muscle tightness because of bruxism.

I have constant pain in the jaw under ear and neck. It hurts sore and burning. My dentist is against the night guards and told me they are just band aids. He want me to see another dentist whom he referred for occlusion equilibrium and want to treat my bite.

Her did check my bite with oral scanner earlier in July . He said it's not big occlusion problem but now he blame the occlusion could be the reason for my pain. I never tried any night guard before. I wanted to try and see if it helps. But he doesn't give one.

I don't know if I should get the expensive ones from the tmj specialist. Those are $4k-$5k and not under insurance. Does orthodontist treat tmjd too? I have got referral for another general Dentist who do braces/ invisalign and treat TMJD.

I see some difference in treatment between tmj specialist and the dentist who treat tmj patients. The tmj specialist treatment is only one phase treatment for 4 months.
Other dentist treatment has phase 1 and 2. Phase 1 is splint for 5 to 6 months. Phase 2 is permanent bite changes after the pain resolved. It's like braces or invisalign, adjustment to teeth etc. I am not sure if this gives permanent changes in the bite and jaw and cause long term damage or this is the right way to treat it?

Please share if you have any thoughts or inputs. @Gordon ,@drhirst

 

[Acheygirl]

I wonder if the injections of novocaine for the root canal injured your nerves? My dentist wanted me to get a night guard as I have cracked teeth but he warned me of the cost - $600 so I went to Amazon and purchased one for $130 JS dental labs. Perfect fit. Granted I am sure it's not of the caliber of the ones the dentists give, it's better then nothing and far superior to the horrible drug store ones.

 

[Useruser]

I wonder if the injections of novocaine for the root canal injured your nerves? My dentist wanted me to get a night guard as I have cracked teeth but he warned me of the cost - $600 so I went to Amazon and purchased one for $130 JS dental labs. Perfect fit. Granted I am sure it's not of the caliber of the ones the dentists give, it's better then nothing and far superior to the horrible drug store ones.

No. I don't think injection of novacaine injured. Because I have the same pain and in the same area even before the root canal. So it's the same after root canal.

I have been told that I am grinding and clenching so hard. I have been told to check the occlusion as well.
The dentist said his office guard is $700 and not under insurance. He told me to get it from tmj specialist. Tmj specialist whom I have been there last year quoted $3.8k and yesterday I called them. Their fee went up in January and it's $4.3k this year. It's not covered under medical insurance. My dentist is against the mouth guards and he told me it's like band aid and don't want me to try it. He want me to find the root cause for clenching and avoid that.
He sent me a referral for occlusion equilibrium evaluation from another dentist who is more experienced in this evaluation. Not an orthodontist. He said get an evaluation consult from him and we can see what to do next.
The new dentist office website shows, he treat tmjd as well with 2 phase of treatment. Phase 1 treatment for splint or orthotic for 6 months and after that, phase 2 is for maintenance of equilibrium by braces, invisalign or bite adjustments. So I don't know who is the right person to go for the treatment. Either tmj specialist or the dentist who tmj patients in phase wise.

 

[drhirst]

I would not consider any occlusal equilibration, which means changing your bite by grinding the enamel or placing crowns until you have been rendered pain free by using a splint. A splint is completely reversible and and equilibration is not. Then when you have been made comfortable you can choose to continue with just the splint or try the equilibration.
It is difficult to advise on who to see as I am not familiar the American system. A good place to start maybe to contact an American Dental School and see if they can recommend someone who is up to date in this field.

 

[Useruser]

I would not consider any occlusal equilibration, which means changing your bite but grinding the enamel or placing crowns until you have been rendered pain free by using a splint. A splint is completely reversible and and equilibration is not. Then when you have been made comfortable you can choose to continue with just the splint or try the equilibration.
It is difficult to advise on who to see as I am not familiar the American system. A good place to start maybe to contact an American Dental School and see if they can recommend someone who is up to date in this field.

Thank you @drhirst . I appreciate it.
My dentist did some bite adjustments in my molars on the right side where I have pain. I went to second Endodontist for an opinion and he adjusted my crown and it was coarse. Then I went to the dentist to smoothen it. He did some more adjustments in the crown which is #30 and he said I am hitting hard on #31 and it was so sensitive. So he filed down #31.
Since this pain episode started in May 2020, I have upper molars on this side so tight, hard and stiff. It's hitting hard on the lower molars and so tight. So my dentist filed down those upper molars too this week. So he adjusted all 4 molars in that side. He said he cannot adjust more like this and wanted me to see a dentist who is good in evaluation of occlusion equilibration and refered me there.
Actually my muscles are super tight and tender, tensed in lower jaw, neck and upper back. It's so hard to bend down too. If I do occlusion check now, its for sure going to show some malocclusion because of tight muscles. I don't know If I need to evaluate occlusion now. Since he adjusted the right side teeth molars , I feel some trouble on the left side . Ear and under ear in the jaw hurts. Not sure if it's because of bite changes in the right. He adjusted a lot more in those 4 teeth since it shows high biting spots.

I contacted a tmj specialist whom I visited for an evaluation earlier. They said they don't check any occlusion or bite. They just give a day and night splint for 4 months and treatment is completed after 4 months. I am not sure if I should go to tmj specialist or the general dentist who also see tmj patients. The dentist whom my regular dentist referred is a general dentist only who see tmj and occlusion issue patients.
I don't want to start with braces or invisalign now. I already did some adjustments and I am sure that is going to hurt me In the long run. My left side starts hurting since 2 days under the ear as the same spot in right side. I have pain in the right side for 10 months now. In jaw under ear and neck.

I regret that I had 4 teeth adjustments with my dentist this week. The new crown is not in occlusion at all now. He fined it so low , so it's not in bite at all now.
I asked him about the fracture now. He is one who was blaming the Tooth fracture and wanted me to extract it. He said this week that I can omit the fracture for now and focus on occlusion. He is against mouth guards and don't want me to spend $4k for tmj guards.
I had root canal on #30 suspecting a tooth root fracture in it and looks like it's an unnecessary procedure done now
I am totally frustrated and tired being going around to dentist and doctors.
I need to see someone who knows about tmj and occlusion and muscle issues. It's difficult to get one.

 

[drhirst]

4k does seem expensive. You just need to search for a dentist that likes providing splints. I dentist provided splint should confirm whether the pain is due to clenching or grinding. If it is, then great, if not, then at least you will have a device that will protect your remaining teeth from breaking.

 

[Useruser]

4k does seem expensive. You just need to search for a dentist that likes providing splints. I dentist provided splint should confirm whether the pain is due to clenching or grinding. If it is, then great, if not, then at least you will have a device that will protect your remaining teeth from breaking.

Thanks @drhirst. I will check with some general Dentist. My dentist referred me to another general dentist who is good in occlusion equilibrium evaluation. He is also doing tmjd treatment in 2 phases. One is for splint for 6 months and second phase is for permanent bite changes.
I don't know if I should go to him for the evaluation of occlusion or for splint.
Here the splints are very expensive. If it's from the dentist or OMFS or tmjd specialist. All are close to the same price.
I have been told to do physical therapy as well for the muscle tightness and Myofascial pain dysfunction syndrome.

 

[Useruser]

Hi,
I have been dealing with lower jaw pain under ear and side of neck for more than 10 months. No injuries prior. It's like burning and sore pain in the jaw under ear and neck. Been to multiple doctors and dentists. They said it's Myofascial pain dysfunction and internal derangement because of bruxism. I do have muscle tightness and stiffness.

I have 2 lump like spots in jaw under ear and neck. The lump in neck is pea like size and hard. It's the same from June'20 till now. No change in size. My physician ordered neck ultrasound and CT scan to check.

Extracted upper wisdom tooth and rct on lower molar 30( suspecting tooth root fracture,cbct clear,no cavity. 30 hurts for tapping and biting pressure before and after RCT )Pain is constant under ear & neck. My dentist told me to check about Eagles Syndrome. He said it's a rare condition and wanted me to check with ent/OMFS. 30 hurts for tapping, biting pressure. dentist want to try numbing shots to see if cause of my pain is from that tooth or not. is it safe? how to find find tooth root fracture?
Is numbing nerve shots really helpful to diagnose if the pain is from tooth or not?

 

[Useruser]

@drhirst
Does numbing nerve shots really helpful indiagnosis?