5 Things You Need to Know About Tooth Pain

August 15, 2012 at 9:05 am , by

I was stressed out last week for a bunch of reasons. So when I woke up Monday morning with pain in my teeth, jaw and ear on the right side, I figured I’d been clenching my jaw in my sleep. Yep, it must be TMJ pain, I thought. (That’s the temporo-mandibular joint; put your finger right in front of that triangular area in front of your ear and then open and close your jaw; you’ll feel it.) Turns out I was in denial, the first of what I call The Five Stages of Dental Grief.

No, I thought. I do not, and cannot, have a major, expensive dental problem right now. I have too many other things to deal with. I will take ibuprofen, and it will go away. Yes, that throbbing, steady, can’t-think-of-anything-else pain on the upper right side Will. Go. Away. Right? This phase lasted three days. The pain didn’t go away.

At the dentist’s office: “Could be from clenching my teeth, right?” “Hmm,” he said, peering at the digital X-ray. “You have a little cavity here. Want to take care of that right now?” Just a cavity? Yes! That will solve it! “But I can’t guarantee it will stop the pain,” he added. Ugh. The anesthesia brought sweet relief. For a while. But when it wore off, the pain came, back, sharper than ever. TMJ pain on top of new filling, I wondered?

The next day, I also started feeling excruciating sensitivity to cold. And now I could tell that the pain and sensitivity were centered on the upper back molar, next to the one that had the cavity. I’m a health editor, so I knew that wasn’t good. “Patients can have some degree of cold sensitivity from receding gums,” says Melanie Kim, D.M.D., an endodontist in New York City. “But if it starts to become sharp and extends for a period of time after it’s triggered, that is usually a nerve issue.” A nerve issue. As in: I may need a root canal. $#*! Hello, Stage 2:

This is the “Why me?” “It’s not fair!” “Who’s to blame?” phase. I’ve written stories about preventive dental care! I brush and floss religiously! My dad had crappy teeth. It must be his fault, right? “There is a genetic component,” says Dr. Kim. “So if your father had a lot of cavities, then you may be prone to having a lot of cavities. But good prevention should greatly minimize it.” So then why me? Grrr.

How do you know the root is dying anyway? I hate root canals! I had a terrible one when I was younger. Dentists have problems getting me numb. Isn’t there some alternative? Do we really need to start the procedure now? Or should we wait?

Dr. Kim patiently explained that many people have anxiety about dental procedures, but avoiding the dentist just makes things worse. “A dentist can identify on the X-ray, for example, that there’s an infection at the root tip—even in people who don’t have any symptoms. It’s very important that you treat the tooth because the mouth is connected to the rest of the body. Left untreated, the infection can spread to other tissues around the mouth, to the bloodstream, heart or brain, and can even be life-threatening.” Oh great. That led to Stage 4:

Now I was really bummed. But Dr. Kim tried to cheer me up by telling me about some of the advances that help make a root canal a shorter, more efficient procedure. “We use more concentrated anesthesia so it gets you numb more quickly,” she says. (Hey, I’m all for that!) “And once you’re no longer in pain, it becomes pretty much like a long appointment for a filling. We have a new kind of imaging that shows a 3-D view of the tooth, and surgical microscopes to give us better views of the tooth’s canals. We have instruments that help measure the length of the canal quickly, so there’s less trauma at the tip of the root. And we have rotary instruments that help draw the debris from the canals more efficiently, which decreases post-op pain.” Okay, I was convinced. Let’s do it.

I really did get numb quickly—and this time the pain did not return. I knew I had made it through all five stages when I said those final words, “Here’s my credit card.”

For a good overview of root canal treatment, see this illustrated Mayo Clinic slideshow.

Photo copyright Jan Mika, Shutterstock

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