Worried about DH :(

[PumpkinPie2016]

Not an AIBU really but just want to ask opinions/offload.

On Wed just gone, my husband said he had toothache in one tooth. Took paracetamol/ibuprofen which was fine and didn't think much of it at first.

It got gradually worse and he used over the counter Co codomol but they were not fully getting rid of the pain.

Saw our dentist on Thur at 12.15pm who diagnosed sinusitis (DH has had a cold recently) and prescribed an antibiotic.

Fast forward to yesterday- anything warm/hot e.g. a cup of tea was aggrevating it but cold water was helping. Painkillers weren't working. Last night was horrendous- he was in agony all night, up every 10-15 mins for cold water.
Rang 111 at 5am who advised him to go to A&E which he did.

He came back with stronger co codomol (30mg codeine and 500mg paracetamol) plus naproxen.

He has taken these as directed but is still in so much pain. Surely they should have had some effect?!

He is honestly not a complainer and had to persuaded to go to A&E as he didn't want to waste their time! But he is honestly in agony.

Has anyone else experienced this? Is it a case of waiting it out? Any tips?

When the nerve is dying you won’t see much that indicates infection. But the OPs husbands symptoms are classic tooth nerve dying off.
Starts with vague pain which you can’t locate, then it localises to the tooth, then extreme sensitivity to hot and cold, then just to hot which is relieved by cold water, then full on banging head against a wall pain.
Fortunately the antibiotics will work but it may take 24-48 hrs.
As for pain, spread out the doses so you can take painkillers every 3 hours. Alternating between the cocodamol and naproxen. If you take them both toga you have to wait 6 hrs before the next.

I can diagnose a dying tooth at 50 paces because the patient is always sat in the waiting room with a bottle of ice cold water.

Unfortunately your DHs visit to the dentist was just too early to make the diagnosis and an X-ray would not have shown anything to suggest the tooth was about to die. Most dental problems are diagnosed with symptoms.

Its the cold water relieving the pain that is the give away.

He ended up going back to A&E at 1am and has just got home.

They are prescribing a different antibiotic and a painkiller specifically for nerve pain. Ironically though, he can't collect them until tomorrow now as the hospital pharmacy is closed on Sundays 🙄

They have managed to give the antibiotics and sent him home with 1 amytriptyline tablet for today until he can get the others. Keeping everything crossed that it helps and lasts until tomorrow.

We are both exhausted. I'm a teacher and have work in the morning but currently, may need to ask to go in later/finish a bit earlier so I can take ds to school as not sure DH will be able to drive to get him there/back and my mum is working.

I’ve had tooth abcesses and also trigeminal neuralgia twice. Trigeminal neuralgia is the worst pain ever - and I gave birth without pain relief! However, the relief from cold water sounds more like an abscess - but that can also trigger the trigeminal nerve. Hopefully your husband can get xrays in the next few days.
Give him a hug from me.

@Womanofcustard thank you (and to the others on here).

He has taken amytrityline and 2 Co codomol 30/500 an hour ago - no luck so far.

If he is no better by mid day, I am ringing the emergency dentist for a second opinion/hopefully another x-ray as his pain is literally unbearable 😫 💔

It sounds awful OP. Don't expect 1 amitriptyline to do anything at all, sorry to have to say that, but for it to work as pain relief takes a period of time (multiple days/weeks). It might help him sleep I guess.

The only time I've ever had toothache that didn't go with painkillers was an abscess. I had experienced awful sinuses for weeks before which is apparently a symptom, because the abscess, nerves and sinuses are all so closely positioned. Definitely a second opinion at the dentist.

Again, thank you to everyone who has/is taking time to reply- it is keeping me going if nothing else!

I am now totally out if ideas 😥

The amytriptyline combined with 2 co codomol did zilch.
I rang the emergency dental service and told the call handler the tale - no appointments but a dental nurse would ring back.

She did but just checked what medication he had and reminded him not to take more than X amount. Nothing else.

Can't get the hospital prescription, no emergency dental appointments and he is still in awful pain.

At this point, answers on a postcard please!!

I would call 111 to see if they can get a doctor to sort the prescription but guessing the answer will be no 😔

Unfortunately amitriptyline doesn't work immediately, it usually needs to build up in your system and I'd imagine they've given him a rather low dose as well. I think I'd be tempted to go back to a&e If I were your husband if there's no relief at all by this afternoon. The don't appear to be acknowledging how painful this is for him, he needs to be very persistent if he isn't already being so. Tramadol is very good for pain relief. I hope he gets sorted asap.

Treating it symptomatically isn’t working. Go back to the dentist and get an Xray. An abscess there is very dangerous!

A&E is not the place for this OP, unless they think it’s not dental pain.

You need to ring 111 and ask for the out of hours dental emergency cover - no use asking your own dentist for emergency appt they won’t have one. You will be sent to a dental surgery in the area that does the out of hours cover for that shift. You can also look for online for the surgeries that do emergency cover in the area.

If you really cant find that then you need to find a local private surgery.

Sorry to hear about your poor DH!
This sounds like dental abscess to me. The throbbing pain and the severity of it is the nerve dying but this then causes infection in tooth and surrounding tissues. I had one in my teens - worse pain I have ever had. Mine ended with my face swelling up and making me feel really ill. They had to give me super strength antibiotics. I recommend ringing round private dentists in your area or even further afield. I don’t know where you are but some private dentists will work on Sunday .Make sure you emphasise how bad it is.

Also as others have said I believe heat is bad for dental pain. Frozen peas or ice pack are better. Honestly though I think codeine took the edge off the pain but nothing stops it from memory. I think it won’t last indefinitely though , the big risk is infection spreading so the right antibiotics are needed.

Toothache is the absolute worst. He could have an infection in the pulp or gum itself. Some tooth decay isn't visible as the tooth is rotting on the inside. An x ray should show it though. At that level of pain I'm surprised they aren't doing more investigation.

Apparently the A&E doctor suggested trigeminal neuralgia.

I have, after much persistence, managed to get the prescription for carbamazepine (had to go back through 111 and get a doctor to redo it on a normal form). So, he has just taken that.

Fingers crossed he gets some relief 🙏

In the meantime, I'll try to find another private dentist offering appointments on Sundays.

How is your husband @PumpkinPie2016 ?

@Mumoftwokids I am pleased to say he is getting better!
The nerve pain killers and stronger antibiotics have helped massively. He is still on both.

Just today, he is able to eat/drink something warm - it's been all cold stuff for him the last few days.

He is now only getting occasional pain and it is much, much milder than it was.

So, fingers crossed, he will continue to get better.