Dental advice: Severe toothache despite emergency dental app. today

[BlogOnTheTyne]

Got excruciating pain up my jaw and face. Went for emergency dental appointment today and he took out old filling, found a crack in tooth and refilled. He prescribed antibiotics and said other cracked tooth on other side (which had root canal last yr) will now need to come out. Haven't been able to eat on that side for the last year.

Back home and 6.5 hrs later and pain has come back on side he did filling. Can't eat or drink normally. Really knocked out with the level of pain.

Sadistic dentist (only NHS one locally available) who's been horrible to me in the past, so it was a horrible experience this morning anyway.

He's referred me to a dental hospital for the extraction of the other tooth and said the currently painful one will have to come out at some point too. NHS wait is at least 8 weeks for emergency dental treatment but private treatment would cost £1,500!!!!!!!!!!!

Can't take anymore Ibuprofen till 2.30AM, as have had 3 doses in last 24 hrs. Pain is awful and untouched by painkillers. DCs broke up from school over a week ago now and are being impossible. I'm also working tomorrow (from home).

Basically, has anyone any advice on pain relief? what I can do - if anything? why my usually great teeth have started to fracture over last yr? how to cope with sadistic dentist who told me today he didn't think he could 'work with me anymore', as I was clearly so anxious (meaning, slight moans when the pain got too bad and clenching hands throughout ordeal but otherwise v reasonable and communicative with him)?

Find another dentist. It's a two way relationship. You don't like him and he finds it hard to treat you, for that reason you are bad news for each other.

Your PCT or LHB will have a list of practices taking on NHS patients.

Co codamol.

I had a wisdom tooth out a week ago and still taking regular doses of ibuprofen (400mg) along with co-codamol (1000mg) and antibiotics.

Tooth pain is the worst..... The above just about made it tolerable for 3-4 hours.

HTH

Thanks for the replies. Am working today and won't get time to buy co codamol but maybe later on. Will it make me sleepy? Can't afford to be sleepy at work nor in charge of the DCs.

Yes, I really do need another dentist. Locally, when I signed up to this one, there were barely any NHS places available to anyone in the entire region, although things might have changed since then.

He's been consistently patronising and at times angry if I so much as tense up with the pain whilst he's doing any dental work. He's one of the 'old school' who expect patients to shut up and not ask questions and never complain.

Incidentally, could the pain be non-dental related and something to do with facial nerves etc? The pain runs right up my face, along upper and lower jaw lines and across my neck and is also giving me a headache too.

This morning, it feels incredibly painful and I don't want to move at all but as I slept through the night, I presume it must be very slightly better, even though I'm not subjectively feeling better.

Am I missing something?

You just need to have a tooth out, right? Why on earth do you need to have that done at a dental hospital? I've just had a tricky wisdom out at a private dentist and it cost £120!

Time for a second opinion and quickly.

That kind of pain is usually caused by an infection of some kind so the antibiotics will help - but they won't cure. Even once the pain has gone, there will still be some lurking infection that could flare up at any time so you need to stay on top of this.

If I were you, I would ring round all the private dentists in your area and go for a consultation. A check up with X-rays should really not cost more than about £50.

Regarding pain relief - you can alternative ibuprofen with paracetemol. For example: 8am paracetemol, 10 am ibuprofen, 12noon paracetemol & so on - up to the maximum daily dose. This will keep the level of painkillers in your system "up", iyswim.

Make sure the ibuprofen is ONLY that (not mixed with anything else) and don't use aspirin instead of paracetemol. This really should work.

You poor thing. Hope you're feeling better. And get that second opinion asap.

Many thanks for your message, CrikeyOHare. I've now been in severe pain for a week and on the antibiotics for 3 days and it's barely any better at all. As I'm working (whilst also looking after the DCs) this week, it's been v difficult as all I want to do is lie down and endure the awful pain.

Shouldn't the antibioitcs be having more effect by now?

I decided I didn't dare take the co-codamol type tablets I bought because of the side effects, which would likely prevent me from working effectively and looking after the DCs. I'm now also worrying about taking ibuprofen for so long, as you're only supposed to take it for 3 days I think.

I had loads of X rays done on Monday at the local dentist and all he could say was that the chances are this pain wouldn't go away, which wasn't v helpful.

Would a private dentist just do everything the NHS one has already done? If I could get the two teeth taken out privately, would that stop the pain and would they do this if I had an ongoing infection and severe pain?

The pain seems to be all round my jaws, up my face, my neck and upper back and I've got a headache (could be the antibiotics) and sore throat now too. Might there be something else going on? I've even thought of going to the GP but they may not want to interfere with dental problems...

Can't eat properly - only foods that can be 'sucked' not chewed and eating stimulates severe pain, as does drinking in any case.

My dentist told me this wasn't an ordinary tooth extraction as both the teeth are fractured. He said that the extraction could go wrong and pieces of broken tooth pierce my sinuses and facial nerves and this was why he couldn't and wouldn't take them out at the surgery. I needed to be in a medical environment.

Emergency patients still have to wait at least 8 weeks and he did say v clearly that whilst this would cost me £48 (which I've already paid), going privately would definitely cost me £1,500 or so. Actually, that was the receptionist who said that, as the dentist himself didn't mention private treatment at all. It was only after I asked about it at reception.

Is it normal for this level of pain to go on so long, even with antibiotic treatment? It's probably the worst pain I've ever had, even counting childbirth and, earlier in my life, a meningitis headache!!!

Antibiotics only rarely help any sort of toothache and are usually a last resort when nothing else can be done. Sometimes they are a useful adjunct to treatment but hardly ever on their own.

blog - poor you ,sounds awful .

I would follow crikey's advice about taking painkillers .

Don't worry about taking ibuprofen for more than 3 days honestly .

Give the co codamol a go ,they're unlikely to stop you functioning ( well ,mentally .Bowels is another matter ) anymore than the constant pain must do .

Can you ring hospital and ask to be considered for a cancellation ?
Personally I would take time off work ,go to dental hospital and weep .

God, you poor, poor thing.

The antibiotics will kick in soon if it's infection causing this. I am not a dentist, but been there, done that etc and I know that antibiotics can't get directly into the infection itself (the tooth root is well encased) so won't cure it, but they will calm down all the associated swelling which is what's actually causing the pain. If in a day or two nothing's better, then you may need other antibiotics so get back in touch with the surgery. Your dentist should be able to write a script without seeing you.

Ibuprofen is fine to take for more than 3 days - and it's really perfectly OK to take with paracetamol.

You should also start using hot, salty mouthwashes twice a day - as hot & as salty as you can bear. Hold the hot water over the relevant teeth until it goes cold, spit and do it again. This may help to burst any abscess - instant relief if that happens!

OK - so it's not a simple extraction. BUT I do think you should still get a second opinion. I do not accept that in this day and age someone should be left in pain like this. Let a private dentist have a look. He can spend more time talking things over with you, and maybe he'll be able to do something to relieve the pain.

I feel so sorry for you. I've been through natural childbirth with only gas and air, and I still maintain the worst pain I have EVER had is when my wisdom tooth got an abscess. Utterly unbearable :(

To add....

Yes, having the tooth/teeth out would stop the pain. Obviously, you'd have associated soreness from the extraction for a couple of days, but nothing like you're experiencing now.

Dentists used to refuse to remove infected teeth without a course of antibiotics first, but that appears to have changed now. The only problem is that infection can stop a tooth getting properly numb.

And, frankly, if it was just the receptionist quoting £1.5k then I would 100% definitely get a second opinion.

Thanks so much everyone. I was so desperate today I rang a private hospital - the one I'd be sent to by the local dentists if I went private - and asked about treatment there. They said I'd not be able to get the teeth extracted in time before we're away on hol. - ie, they COULD do it (for £2,000+!!) but they'd not want to, in case complications occurred whilst I was away in mid August.

So I called the NHS place and asked about their waiting list and they told me - with relish - that it's over 8 weeks for emergencies and they're booking people in for September now.

So I phoned my own dentist and asked about pain relief recommendations over the next 7 weeks. He eventually got back to me (I'd also left a message about trying to go private too) and was furious I'd not told him we were away on a one week hol. in August?!? Why's he get so angry?? He never asked me and I wasn't exactly chatting about hols when I wa slast being 'tortured' by him!

He said in that case, he'd do an emergency root canal next Tuesday - which will kill the tooth and so he says, stop the pain and then I should be pain free and then have the extractions in Sept.

IF IF IF this stops the pain, then it's a good thing - but when he did the root canal on the other side last year, it was such a horrendous experience, I couldn't go back to have that tooth capped. He was absolutely horrible whilst he did it, saying if I moved or flinched, I'd lose the tooth, I'd have to go private and spend thousands of pounds etc etc. Meanwhile, I could still feel pain whilst he drilled away.

So he's doing this again on Tuesday and I'm already in huge pain....

But WILL it relieve the pain? I know last time he told me it'd leave the tooth so brittle that I mustn't eat on that side so this time I have BOTH sides I can't eat on, even if the pain goes away. However, relief from pain is my top priority at present.

He DID recommend the swopping over ibuprofen and paracetemol thing, so I've started that - but am still feeling pain coming back again now.

Please someone reassure me that the terror and pain I'll feel on Tuesday is going to stop this pain for now???

Hopefully Grumpystiltskin will come back because she's a dentist and will obviously be the best person for reassurance.

But in a root canal the nerve of the tooth is, basically, killed - and it's the nerves that cause all the pain, right? So I'd say this is good news, yes.

Quite why this dentist has to be such a wanker about everything, though. Once this treatment is complete can you find someone else?

Here's a really, really great site that will help you loads with information & advice. There are a few actual dentists that post on the forum (Dr Lincoln is my fave) and they'll be able to offer better & more professional reassurance than I can. Try it....

www.dentalfearcentral.org/

God, I hope this gets sorted out for you soon, I really do. Please don't forget to update & let us know how you are.

Can't you find another dentist to do the root canal ?

One that would sedate you ?

Or ...how about visiting GP ,explaining situation and relationship with dentist and ask if they could prescribe you a few diazipam to take night before and on day of root canal work ?

Oh - and if you're really, really anxious about Tuesday, you may be able to get your GP to prescribe a one off dose of valium or something. Might be worth thinking about - just don't forget to tell the dentist that you've taken it if you do go down that route.

Oh - X-posted with gingeroots. Great minds, eh?

Your dentist can prescribe anxiety meds, it pisses me right off when people take a GP prescription just to see me because I almost always reschedule their appointment so I can get valid consent (invalid if you're under the influence of drugs and dentists in the UK get sued more than anywhere else in the world). It sounds like there has been a complete breakdown in the dentist patient relationship (you saying he was torturing you and him getting cross he didn't know you were going away). You need to find someone else to treat you.

Have you spoken to NHS direct to find out if there is an OOH clinic near to you? Any dentist should be able to start the root canal treatment and once that is done, yo can spend time on the waiting list because the pain will go.

In the mean time, I'm going to get on my soap box because so many parents I see have children with stacks of decay in their teeth and their excuses are "oh well he gets really stroppy if I don't give him sweets at the supermarket" or "I keep telling him not to have so much coke" yes, he's six. This is the sort of problem that they are storing up for their children and I'm sure no-one would wish that on their child no matter how far down the line it is.

Thanks again. Pain still hasn't gone away, despite now taking alternatively paracetemol and ibuprofen every 3 hrs. This is the last day of the antibiotics too. I've never ever in my life taken anything at all like this number of painkillers beyond the occasional one dose of these every year or so and now I feel like a 'drug addict', just waiting for my next dose in desperation. It doesn't seem to be touching the pain at all, however.

The dentist had mentioned needing the presumed infection to calm down a bit before the root canal. So I'm a bit worried about trying to find someone else to do it today or Monday, when he's seeing me anyway on Tuesday. I've got the DCs in tow this week until they go to a daily holiday club next week, which also makes it tricky and I'm also working some of the time.

You know, I think another thing is that I'm actually afraid of the dentist's reaction if I did track down someone else to do the root canal! I've never met anyone like him really. He scares me!

I'm not actually dental phobia - just rather anxious - and this is a result of bad experiences in early life and most recently with him. Apart from him and the dentist I had as a child - who did fillings without injecting anesthetic and told you not to cry or move - I've always been able to explain to a dentist that I'm nervous and I need their best bedside manner. Their attitude makes ALL the difference to me.

I've never taken nor would want to take anything like valium and feel that what I need most is a normal, professional dentist with good interpersonal skills.

I primed my current dentist about my nervousness when I first began with him and would even try to make jokes about it all, to put us both at ease. He seems to have a real problem however with anyone flinching at all or even asking any questions.

I was there recently with my DCs on a different occasion and he's referred them both for braces for different reasons. One DC was v v upset, so I brightly asked some questions, to 'lead' the dentist to say reassuring and positive things to DC. Instead, he got cross and said any questions I had should be taken to the other clinic when we got an appointment and was I suggesting that I wouldn't be following through on his advice, as that would be tantamount to neglect!!!

I was stunned, as I'd never consider not following professional advice and my DCs well-being is of course my top priority. Surely it's normal for a mum to ask a few questions about this kind of referral? I just really can't understand his attitude. I've even tried flattering him, joking with him, being ultra professional with him - and nothing seems to work. So I do think I need to change dentist but am cautious to do so in the middle of the current crisis.

Ironically, the fractured teeth may be due to my ultra healthy diet, rather than sweet drinks and sweets, which I've never really had much of throughout my whole life. I'm a vegetarian and have eaten lots of raw fruit snd veg and assume that crunching away for 49 yrs may have caused fractures. I'm sure I'm not calcium deficient as I do eat and drink things with calcium in them - but maybe my age could also play a part, as there's a family history of osteoporosis?

The DCs are getting v v cross about me being 'ill', which isn't helping. I don;t feel up to anything other than the most basic household tasks, interpersed with working and all I really want to do is lie in bed and rest. This constant level of pain is exhausting and of course the penecillin is giving me a thundering headache too and nausea. I've stopped even wanting to eat or drink, as it results in severe pain afterwards but of course am still eating and drinking enough to get by.

I really wouldn't wish this pain on anyone. Thank you for being so kind, all of you. I'll keep you updated.

As promised, here's an update on my situation: Fortunately, the terrible pain subsided about 2 days ago and I stopped taking any painkillers. Still got localised throbbing but the flu-like symptoms and stiff/painful neck plus the absolute agony in my jaws, face and head - diminished.

I assume this was the infection responding to antibiotics.

Saw local dentist for root canal yesterday but he decided not to do one, as the pain was better. He recommended a different private clinic where they would do sedation and it'd be cheaper than the £2,000+ quoted by the other place. He recommended that I don't wait for the NHS - mid-September now for emergencies - as my teeth probably wouldn't make it that long.

I've contacted this other clinic today and they quoted not thousands but a few hundreds but could see me on Tuesday next week. I would also plan NOT to have sedation because of childcare issues afterwards and am highly motivated to go without.

I think a good dentist can keep me calm and also give me more effective localised anaesthesia. Anyway, I think I'm going with this clinic and am waiting to see if my local dentist will release my X-rays for me to take to that clinic.

I'm so thankful that the excruciating pain has currently gone but I can't eat normally at all. I'm living off anything that can be mashed and cooled to room temperature. A good side effect is that I've lost a few necessary pounds in weight, although surprisingly little, given I've barely eaten at all for nearly 2 weeks now! Ah, the joys of being a perimenopausal woman!

What shocks me is how much pain I was in - to the extent that I couldn't focus on anything else for the time each bout lasted and how much the pain spread in my upper body and made me feel flu-like. Is this normal for dental pain? I've never felt anything like it and would rather give birth several times over any day than feel this!

Thank you again to those who've taken an interest and I may update again after treatment.

Gosh ,pain spreading to upper body ?

That sounds awful - and not common as far as I know .
I've only ever had localised pain around the tooth .

Did you tell the dentist about where you were feeling the pain ?
What was his response ?

I feel for you. Pleased the pain has went away somewhat. I've got the same just now and like you never felt pain like it. Have been up to my eyeballs on painkillers and still in agony. Luckily booked in tomorrow for root canal and on antibiotics today after emergency appointment but feeling so so ill. Been crying all day. Also on holiday as am a teacher so that's fun though at least I don't have to work. Sorry for high jacking and moaning. :( x

Poor both of you .

Toothache hell .

foodtech - hope you,re feeling better soon .
Let us know how root canal went .

Gingeroots, the dentist refuses to let me ask any questions or impart any information. That's what's been so scary. So there was absolutely no chance at all to tell him anything about the pain. In fact when I saw him yesterday ans had just started to respond to "How's the pain?" with "Well, I stopped needing to take painkillers 2 days ago and it's about 85% better but it was the worst pain I've ever experienced and...." He did what he always does and talked over the top of me and just told me his opinion - ie go to the private clinic and get sedation.

Anyway, I'm getting at least one of the teeth taken out on Tuesday at the private clinic and am definitely not going to have sedation, as I need to pick the DCs up afterwards but also, they were v reassuring and on their website, it indicates they have a choice of 2 injected local anaesthetics - one more powerful than normal. That's all I need. I'm not afraid of going to have dental treatment, per se - only of the inevitable agony that it's caused me, at my current dentist and the dentist I saw as a child.

I feel pretty confident that all will go OK and just wish they would take both out on the same day as I'll have to bring DCs along with me on the second extraction.

What was quite 'telling' at my local dentists was that he adnitted to feeling uncomfortable himself with my anxiety and that he was now 61 and used to use sedation in the surgery but can't any longer etc etc. The impression I got was that he just doesn't dare do anything more than routine stuff now because of Health & Safety and Litigation etc etc.

I feel he should retire really....

That's good your getting one out. Root canal went okay. Was actually much better than expected. Got another appointment in 2 weeks and she said will take 3 appointments to fix but at least the pain should go away. She said to phone if still hurts so hopefully once antibiotics finished will be pain free. Hope your feelin ok OP. I listened to my i pod which I think helped to calm me down as get stressed too. FT

Thanks for up date both .

Sorry blog I'd forgotten your dentist was a bit unforthcoming ..
I must say you sound very understanding about the whole thing .

foodtech - glad it went ok ,well done .

I've got some dental work looming ,root canal through a gold crown and the dentist has said it will be very difficult and I might loose the tooth .
But difficult doesn't = painful and I know he will do everything he can to keep me comfortable .
Or the logical part of my brain does .

ginger I had a root canal through a crown and it was fine. Good luck!

Just wanted to say OP glad you are feeling better, but no one should ever been left with that level of pain! I am astonished that neither your dentist or dental hospital could help. I think that's disgusting.

Good to know billybb - did it take a long time ?

And I quite agree with you about poor blog - how can that be ok ?