Constant pain with teeth

[PeevedOfPortishead]

For the last 18 months or so I've battled overly-sensitive teeth, have made several emergency trips to have the gel stuff out on and for the last 3+ months have been prescribed duraphat.

This week was my regular check-up and my dentist was very surprised by the sensitivity I'm experiencing despite treatments. She x-rayed but found absolutely nothing amiss. When she was painting on the gel I was squirming in pain and she said it was extreme and what she would expect from severe decay - literally nubs!

I'm in constant low-grade pain and I can't stand it any longer. :(

She's referring me to the dental teaching hospital but I have no idea what to expect.

There are rumblings online in groups I'm in where people are on lamotrigine and are having enamel issues. Has anyone come across this correlation before?

I am so fed up.

Op I suffer from gum disease which gives me hours of sensitive teeth. When this happened I floss gently with iodine and the pain totally disappears for weeks, give it a go.

No enamel issues or gum disease, but I suffer from constant “toothache” which has been diagnosed as problems with the nerves in my face sending out the wrong signals. It has no dental cause. I am under maxillo-Facial at the hospital. I have been offered amitryptyline - that will undoubtedly be the wrong spelling - but am not keen to take it. I had a full head x ray and an MRI scan, plus a billion trips to my own dentist before she referred me on. Having a diagnosis makes it a bit more bearable, as the pain shifts about so I constantly worry a tooth is bad, but chronic pain is very difficult.

charlie what's this iodine flossing all about?

Judy that'd be right. I've had amytriptyline (?) Before for something else and it sent me mental. Literally sectioned.

I'm dehydrated because it hurts to drink.

I'd kill for a set of gnashers in a glass by the bed.

I also have facial nerve pain that started off in my teeth. Brushing my teeth was agony and so was eating and drinking. I also got low grade pain constantly.

My dentist x rayed and couldn't see anything wrong, so as the tooth had an old, big filling in it, she removed the tooth. The pain didn't go so she was prepared to do something with the next tooth but I had strong pain even while under the local anaesthetic, so I took myself to the doctor and asked if it could be nerve pain. He agreed it sounded like trigeminal neuralgia and I'm on gabapentin to keep on top of the pain.

A few key questions...
Is your pain triggered by certain things (like those you've already mentioned).
Is it localised or does it move around?

Is it just in one part of your jaw (upper/lower)
Does it respond to normal pain killers like paracetamol/ibuprofen?

Hot, cold, black coffee, cold air, touching, toothpaste, salivating...

It's mostly lower front and right hand side although upper front sore tonight. To my recollection, left side is fine.

I don't use painkillers (generally) so I'll have to trial, took ibuprofen and hour ago.

Well I have shitty teeth so gum disease is my issue and in desperation, I reached for the iodine. It’s antiseptic antifungal
And antibacterial. I was thoroughly pissed off with dentists inability to get on top of it and just went all creative hahaha

It really bloody works on me also coldores - they never even emerge any more

Does an iodine smile not make you look somewhat terrifying?

Has your dentist ruled out grinding? If I don't wear my guard for a bit, the pain will start to emerge.

I am also a night guard wearer, but more of a clencher. That's definitely a contributing factor for me!

Thank you, I will ask about this. None of my partners have ever mentioned it.

My front teeth don't actually meet! The top front overlap the bottom and there's no contact although my pre-molars and normal molars do meet as normal.

Gah!

Mine are the same. Dh wouldn't know. You can't hear it. They all seem to set each other off.

It was my dentist who realised I was clenching (by which point I had done a LOAD of damage to my back teeth!) so I think yours would have noticed if you just had a checkup? Interestingly, once I got a night guard made, I started to clench my top front teeth into it, causing pain, even though those teeth have never had any decay, fillings etc. I was essentially rocking them in their sockets! I had to switch to a rigid lower guard from a standard soft(ish) top one.

My DP had never noticed it either, but he definitely notices me putting in and taking out my very attractive night guard. It is a total passion killer in terms of spontaneous sex. I also wear ear plugs because he snores, so I am a real joy.

I would've thought a dentist would've picked up on the grinding - I've seen enough of the buggers the last few years! Clenching I'd not considered.

I spoke to one last year about cosmetic work - I am a child of the 70s and my teeth are normal for my generation but not Instagram-worthy iyswim. He implored me not to do it saying I have really healthy teeth.

I'm bloody confused.

Judy I eschew all men - your nighttime attire sounds an ideal way to maintain that!

Just been reading up on trigemal neuralgia and ironically one of the epilepsy drugs which can be used to treat it... Is one I'm already on - and is rumoured to mess with teeth.

If it was trigeminal neuralgia it would most likely be one side of you face, as it follows your trigeminal nerve.

I think an oral medicine referral to the dental hospital would probably be best, they will be able to diagnose trigeminal neuralgia if it is that, as well as other conditions that can cause pain. It's unusual to find the gel sensitive.

What sort of pain is it? Is it like a sharp nervy pain, an ache, is it more your gums? A burning?

It's possible it could be grinding or clenching, it's not always evident in your teeth so a bite guard might help. It might be a case of trial or error if there's no problems with your teeth.

Have you ever had gum disease? Or gum issues? Do you floss? Ever get any bleeding or bad taste?

I get intermittent burning in my front teeth where the pain is excruciating. All xrays normal. I'm seeing a max facs consultant on Wednesday.

dishranaway thank you so much for your comprehensive reply - I do agree - it's going to be a wait and see until the experts take a look.

The pain usually comes in lightening like flashes which make me screw up my eyes and clamp my hand over my mouth. Cannot focus on anything else... That very strong pain lessons over the course of 1-2 minutes and then there will be a dull ache lasting up to an hour or so. Rinse and repeat. Initial pain feels like nerves I suppose - like if someone took a hammer to them and smashed them in half!

No gum issues ever. Last filling I had was 9 years ago and was a replacement (sold a cosmetic replacement rather than functional - very very painful at the time and I regret it!). Generally healthy if not overly beautiful.

It doesn't sound like gum issues pain. It could be trigeminal if it's in one side of your mouth.

The other thing is if your filling was really painful settling down I'd wonder if that tooth was causing all this pain, but again it depends on the location of your tooth vs where your getting the pain and what the x ray looks like, if the filling is deep etc.

Lamotrogine can cause a dry mouth, which makes you more prone to decay and can make sensitivity a lot worse, it doesn't damage the enamel persay. However again it sounds very extreme to be sensnitivity

It sounds like you have thin enamel which is causing the sensitivity. Do you have retainers at all? If you do put sensodyne toothpaste in them and sleep with it. Sensitive teeth are awful.

Lightning flashes of pain is classic description for TN. Perhaps make a gp appt to discuss it. Or ask your dentist as they should be trained in it although mine missed it and had no clue

I had a similar problem for edges, it turned out to be a hairline crack in the tooth which wasn’t really visible. Eventually the crack went all the way through the tooth and I ended up losing it :/ but no pain since

housequery that’s exactly what mine started with - those teeth have never been filled or had any decay, so it was perplexing. The pain then started to move around, and sometimes was in the gums, or even my nose. It felt like I had burned the gums on hot pizza cheese. I was eventually diagnosed with both atypical facial pain, and burning mouth syndrome, so not true TN, and I also have TMD - I think it is all linked together and tied into clenching at its root. (Ha)

dish my pain has switched sides over the last month or so, but again, no dental cause has been found. This doesn’t sound right from what you say about it staying on one side? My dentist said the teeth were fine and it was “just” nerve related, she did x rays and loads of tapping and prodding when I went in a couple of weeks ago to get it checked. My gum scores with the poky thing were 0 and 1 in my last checkup in October, and no tooth issues were found. I am certain it’s not the gums, although they currently feel like they are going to combust! I am back at MF next month but paranoid that there is something wrong with the teeth now having read your post about it staying on one side.

Trigeminal is on one side, and if it was referred pain from one tooth (so crack or filling into the pulp) that would be on one side most likely. Burning mouth syndrome and atypical facial pain aren't TN, they are completely different conditions. So they can be all over.

Sometimes people with gum disease can get a lot of pain that was why I asked, but your dentist would pick up gum problems so don't worry. Scores of 1 and 0 are good

I'm taking comfort in not being the only one avoiding talking/drinking/eating/smiling/moving in case it causes pain!

The temperature has really dropped here and I spend a lot of time outside (riding). So I'll be spending the foreseeable with a scarf tied around my face.

I also find in sucking my lips + cheeks in because it seems to give some comfort to the teeth if they're in constant contact - this probably is bad in some other way is it means when I'm awake I'm consciously doing it and so my mouth region is not relaxed.

dish thank you for your reply. I swear I have gone from a person who brushed and flossed twice a day, then forgot my teeth altogether to being completely obsessed with them. The whole saga has been awful, but I am glad to now have a diagnosis at least.

My dentist must feel like crying when she sees my name come up, although she has been absolutely amazing, even when I have been a weeping mess. The Max Fac consultant has also been fantastic.