Tooth pain like contractions

[vitahelp]

I went to the dentist 3 weeks ago with an aching pain radiating into my face & head. The dentist did X-rays but couldn’t see anything. He told me it was potentially a dying nerve but in the early stages. Thankfully the pain went away a few days later.

But this week it returned and over the weekend it has become excruciating. What is odd about it is that it comes in waves, it reminds me of labour pain in the sense that it starts off slowly then increases in intensity for 5 minutes reaching an unbearable point, then starts to fade off and eventually goes completely. It then returns 20-30 mins later and goes through the same cycle.

Obviously I’m grateful the pain isn’t continuous (it’s easily the worst pain I’ve ever felt) but I can’t understand why it would come and go like this. Is it when the nerve is triggered somehow?

I’ll be calling the dentist in the morning but just want to see if anyone has had a similar experience.

Hi @vitahelp
Im not a doctor, but did the dentist consider trigeminal neuralgia? That can often come on in waves..

Are you taking pain relief? Does it help? Any swelling/red/hot to touch areas on your face?

@Salcal Thank you for replying. The dentist didn’t mention this but I have read up on it myself and considered it could be that. The dentist seemed more focussed on it potentially being sinusitis but I’m not so sure.

I’ve taken some ibuprofen over the weekend but none yet today. I don’t often take painkillers so it’s feels a bit unnatural and with the pain only coming in these short bursts and being so intense I’m concerned the pain relief won’t help that much.

My face is looking a bit red and flushed on that side but I think I might have a slight fever or the pain is making me burn up a bit.

@vitahelp I think there are some sinusy-type illnesses going around but if you're having severe pain (even if not constant) and redness in area/fever i'd probably speak to 111? You can do their online symptom checker and then it triages it and tells you what to do and if you need to be seen (just thinking in case of possible infection)

If you're able to take other pain relief, you could stagger ibuprofen and paracetamol throughout the day (just making sure not to have more than recommended dose/dose per day, following instructions on the box) to see if that helps?

Sorry it's not a nice/relaxing Sunday for you, really hope you feel better soon.

I had this before it was a root infection. Morning could be seen on the first X-ray but by the time I went back again the infection had got worse so they could see it. I had antibiotics and then a root canal.

ORAJEL is amazing and very effective whilst waiting to get it seen to .

I've had on & off toothache, couldn't work out which tooth it was & then two days later tested positive with Covid.

@Salcal I do have a mobile number for an emergency contact at our dentist (private) but holding off calling until the morning.

@bravelittletiger did you find the pain constant or coming & going? Mine is one extreme to another, for example it completely went away earlier to the point where I decided to do a spin class (at home) and was fine through that, but as soon as I got off the bike it started and I had to lie down in agony for 5 minutes. Then suddenly it’s gone again and I feel completely fine and had lunch. I can’t get my head around the way it happens in short episodes. I get a few twinges in the in-between parts but nothing bad.

@pavillion1 Thank you for the recommendation 😊

@Nat6999 Oh how odd, I hadn’t even thought of doing a covid test as I mostly feel ok other than a bit feverish.

@vitahelp mine was constant but was varied a bit in intensity. It's odd that yours comes and then goes completely.

@bravelittletiger I know, it’s really odd. Like right now there is nothing, not even a slight ache or twinge. But any minute now I could be in unbearable searing pain.. I’m getting increasingly worried it isn’t a dental issue but something more complex/serious 😞 Hopefully I will be seen at the dentist tomorrow so things should be clearer soon.

I have trigeminal neuralgia and the intermittent pain you’ve experienced is very much how mine started. I get waves of pain radiating down one side of my face rather than the electric shock type pain.

Ask your dentist tomorrow if it’s a possibility or get in touch with your GP. I was back and forward to my dentist for 2 years before I went to my GP and finally got medication that helped.

@Pushkinia Thank you for sharing. I’m sorry to hear you’ve suffered in a similar way and glad you have it under control now. I’ve been pain free for about 3 hours now which does seem odd if my tooth is to blame, I would have thought tooth pain would be more consistent/regular than that.

@vitahelp I’ve had TN for more than 20 years but I have long periods of remission from flares - usually about a year. Each flare is about 6/7 months long and consists of attacks of excruciating pain, each attack lasting 20-30 minutes or so, which can happen multiple times through the day.

Triggers for me are hot food, going from a cool temperature into a warmer one and blow drying my hair (these are the main ones!). Some people are badly affected by cold temperatures but it’s definitely heat with me. It’s a horrible condition but there are medications that work for some people.

It’s definitely worth pushing for a diagnosis if any of this sounds familiar to you. Don’t leave it two years like I did ( dentist even referred me to have my wisdom teeth removed because he couldn’t think of anything else that could be causing the pain).

Tooth pain can come and go, as can TMJd as can sinusitis

It's not screaming TN. That doesn't tend to build. I would rule out the above before considering TN. I've seen many a TN diagnosed by a Gp that turned out to be something more simple.

I’ve just had similar. Searing pain stabbing into my head and ear, saw dentist who said nothing wrong but it just got worse and worse. Very cyclical like yours and seemed to resolve spontaneously as soon as I picked up the pain killers! Went back and had X-ray that showed an abscess inside the tooth. Antibiotics kicked in after about four days but I can understand why people yank out their teeth with pliers. As above orajel was my friend and rubbing sensitive toothpaste on the gum and wall to wall painkillers. Now I have to decide between a root canal or an extraction. Good luck x

@Pushkinia Have you ever discovered the reason behind your TN? I read that it is due to compression of the nerve but that various things can do that. I actually went out in the cold this evening to an event at our local village, it was bitterly cold but I felt fine. However seconds after walking back into the house I got a bad attack lasting 5 minutes.
What baffles me, if it is TN, is how it could just come out of nowhere like that. 3 days ago I had never had any pain like that and none of these attacks, and now I’m getting it multiple times a day? I suppose it has so start somewhere.

@CarPoor I hope you’re right as TN would probably be the worst case scenario. Can the other conditions really go through such extremes though, so hours of feeling fine followed by debilitating pain for 5 minutes then back to fine? I very much hope so but it just seems so unusual.

Does anything make it better or worse? Hot/cold. Lying/sitting. Do painkillers work?

@tadpole39 I’m glad you got to the bottom of it and can now have the appropriate treatment. I’m hoping for that clarity tomorrow. It’s interesting that you also noticed the pain could follow a pattern and wasn’t constant.
I did have an X-ray when I went 3 weeks ago but it was only a mild ache back then and he said things can change very quickly, but also slowly in some cases.

@MrsMorton During one of the attacks nothing really helps, having said that I haven’t really tried anything as I am finding they don’t go on longer than 5 minutes so I just lie/sit down quietly with something soft & warm on my face and wince until it stops. The pain is so intense though, the worst I’ve felt.

I did have 2 ibuprofen earlier and didn’t have a significant attack for 3 hours, just a milder pain a few times which I could carry on through. So they may well have improved it.

I've had exactly this before. It builds up, gets the the level of please cut my head off, then dies down only to return a few minutes later. I was treated for sinusitis with a steroid spray which did nothing. Turned out to be a tooth infection and cleared up with antibiotics. I found rinsing my mouth with a peroxide mouth wash as it was building took the edge off. Go back to the dentist asap.

@vitahelp I was referred to a neurologist for assessment many years ago and he arranged an MRI scan but I never found a reason for the TN. Sometimes the compressions don’t show up on a standard MRI, maybe I don’t just have any and it’s idiopathic. I’ve just had to learn to live with the TN and take medication which reduces the pain (but doesn’t stop it).

Yes and tbh it's relatively classic presentation of a dying nerve in a tooth, but would need proper examination. It's certainly not unusual

XRays alone aren't really enough to diagnose whether there's a problem with the tooth. You need to check vitality etc.

Dying nerve pulpitis usually worse with warm & lying down though so it's not a pathognomonic diagnosis.

Sorry, symptom, not diagnosis