Make the Most of Your Mouth

Oral Pain, Tooth Pain, and Injuries: Ask the Dentist

Dentist Steven E. Roth, DMD, answers your additional questions about oral pain, toothaches, and mouth injuries.

Question:

I had my teeth cleaned yesterday and when I woke up today, I found a “bubble” inside my gum, on top of my wisdom tooth. Now it has doubled in size. I can only open my mouth about 2 inches and it hurts to swallow. I can’t close my mouth without hurting it. I got an emergency appointment but it’s not for three weeks. What can I do in the meantime?

Answer:

All of the symptoms you are experiencing are signs of infection and are a real emergency that can get worse. I would get to a dentist as soon as possible. These types of infections can be quite painful and end up with a hospitalization or worse.

Question:

I went to a dentist with pain in my lower right molar. The dentist recommended and performed a root canal. I was OK until the anesthetic wore off, and then pain in the tooth started to increase. I took amoxicillin and Vicodin for five days without any real improvement in the pain. When I went back to the dentist the next week, I was told this was normal. Pain wakes me up and makes eating difficult. I'm living on ibuprofen to manage the throbbing pain. I am scheduled to see this dentist again this week to have post and crown put in. I'm not anxious to put in a crown if the pain hasn't subsided. Is it normal for pain to persist for seven to ten days after the root canal?

Answer:

Patients react differently to different situations. Some people experience pain while others do not. It sounds like the antibiotics and pain medications are the way to go, but if the pain is severe, I would call the dentist immediately and not proceed with any other work until the pain completely subsides.

Question:

I have been up all night in pain from seeing the endodontist at 1:00 p.m. to finish a root canal. I am on Z-Pak antibiotics because it became infected. I take Vicodin extra strength, OxyContin, and Motrin every few hours. Nothing seems to work. The pain is pulsating, and as soon as the painkiller helps a very little bit, it only lasts for half an hour and I am back to where I started. Other than taking more and more painkillers mixed with Motrin (which I do not want to do), what can I do?

Answer:

It sounds like the antibiotics and pain medications are the way to go, but if the pain is severe, I would call the dentist immediately and not proceed with any other work until the pain completely subsides. Only the treating dentist knows the exact situation, and communicating with him/her is the best advice I can offer.

Question:

I had my 2 left wisdom teeth extracted a week ago. I ended up with a dry socket on the bottom. My oral surgeon went with the clove oil technique -- gauze soaked in clove oil and packed in the cavity -- for 7 days. Is it really safe to leave it in for 7 days? Sounds like an infection waiting to happen.

Answer:

Without knowing the exact circumstances, normal treatment is to remove that packing within 48 hours or an infection can ensue. Please contact the oral surgeon as soon as possible to resolve this situation.

Question:

I've been dealing with my wisdom teeth rotting for quite awhile. I actually was scheduled to have them extracted last year, but a week before surgery, I found out I was pregnant and couldn't be put under anesthesia. Then I had to switch dental insurance, and now I have a six-month waiting period. My wisdom teeth have come in and started rotting. The side and part of the top is gone on both of them. They go through cycles of hurting and not hurting. I use Orajel and Tylenol for the pain. I'm just wondering, if they don't become infected, will they eventually just finish falling out and the nerve die? Or if the tooth is gone, will the root still hurt?

Answer:

It sounds like a deteriorating situation to me. The teeth will not fall out, the remaining teeth or roots can get infected and cause big problems. I would get to an oral surgeon as soon as possible to properly assess the situation and to hopefully prevent major infection and problems.

Question:

This is a weird issue that I've had for many years. Whenever I eat or drink something that has a flavor for the first time in several hours, I get a sharp pain around the sides of my jaw. It only lasts for a few seconds and then I'm fine. Nobody I've ever mentioned it to has any idea what I'm talking about. It's been something that I've lived with if only because the pain period is only a few seconds at a time, and only a few times per day, so it’s not super bothersome. However, it does raise my curiosity and maybe a bit of concern because it's clearly not normal. What could this be?

Answer:

It is extremely difficult to help you with a diagnosis without seeing you in person. There are many tests that can be done, such as pulp testing, X-rays, or temperature testing that will help in determining the problem. I would see the dentist and if he/she cannot determine the problem, there many specialists including endodontists, periodontists, and oral surgeons that might be able to help. ... Good luck!

Question:

About 4 years ago I bit into something, and my second from the last lower left broke in half. I had a root canal and a crown. The crown felt - not like my other teeth. Now my tooth (the crown) is in a ton of pain. Not a sharp pain but a constant, nagging, "heavy" pain. Not overwhelming, more like a 2.5 on a 10 scale. For what it is worth, the gum line where the crown meets the gum is black although I was told "that is normal". Basically, it feels like something is rotten below the crown, like there may be an infection under there. I have now visited 3 different dentists who have told me that it was "impossible" for there to be pain under the crown because there was "no nerve". Well, I can assure you there IS pain, and it is 24 hours a day. I think this is a contributor to a huge amount of stress in my life and even my mind-set to the point that it is driving me crazy. One dentist even X-rayed. Said there was nothing. What could be the problem? Could there be a real pain caused by an infection.

Answer:

There are several possibilities. The bottom line is if there is pain, your body is telling you that something is wrong. Root canals can become re-infected. The tooth could be fractured and infected, or there could be a deteriorating periodontal or bone situation where the housing of the tooth is shrinking away. It is easy to get overwhelmed by pain because your body wants it to stop. My best advice is to see a dentist who can evaluate the situation with X-rays, visual exam, periodontal probing, tapping the tooth, feeling the tissues around the tooth. When I cannot diagnose the specific problem, I will always refer to a specialist such as an endodontist, oral surgeon, or periodontist for their expert opinion.

Question:

I had a crown done in October. It continued to hurt and was sensitive. I went back to the dentist several times for bite adjustments and ended up redoing the crown in January. One week later the pain was more intense and he did a root canal. The tooth itself has gotten better. But now my entire lower jaw hurts and I still have a hard time chewing anything real hard on that side of my mouth. I have a great dentist. But it's frustrating that nothing is getting better. Can you think of anything we could try?

Answer:

It sounds like your dentist is doing everything right! Sometimes it takes your body a little time to readjust itself and heal. I would follow your dentist's advice, and things should improve over time. There are some patients who increase the amount of grinding and clenching they do when they are in the middle of treatment. Sometimes a bite appliance/night guard can help ease the jaw pain a little quicker. Good luck!

Question:

I just had all four of my wisdom teeth removed yesterday and they gave me Lortab and ibuprofen. Yesterday I had no puffiness of the cheeks but I had severe pain. I took a Lortab before I went to bed and I woke up about every hour all night long. This morning my cheeks were swollen. How do I know if this is a normal thing with wisdom teeth extraction or if I’m allergic to the Lortab?

Answer:

The trauma of wisdom tooth surgery can cause pain and swelling. However, you are always right to question what is going on. I would definitely get in touch with the oral surgeon as soon as possible, and describe exactly what is going on. The chances of an allergic reaction are small but find out for sure.  You are probably also on an antibiotic and they can cause allergic reactions as well, so definitely phone your surgeon and double check!

Question:

I had my 4 impacted wisdom teeth removed a little over a week ago. I'm 23 and know now that I was a little overdue to have them removed. When they removed one of my lower ones it caused a stress fracture in my jaw. When he initially discussed everything with me his only concern with that particular tooth was that it was near my nerve. Everything is healing fine. However, I'm having trouble opening my mouth and some pain when I try. I'm not trying to stretch it too far because I don't want to damage anything. When I asked my doctor about it he said it could be muscle related and usually he has people try to stretch it using their fingers, but he doesn't want me to. I'm just very confused as to how/why this could have happened. Any insight would be fantastic.

Answer:

Without knowing the details or seeing you it is very hard to give you an accurate assessment. I recommend returning to the surgeon for a consultation and having a detailed examination and diagnosis. If you have any difficulty understanding the situation, perhaps a second opinion would be of help.

Question:

I am currently pregnant and having issues with my teeth. My wisdom tooth is coming in, causing a great deal of pain. I am not able to see my ob-gyn for two more weeks, to let me know if I am able to have my wisdom teeth taken out. It is starting to become sickly painful. What can I do until then?

Answer:

Removal of a tooth is considered surgery. Even though you are having pain it is important to receive medical clearance from your ob-gyn first. If you are in pain you should be able to get medical clearance from the ob-gyn immediately. Pain and infections are a risk to the fetus and the pregnancy. Get in touch with them immediately or go to your local ER if you can’t.

Question:

I've had a four surface filling done three weeks ago and I am still having pain. I've gone back to the dentist a week ago for her to look at it. She shaved it down a bit and told me not to eat with it for 4 to 5 days. So today, a week later, I've tried to eat a pb&j, and it had a stinging pain in the middle, so I took some aspirin. I am worried as to why it is still hurting. I've waited this long and until the afternoon, since I grind, but have been using a mouth guard. The dentist explained that the grinding may cause some pain since the nerve was over stimulated. I am not sure if I need a root canal or something else. I have an appointment for some more fillings on Monday. Should I wait until then or should I go see her again soon?

Answer:

If you are having pain after three weeks it is possible that there is an irreversible pulpitis or an inflamed nerve that will not get better. This may need to be treated with a root canal, or further bite adjustment. I would go back to the dentist before beginning more treatment.

Question:

I had braces for two years and now I will be using a retainer for about 1 and a half years. I admit to being very lazy with my retainer, which I realize can cause some major issues. About 4 days ago I realized I have an orthodontic check-up on the 30th. Thus I scrambled to begin wearing my retainer 24 hours a day in hopes that my teeth will form back. However, the pain has been significant and is still strong after 3 or 4 days of continuous retainer use. My question to you is, what do you feel is the best pain reliever for oral pain?

Answer:

Based on your question, I would say that the pain you are experiencing is pain from teeth moving. The best pain relievers are anti-inflammatory drugs like Advil or Aleve. Use as prescribed. You may be better off not wearing the retainer so the orthodontist can see where the teeth have moved to.

Question:

I began using Crest White Strips Supreme to whiten my teeth. But the pain was too intense and I stopped after two applications. That was earlier last week. Last night, everything was fine, but I accidentally knocked on a front tooth with a pen, very, very lightly, and it somehow reverberated and created intense pain. Moments later, the tooth nerve was inflamed and I've been feeling the effects of an inflamed tooth all night (intense pressure in the tooth, painful to touch, etc). Ibuprofen relieved the INTENSE pain, but there is still a lot of discomfort. My first question is, is it possible it was done by the White Strips? This was the same tooth that was being bothered by the White Strips. Secondly, does this require a visit to a dentist to take care of?

Answer:

The best advice I can give you is to see your local dentist. Every patient responds differently to whitening procedures. Even though over-the-counter products are milder whiteners, there needs to be an assessment of the teeth by a dentist to determine the chances of sensitivity. Gum recession, wear from grinding or clenching, and leaky fillings all can cause sensitivity. Many patients respond well to intermittent fluoride applications between whitening treatments. Sometimes limiting the whitening to every other or every third day will keep that sensitivity at bay. The bottom line: Get to your dentist. There may be irreversible damage to that tooth!

Question:

I have been in pain for the last 2 or so weeks. I have scheduled a dentist appointment but it’s not until next week. Lately the pain has gotten so bad that I can't think. All I want to do is cry. Last night I actually woke up panicking because the pain was so bad. It's in the back of my mouth, where I have a very bad looking tooth. But the pain goes to my jaw. I tried using Orajel last night, but it did nothing. One 600mg of ibuprofen did nothing for it either. I am hoping I can make it till next week, but I am really nervous and in a lot of pain. Is there anything I can try?

Answer:

If you are in that much pain and the pain is in your jaw it is very likely that you have an infection. Waiting is not an option. See your dentist today! If you can't, see another dentist or go to your local hospital’s emergency room. Extreme pain is an EMERGENCY. Emergencies are supposed to be seen immediately because they can get worse.

Question:

Seven days ago, I had a root canal on an upper right molar. At that time, only 2 roots could be found. I returned two days later, for another 2 hours. During that time the third root was found and the first two were packed. That night I woke up with such severe pain I considered ER treatment; pain shooting into my ear, glands, and eye. The pain continued into the next day, when I had an emergency appointment with an endodontist. He said everything looked fine on the X-ray, put me on clindamycin and gave me 600mg Motrin q4h. I still have numbness and tingling, along with ear pain on the right side of my face. I am supposed to follow up tomorrow for filling of the last canal, but I am hesitant due to the continued issues from the first two visits. Is this normal?

Answer:

Every patient responds differently to root canals. Proper antibiotics, pain medications, and following the exact instructions of your dentist are the best things you can do. I would continue to follow the advice of your dentist but be sure to voice your concerns.

Question:

This past week I was in an ice cream eating contest. I ate at least 8 scoops of regular vanilla ice cream in about 60 seconds. Since that day, I have been having pain in my back molars but only when something cold touches them. It doesn't matter what beverage it is, it just hurts. I read about tooth sensitivity on this site and it answered none of my questions. What could be wrong?

Answer:

It sounds like there may be some abnormal sensitivity to cold. This can be a reversible situation that responds well to desensitizing toothpastes like Sensodyne or prescription-strength fluoride treatments done at home. However it may also be an irreversible pulpitis situation in one or more of the teeth that could require root canal. Either way, your dentist needs to check out the problem and may need to take X-rays to be sure! Bottom line: Make an appointment to see the dentist.

Question:

I went to a cosmetic dentist and ended up with labial veneers on the back of my front teeth. Not only do they feel thick, like Chiclets, but I am in so much pain from them. The dentist filed down over the eroded areas and then instead of putting "minimal composite restoration over areas of erosion" I ended up with veneers that I had no idea he planned on using. I have gone back to this dentist to have him fix the problem more than a few times. But each time I leave, I am in as much, if not more pain. Any suggestions?

Answer:

The definition of a labial veneer is a custom fabricated porcelain shell veneer that is bonded to the front surface of a tooth for either functional or cosmetic reason.  If you are in pain from the treatment the first thing you should do is return to the dentist for an evaluation. At that visit I would ask any questions you feel you need to ask about the treatment.

Question:

I had a deep cavity filled 2 weeks ago. It's a tooth-colored filling. It's on the side of my tooth, not the chewing surface. It doesn't hurt to brush my teeth or chew, but it's still sensitive to heat and cold. (It wasn't sensitive before the filling). I can feel that it's there. I wouldn't describe the feeling as "pain", probably not even as "discomfort". I'm just aware of it when I think about it. It's more of an annoyance than anything else. The dentist said it would probably hurt for a couple weeks since it was deep. Looking online, I'm seeing people say anything from 1 to 8 weeks. What should I expect?

Answer:

It is not unusual to have sensitivity after a deep filling. It could last 8-12 weeks. The most important thing to know is if there is a change for the worse, you may have an irreversibly damaged nerve that can get infected. This would require root canal therapy to save the tooth. I would carefully monitor your symptoms and get in touch with the dentist if something changes.

Question:

Starting earlier last week, while I was brushing, I noticed I was spitting out quite a bit of blood when rinsing. Shortly after, within a day I started to notice my teeth hurting. They are HIGHLY sensitive to cold food or water. My teeth and gums ache and throb as soon as I eat anything really cold. They do not hurt when chewing gum, eating, etc. They actually hurt more when I'm idle, or not using them at all. Sometimes the pain is in the top back teeth, and sometimes it’s in the bottom, all the way up to the front (but NEVER in the very front teeth - top or bottom). I don't think 8-9 cavities would spring up out of nowhere and all be bothering me at the exact same time? I'm thinking it's more of a gum or root problem? Any ideas?

Answer:

My first reaction would be that the spitting out a lot of blood is a sign of severe gingivitis or gum infection. The temperature sensitivity can be caused by the gingivitis, irritated exposed roots, or tooth decay. Rather than something springing up and causing pain in a quick fashion, it is probably a situation where you need a complete examination and a hygiene visit. I would recommend making an appointment to see a dentist before any of the problems get worse.

Question:

I have dry socket (confirmed) and was given the dry socket pack. It helped on my left side but not the right. The left side has a dark red circle (new clot, I’m assuming) and the right just looks like cut gums. I can irrigate the left with no problems. But on the right side, the irrigation cause pain, shooting up to my ear. INTOLERABLE! As I see it, I have to eat to get nutrients to heal (which I REALLY haven’t been able to do). But I need to irrigate after eating, which is so painful I don’t even want to eat! What do I do?

Answer:

It sounds like you still have a dry socket. You should go see your oral surgeon immediately. A lot of pain is a sign that there is still a problem. Please get in touch with your oral surgeon immediately.

Question:

This is strange, but I had a root canal 17 years ago. I have never had any trouble with it. I had the cap replaced for cosmetic reasons in 2001. Still, no trouble. About a month and a half ago, I started getting throbbing, unbearable pain from it. I knew it was that tooth, but didn't know what to do.

Answer:

The human body is constantly changing. A root canal that has lasted 17 years can get re-infected. There could be a leak around the crown that is allowing bacteria to re-infect the area. There could be a fracture in the tooth or root system. It may even be another neighboring tooth. I recommend seeing the dentist as soon as possible to have an X-ray and an evaluation. If there is a problem your dentist can best help you.

Question:

I was told I need a root canal. There is no way I can afford to have one but the pain is getting pretty bad. I was referred to a specialist, which honestly I can’t afford at the moment, either. But I heard that you can just get the tooth in question extracted and it will "fix the problem". And that way I wouldn't need to pay for a root canal. Basically, I just wanted to know if pulling the tooth and getting a bridge later down the road when money isn't so tight would be a different way to go about this.

Answer:

The pain from the tooth needing the root canal will only get worse. If there is an infection it will get worse and could be very dangerous. There are always treatment options. Extraction is an option but replacement of that tooth with a bridge or an implant later on could ultimately be more expensive. I suggest calling your local dental society for some other treatment options, like a dental school or hospital-based program. Additionally, most dentists offer easy financing options. So don’t give up on that tooth just yet!

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