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Dental and Oral Health (Adults)

Pain and Sensitivity in Teeth, Jaw and Ear

11/02/2009

Question:

I went to the dentist for some minor sensitivity in 2 places on the left side of my jaw---one upper, one lower and the exam revealed a broken 2 sided filling. During the several minute exam on all the teeth, he routinely asked questions and made comments---usually to his assistant taking notes. He did ask me if I was a tooth grinder. I replied that I had been in the mid 80s (I`m 43 now). He casually mentioned recommending a night guard and completed the exam.

The next day he removed old filling and replaced with white composite filling (#18 tooth, I believe--the last molar on the left, lower side for me). It was a lot of work and they told me to expect some soreness and some sensitivity in that tooth for a few days. They also recommended Sensodyne for other sensitive areas that he said had some gum recession.

After the numbness wore off and the next couple of days, I did have soreness from the stretched jaw and drilling and scraping, etc. I also began to have some other pains located in various areas of my upper and lower jaw and into my ear, but only on the left side. The pains varied in intensity and location---sometimes a tooth or group of teeth, sometimes the gum/jaw bone, deep in my ear, even the back of my throat, the left side of my tongue and under the tongue. These pains come and go at odd times and last for varying lengths of time. Often it flares shortly after eating a meal or even a small bite of something.

Yes, I have a small bit of temperature sensitivity, but in general I`m not bothered by eating though all teeth on left seem to be sensitive to pressure---from biting down, or even pushing from my tongue or fingers.

I called the dentist back a week later to report this. The assistant on the phone took my information, spoke to the doctor and called me back. She asked if I was wearing my night guard. I was shocked saying I heard the doctor mention it, but he never told me anything about it, where to get it, or why I needed it. I told her I didn`t believe I was grinding as typically family would notice this annoying habit. She then launched into a personal diatribe on clenching--night and day. I told her it wasn`t possible during the day as I can`t stand to even have my teeth touch one another! As far as the night---who knows. But, I am in lots of pain now and this started AFTER my filling was fixed. She told me to go to a sports store, get a mouth guard and see if I was better in a month!

It`s now been 10 days. I have called back (got an answering machine) and asked to please see the dentist or have him refer me to my MD or should I go see another dentist. So far, no reply. I have been researching online, but nothing seems to fit the types of pain i`m experiencing or makes sense as to why it is in different locations. I`ve read about problems with composite fillings, infections, anesthesia, muscle spasm from improper bite---nothing seems to fit. I have not had a fever or any other visible signs of an infection. I`m even on 1000mg/day of Naproxen for post-op inflammation from foot surgery 10 weeks ago, and STILL excruciating face pain!

Can you please help direct me? I`m sorry for the long story, but I didn`t know what information might be important to you. I understand you can only give limited advice through such a forum, but any suggestions are greatly appreciated.

Answer:

There are actually several things that can be contributing to your problems right now. I do have to state that a nightguard may be beneficial, but it may not be all of the problem.

If your tooth hurts when you just tap your teeth together, the filling may be high. If it contacts first, it can lead to some inflammation and can create a "toothache" that can refer pain up to your ear. If it hurts if you bite down and grind around, the angle of the filling may need to be adjusted. Composite fillings on back teeth are very difficult to do well without over-drying the tooth, putting too large an increment of the filling in at a single time or any of several other issues that could lead to sensitivity to cold or pressure.

In addition to the actual filling, you could be having problems with the nerve of the tooth. Depending on the depth of the filling, the tooth may actually be dying. This could lead to many of the symptoms you have listed.

All of that being said, your dentist needs to get you in. It is his/her obligation. If they refuse or do not return your calls (please make sure they are open and not on vacation), go someplace else. There are tons of dentists out there who would be happy to see you.

Good luck.

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Response by:

Daniel Nathan Reed, DDS Daniel Nathan Reed, DDS
Clinical Associate Professor of Primary Care Dentistry
College of Dentistry
The Ohio State University