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Hello,

I have a few questions about an irritated tooth nerve that I'm hoping somebody might be able to answer:

a. What are the symptoms of an irritated nerve?
b. How can a dentist diagnose that you have an irritated nerve?
c. Can an irritated nerve calm down on its own?
d. Can trauma to a tooth (such as a blow) cause an irritated nerve?
e. Will medication calm down the symptoms such as painkillers/antibiotics etc?
f. How is an irritating nerve treated?

If anybody is able to answer some or all of the above, I'd be most grateful.

Thank you.
There are 2 types of nerve irritation, they are reversible and irreversible pulpitis. Both can make you experience hot and cold sensitivity and pain associated with pressure or biting. Reversible will eventually calm down. Taking an anti inflammatory such as Advil or Motrin can help with the inflamation in the tooth. Tylenol or pain relievers will only help with the pain, not help the problem. Irreversible will require a root canal to stop the pain. What exactly is your problem, and what are your symptoms. Let me know and I will be able to answer your questions better.
Okay, I have quite severe burning, throbbing pain in a tooth which was knocked some time ago. The tooth is quite sensitive to hot and cold and extremely sensitive to pressure. It is also very tender around the gum/jaw area at the root/base of the tooth. It is even uncomfortable to smile, talk, eat, brush my teeth etc. When the pain is at its worst the two adjacent teeth become slightly tender but not to the same extent.

I've been to a dentist who thought that the tooth might have died and abscessed. However, the tooth responded to the cold test which showed him that the nerve was still alive and the X-ray showed nothing obvious. Painkillers didn't make much difference so he gave me some antibiotics to take as a diagnostic tool. I've been taking the antibiotics for a couple of days now and although I still have toothache, the severe pain has dulled to a mild/moderate ache and the tooth is still very sensitive. I'm hoping that by the end of the course of antibiotics it has calmed down much more.

I spoke with my dentist on the phone today as he was curious to see if the antibiotics were having any effect and is quite surprised that they have made a difference because he can't see any sign of infection on the X-ray.

Do you have any suggestions as to what might be causing this pain?

Thanks for taking the time to answer - I really appreciate it.
It's not uncommon for a tooth that has been hit to eventually start to die. An abscess doesn't always show up on an xray right away. It sound to me like you are going to need a root canal. It can take up to 72 hours for the antibiotic to really take effect. Although your nerve is not completly dead yet, it sounds like it's well on it's way. With your symptoms as they are, and the trauma that the tooth took, I don't think the tooth will calm down for good. The antibiotics will make it feel better but after some time the pain will come back again, but next time it will be worse than this time. I have seen too many people not do anything after taking the antibiotics because the tooth stopped hurting. Trust me, it's only a temporary fix. It may feel better for a week or a month or two. Is it a front tooth? If it is, has the tooth started to get darker than your other teeth?
Thanks for your response.

Yes it is a front tooth, it's a top incisor. I had it knocked a few months ago whilst playing sport. It hurt at the time and I thought it was just bruising. It seemed to calm down a bit and then Wham!!! The pain and sensitivity just went completely crazy and I thought I was dying. haha.

I haven't noticed the tooth start to turn darker than the others, although I'm guessing it probably should do if the tooth is dying. It's a bit weird because all the symptoms I'm experiencing seem to be typical of a dying tooth (and I'm convinced that this is the case), yet the dentist's evidence is suggesting otherwise (ie. the tooth is responding to the cold test, there is nothing abnormal on the X-ray etc).

Is this a common scenario to occur? Or should the evidence be more clear cut than this?

It is probably worth noting that I had absolutely no pain in the tooth prior to it being knocked.

Again, thanks for your time, I appreciate it.
You are in the first stages of a dying nerve, but eventually it will die completely, and then it won't respond to the cold test. When the xray looks normal, you have to go by the person's symptoms. In your case, your symptoms point directly to root canal. Don't put it off, and if your dentist is not convinced it needs one, then you might want to consider a second opinion. The longer it goes untreated, it can cause damage to the bone at the tip of the root. The infection will make a hole in the bone in that area. And the tooth will eventually turn dark after the nerve dies off completely. I work in a dentist office, and if this were my tooth I would have the root canal done as soon as the antibiotic calms the tooth down. It's hard to get a tooth numb when it is hurting, the anesthetic is not as effective.
Thanks again for the quick response.

I completely agree with you and the information you gave me has been extremely helpful.

I remember I was assaulted some time ago and one of my teeth abscessed a few months later due to the trauma. To be honest, this pain feels exactly the same as that did. At the time the abscessed tooth didn't seemed to go darker and I didn't notice any swelling as such around the tooth but infection was obvious on the X-ray so it was easy to fix.

Obviously this time it hasn't been quite as clear cut, which is making it a bit more frustrating. I actually wish that something obvious was showing up then I could get things fixed in the next few days.

So is it quite normal for an irritated nerve to give this kind of severe pain? And if a nerve is irritated or dying, is it also infected? I'm just wondering why the antibiotics seem to help?

I just want to make as much sense of the situation as I can so then I know exactly what I want to do. Certainly speaking with you this evening has made a lot of sense. You've been really helpful thank you.

I think in the future I might just have to wrap myself in cotton wool and get myself a solid steel gumshield. haha.
I just had a root canal on a tooth that was causing me quite a bit of pain. There was no evidence of infection on the x-ray. The dentist thought that it was that tooth because of the pain that I was having and because there was a filling in the tooth that was very close to the root. He said that constant pain like I had indicated a root problem, whereas a cavity would just be sensitivity (or something like that). He did a test with tapping on the teeth, which caused pain in the affected tooth and the ones behind it. Then he did the cold test. He said that if it was a root problem then the pain from the cold would be worse and last a lot longer. In the normal teeth it went away very quickly, but in that tooth it lingered. The tooth wasn't discolored, either.
[QUOTE=kehorner]I just had a root canal on a tooth that was causing me quite a bit of pain. There was no evidence of infection on the x-ray. The dentist thought that it was that tooth because of the pain that I was having and because there was a filling in the tooth that was very close to the root. He said that constant pain like I had indicated a root problem, whereas a cavity would just be sensitivity (or something like that). He did a test with tapping on the teeth, which caused pain in the affected tooth and the ones behind it. Then he did the cold test. He said that if it was a root problem then the pain from the cold would be worse and last a lot longer. In the normal teeth it went away very quickly, but in that tooth it lingered. The tooth wasn't discolored, either.[/QUOTE]

Ah! That's interesting because the weather seems to be turning very cold here and it is giving this tooth a painful lingering ache. I wonder if that's an indicator of pulp damage.

How has the tooth been since the root canal?
The pain instantly went away after the root canal. I had a slight ache the day or two afterward, but it was nowhere near as bad as the pain beforehand, and now I am pain free.
[QUOTE=kehorner]The pain instantly went away after the root canal. I had a slight ache the day or two afterward, but it was nowhere near as bad as the pain beforehand, and now I am pain free.[/QUOTE]

Nice one! That is good news! I hope to be pain free too very soon.

Were you also given antibiotics? And if so, did they make any difference to the pain?

Thank you so much for responding.
I didn't get any antibiotics. The dentist said that normally he would have prescribed antibiotics for a few days before going in to do the root canal because the infection is acidic and the novocaine is basic and it makes it hard to numb the tooth when there is an infection. But I was in a lot of pain and I was going out of town for four days during which I was to be in a leadership position, and there just wasn't going to be any way that I would make it through those four days in that much pain. So he went ahead and used tons of novocaine and did the first part of the root canal that day (just drilled straight down and cleaned out the root). I went back a week later and he finished the root canal (cleaned out the root cavity again and then got the tooth ready for the crown).
Hi
I have a question for you and I hope you can help me. Last august 2003, my lower right tooth #27 started to bother me. It hurt a little to bite down and tingled a bit, actually it was constant. One dentist said it was a tooth #30 that I had just gotten root canal on, I went to the dentist that did the root canal and he did xrays and all and said it was not the root canaled tooth. He adjusted my bite and I was fine for about 10 months, then it started up again, I went to my new dentist several times and he did not know what was wrong. And redid the rooth canal on tooth #30 and killed the nerve in tooth #31 causing me another root canal. Dentist said he was positive tooth #30 was causing all the problems. Tooth #27 still is bothering me. It's the canine tooth on my right side and now the canine on the left side hurts too. If I tap it, they hurt. I feel the sensation 24-7. The root canal specialist did not see anything and did a lot of tests to see what was wrong and found nothing. But obviously something is wrong or why would it bother me.
Do you have any idea what this is and how I should treat it?
I am hoping to get root canals on them because they bother me so much.
Any advice would be appreciated.
Thanks
Kristin
It definitely could be the root. The problem with x-rays is that infection and decay don't show up until over 30% of the tooth density is destroyed. My dentist didn't see anything on the x-rays, but went based on the symptoms (sensitivity to cold and tapping). It sounds like you need to find a dentist that listens to your symptoms and will try to figure out what the problem is, rather than jumping to conclusions. My first dentist just assumed that my pain was being caused by the cavity in the next tooth over. He cancelled my appointment for the filling, however, and the second dentist said that even though there was a cavity in that tooth, it wasn't anywhere near close enough to the root to be causing the pain I was having, so based on that and the symptoms he decided that it was the other tooth even though there was no root problem visible on x-ray.
[QUOTE=kehorner]It definitely could be the root. The problem with x-rays is that infection and decay don't show up until over 30% of the tooth density is destroyed. My dentist didn't see anything on the x-rays, but went based on the symptoms (sensitivity to cold and tapping). It sounds like you need to find a dentist that listens to your symptoms and will try to figure out what the problem is, rather than jumping to conclusions. My first dentist just assumed that my pain was being caused by the cavity in the next tooth over. He cancelled my appointment for the filling, however, and the second dentist said that even though there was a cavity in that tooth, it wasn't anywhere near close enough to the root to be causing the pain I was having, so based on that and the symptoms he decided that it was the other tooth even though there was no root problem visible on x-ray.[/QUOTE]

I think I need to see your dentist. They sound like they would certainly be prepared to the fix the problem rather than "Let's wait and see....". I have to go back to see my dentist next Wednesday about this irritated tooth. Unfortunatley I still have the pain all the time and it's getting to the point now where I'm really getting fed up with it. I hope they managed to fix the thing soon. I just hate having to rely on other people to fix my problems, I feel like people aren't listening to my properly.
Hi
The root canal specialist was pretty dumbfounded as to what the problem could be. He checked for cracks, decay, sensitivity to hot and cold, and xrays as well and found nothing. He actually spent time into looking at what it could be. He said I might be grinding my teeth in my sleep which I know I do not because I rarely get into a deep sleep.
I am wondering if it is the root. Because its a constant tingling pain sensation I have been feeling, and I feel it every day. It hurts a bit to tap on it and bite on it.
My other dentist maxed out my insurance claiming my pain was coming from my back molars(it was not) so I basically screwed till February 1st. I am trying to get some of the insurance back because I was misdiagnosed and my dentist charges $1200 for molar root canals, verses a regualr one $800.
Its my canine teeth that are bothering me, the one on the lower right and the one on the left. No other teeth are bothering me so I do not know what is up.
Does this sound like this is the root, and if so do I need a root canal for them?
If anyone has any advice, that would be great!
Kristin
Kristin, you can be clenching or grinding your teeth day or night and not be aware of it. Before you jump into doing another root canal, I have another suggestion. Rule out the grinding issue. Go to Walmart and buy an athletic mouth guard ("youth" size is usually better, because they're not as bulky), follow the instructions to mould it to your teeth. Wear this at night,when you go to bed, for a week or so and see if things improve. Also try taking an anti-inflamatory, such as Advil or Motrin, if your are able to take it without any problem. Even generic ibuprofen(same thing). Can you take Advil? If things get better by doing this, you might want to check into getting one of these from your dentist, they are called "nightguards".
Hi!
Actually I have tried Tylenol, Motrin, Vicadin and nothing helps for the pain. I think that the nerves are slowing dying and that is what is the problem. If I tap the tooth it hurts and it hurts even when I do not even touch it. I know some stuff is not visable on xrays and I would rather pay for the root canal and be out of pain then go on another year feeling like this. The specailist I saw said it might be a grinding thing and he would hate to say it was and have me find out its not. And be out of more money.
I can try the mouth guard thing. If that does not work would you think it was a dying nerve issue?

Thanks!
Kristin





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