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Dentistry/Bridge problems

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Question
Jonathan
Here is my story:
Last summer I had a bridge placed in the left side lower jaw, one space from the back. The space had never given me any trouble, so a bridge was not really necessary, but I have a very good dental plan, and I thought I should use up my credits for the year. My dentist said the work might be a bit difficult, but he saw no reason not to put a bridge there, so he did.
Immediately after, it started giving me pain, which radiated into the upper jaw. I went back and he said it looked fine, but put me on antibiotics, which did the trick for a while. A month later the pain came back and again I went on the antibiotics. Since then, I have had periods of a few days with no pain, then some pain, which a couple of motrins quickly resolves. Since the new year, however, the pain has been daily. It seems to have gotten more sensitive to hot and cold foods, which triggers the pain, but the strangest thing of all is that every night around 10:30, like clockwork, the pain comes. Not intense, enough for one motrin to resolve. I brush daily and floss several times a week. Do you have any idea what could be happening? Could it be taking this long for my jaw to get used to the bridge or something?
I will be seeing my dentist in a couple weeks for hygeine and a checkup. I am so frustrated I almost feel like asking him to take it out. I feel its partially my fault as I didnt really need it anyway!
Another strange thing is that I had another bridge replaced on the other side just recently. The hygenist discovered the tooth was decaying, and I was told this was a necessity. This newer bridge is just fine!
Your thoughts would be greatly appreciated!

Answer
Hi Bud,

That does seem like a very frustrating story.

Your dentist did the obvious common sense thing.  He see's a space on your left lower jaw and says you need a tooth there.  It's just not normal to have a space or hole where a tooth should be.  Random things could happen without a tooth there.  Your teeth could shift or you could get food stuck in that spot, etc.

While it is common sense to put a bridge on your lower left.....it is not common sense to live a life with constant jaw pain.  Since you say that the pain was "immediate" after the bridge was placed there, it is pretty obvious that we know the culprit.

Then shortly thereafter when you started taking antibiotics and Motrin, it probably masked or mitigated the pain for a while until the situation got worse.  You say that every night, the pain comes around 10:30pm like clockwork.  Let me ask you a question....what time do you go to sleep?  Is that pain beginning after you are sleeping or still awake?  Because if you are sleeping, you are probably grinding your teeth which is further aggravating that bridge in your mouth.

Whenever people tell me that some work was done in their mouth, and after a reasonable amount of time there is still pain and discomfort, I suggest retracing the steps back to when they were last comfortable.  Now in your case that would mean removing your bridge and seeing if you notice any pain relief without the bridge there.  Just remove the bridge.  See what happens.  The other thing is you don't want the pain to interfere with the normal use and motion of your jaw.  Everything you do.....eating, talking, sleeping.....all of these activities should be relatively pain free.  I also would not want this to create new issues.   As for your newer bridge on your right side, I would just leave it alone.  You seem happy with it.

Dentists usually have their allotment of cranky patients.  So between cavities, abscessed teeth and a host of other misfortunes, dentists usually take a wait and see conservative approach before reversing any work they have done.  But in your case it seems like you have given this bridge a chance for some time.  You mention that you are going back to see your dentist in a couple of weeks.  You need to speak up and be very clear that this really hurts, and ask your dentist for suggestions beyond just the pain medication.  Again.....if it were me.....I would ask him to remove the bridge, and then see if that helps relieve your discomfort.  Give yourself some time to get used to not having a bridge there.  Then at a later time, you could try the bridge again if you choose to.  Believe it or not, sometimes redoing the same work again is all it takes to be successful on a second try.  Usually there is no rhyme or reason for success on the next go-around.  Maybe the lab did a better job in making the bridge or tried a different material.

Let me know how things turn out!

Best Regards,
Jonathan
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Jonathan at PatientBabble

Expertise

My area of expertise from the patients point of view would be Dentistry/TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my TMJ/bite problem. I AM NOT A DOCTOR...but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their TMJ/bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. I will try and recall information or experiences that may be helpful to you.

Experience

About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. The majority of dentists believe they can treat TMJ, but only those whose primary focus is TMJ treatment, are really any good at it. Any dentist, can take an impression of your teeth, send that impression off to the lab and have them make a night guard. That is the easy part. The tricky part is what the dentist does with the night guard, once receiving it from the lab. The dentist has to do a "fitting" where they tailor the night guard to be evenly balanced and comfortable in your mouth. Sometimes it can take a few visits, because further adjustments need to be made to the night guard appliance, to get it just right. I have found that dentists, who have had the most practice, do a better job at fitting your appliance. It's almost like an art form.

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Jonathan's Blog is: https://patientbabble.squarespace.com/jonathans-blog

Education/Credentials
College Graduate with Bachelor of Arts Degree

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