Expert: Susan Tannenbam - 11/28/2007

Question
I have had TMJ for 7+ years and was treated successfully in my home state.  Six years ago moved to another state, and recently went to the dentist.  She recommended an endodontist for a root canal on #12.  The first time I went to him he said it did not need a root canal, just had decay behind an old filling.  He cleaned that out and told me to see how I do.  My tooth began hurting alot more, so he said I needed the root canal after all.  I went to him the 2nd time and only did the first part of the root canal because time was an issure, for him not me. It has been 2 full weeks now, and I have been miserable.  I had severe facial swelling after leaving his office, and TMJ seemed to have flared up really bad.  Difficult to eat, talk, sleep, could not wear my night gaurd, and cramping of my face muscles when I eat.  I am doing somewhat better now, but not back to where I was before I saw him.  I am due to see him in about 5 days to complete the root canal, which will make it 3 weeks since the last visit.  I wonder if the Septracaine he used played a part in any of this.  I didn't know he was using that, I would have told him to use Novacaine.  Also why does my tooth hurt now, after the root canal, but not before.  He said it should not hurt, that there is somethng else going on. He checked all the other teeth and doesn't know what is hurting and why.  All I know that the past 2 weeks have been the worst of my life, with tooth and facial pain, lack of sleep, and having to walk around with a swollen cheek.  Please help

Answer
Dear Sandy,
I am not a dentist so I can't fully answer your question, but i do have TMJ so I can answer it from that perspective.
When you clench your teeth, it causes the jaw muscles to become tight.  This causes pain.  This pain, in turn, can REFER into the teeth, head, neck, back, gums.  This REFERRED pain can make it FEEL like you have the worst toothache, even though there is absolutely nothing wrong with the tooth.  Same goes for pain that is referred from the tight muscles, into the head, neck, gums, etc.  My experience has been that most dentists and endodontists are NOT AWARE OF THIS REFRRED PAIN caused by the clenching.  THerefore, some root canals are done unnecessarily, and/or extractions on teeth that have nothing wrong with them.
I am not able to say, obviously, if this is what happened to you, as I cannot, of course make a diagnoses .
It is good, as someone who has TMJ, to be aware of this situation, as many doctors and dentists that cannot figure out why a tooth hurts, do not think of this referrred pain that can occur with TMJ.
I do not know anything about Septraciane, as I am not, as I mentioned, a dentist.  
I do not know why your cheek is swollen.  As a TMJ patient, I have never had that happen.
Hope this helps.
Susan