Expert: Frederick R. Liewehr DDS, MS, FICD - 1/12/2006

Question
Hi Doctor Liewehr,
I have developed some tooth pain in the last few days that can be very painful at times.  About 3 days ago I woke up with fluid build-up in my eyes which subsided during the day.  However the next day I had some terrific headaches that radiated to my jaw and all teeth.  Over the counter pain relievers did not work.  The next day, this pain now was centralized in my upper and lower rear molar areas.  Was able to see my dentist today with no indications of any tooth problems.  I can eat cool food and drink which seem to help, but hot food kills me.  Cold water relieves pain just momentarily. Some nose drainage but no toothache relief.  Dentist prescribed some Lorcet 650 for pain, but it is not kicking in yet...2 hours.  I'm worried about these symptoms, can you help me   Thanks  Tim

Answer
There are two possibilities here, Tim. One is nonodontic pain, meaning it does not come from a tooth. The eye watering and headaches sound like something other than a dental cause. You will need an astute diagnostitian to determine what your problem is.

On the other hand, you could have what we call an irreversible pulpitis in a tooth. The easiest way to find which tooth is the offending one is for your dentist to wait until you have tooth pain, then put some freeze spray or ice on several teeth until he finds the one that the cold relieves the pain. Then, root canal therapy can be initiated.

Of course, you could have a combination of things; a tooth problem plus something else. The easiest is to find the tooth, initiate treatment, and see if that fixes everything. If an offending tooth cannot be located, don't start doing root canals everywhere, find someone who can give you a good diagnosis instead.

As for pain killers, if you have an irreversible pulpitis or nonodontic pain, they will not be of much help other than perhaps taking the edge off a bit. You need to get someone to get to the bottom of the cause. I hope you will get some relief soon.

Dr. Liewehr