Expert: Debbie - 3/24/2005

Question
Pain in Back Teeth, Left side, Upper and Lower For the past two and a half years I have been suffering from the recurring toothache and sore gums. The pain starts in either my upper left or lower left back teeth and is triggered by pressure caused by chewing. The pain flips between my upper and lower teeth. It is a numbing-aching sensation that can last up to two weeks. My gums redden but I can bite on my teeth without further discomfort. Neither are my teeth sensitive to hot or cold drinks. My dentist referred me to an endontic specialist who carried out a deep root filling on one of my upper back teeth in late 2003/early 2004. This treatment seemed to reduce the intensity of the pain and after a period of relative calm, the symptoms returned in June 2004. In September 2004 the specialist operated on the root of one of my upper back teeth, accessing it via the gum. He made it clear that if this did not work he felt that the problem was not within his field of speciality. By the end of 2004 it was apparent that my condition, which began around October 2002, had gradually improved in that the pain/discomfort level was less intense and the cycle of occurrence less frequent. Nevertheless, every time the condition re-occurred my gums ached and reddened and I had a battery acid type taste in the left side of my mouth. In January 2005, my dentist replaced my three left, back, gold, teeth and amalgam fillings with non-metal alternatives (one lower left, two upper left – I now have just one gold tooth on the right side). Since then the battery-acid taste has completely gone. My position presently is that every 4/5 weeks the symptoms return. They seem to follow an episode of me chewing on my left side although I try to avoid this. (I know I occasionally grind my teeth in my sleep but I do not believe this to be the cause). Paracetamol relieves the pain but I am loathed to keep taking drugs. Since October 2002 I have my dentist on countless occasions, the endontic specialist and a hygienist. Although my condition has improved it is still a major problem for me. My dentist does know what to do next. My question is from whom should I seek help next? I'd be grateful if you could advise.

Regards,

Steven Smith
Stevensmith@bacupshoe.co.uk

Answer
My first impression was that you may be grinding your teeth - even before I read that you sometimes do this.  I might try an occlusal guard to wear while you sleeep and see if this helps.  If not - this may be a medical problem with the facial nerves - and you may need to see an Ear/Nose/Throat doctor.