Expert: Gary Backlund, DMD, MSD - 11/21/2006

Question
Gary -
Thank you for your opinion.  The dentist did do an xray and a few tests with the pulp meter thing.  It always makes me nervous with dentists.  I've just never had one that I have trusted I guess.  This morning my jaw was so stiff.  I do find myself grinding my teeth at night...but have never had any pain like this before.  My ear actually hurts this morning - like a little bit of an earache.  If I make an exaggerated smile - it's almost like something is "pulling" at the bottom of my jaw in front of my back teeth.  And, of course it hurts when I clinch my teeth together or bite down.  I have had toothaches before.  This is just so new - and I guess I have concern that root canals and crowns are often diagnosed too soon by regular dentists because they are a lot of money.  I think I need to take your advise and see an endodontist.  I would probably feel better knowing the results from somebody who specializes in this kind of thing.  I guess the other reason I am hesistant is with having no family dentist in the area already established.  I was forced to pick somebody off of a list that was in my network and has never seen me before.  And it was an emergeny visit - like get me in today kind of thing.  I can't help but feeling a little like I'm an easy target.  Too bad you aren't close to Shippensburg, PA!  I have faith in you already and I haven't even met you!
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The text above is a follow-up to ...

-----Question-----
I recently went to the dentist for a pain in my lower back molar on the left side.  It hurts when I bite down and my jaw hurts to open.  It feels very stiff in the morning.  The dentist put me on antibiotic and has a root canal schedules for a week from today.  My question is more related to my jaw.  My jaw hurts up near my ear.  There is no popping - just pain.  Could it really be the tooth that needs the root canal...or could it be some other issue.  This tooth has a filling and hasn't really given me any problems until this pain just woke me up in the middle of the night.  If my jaw is bumped...it just hurts terribly.  Should I get a second opinion.  I guess I have just never had a tooth cause my jaw so much pain.  Thanks much! Also, I am so afraid the root canal will hurt!  tell me about it.
-----Answer-----
Hi Karen,

While it is very difficult for me to diagnosis via the internet, I think you have some valid basis about whether you really need a root canal of not. While abcessed teeth can refer pain to your ear, it could also be caused by you clenching or grinding your teeth. If you have any history of doing that, that should certainly be considered. You didn't mention how the dentist determined your problem was the tooth, but he/she should have taken an xray and ran some tests to determine if the tooth was alive or dead. Teeth needing root canals are often sore to bite on, but that should not cause you pain when you open. I guess I would suggest a second opinion from an endodontist unless you are convinced the tooth is dead, which it doesn't sound like you are or you wouldn't have written me!

As for the procedure, it really is no big deal, especially if an endodontist does it. Rather than me go on & on, I would refer you to the website of the American Association of Endodontists, www.aae.org, where there is a great explanation, with pictures, that should answer all your questions. If you still have some after reading there, feel free to write back!

Hope this helps. Good luck. You'll do fine.

Gary Backlund DMD, MSD

Answer
Thank you, Karen. I think you are on the right track. A good way to find a good endodontist is to call around to some of the other specialty practices in your area...periodontist, oral surgeons, etc and ask who THEY refer to. If the same name comes up a few times, you probably have a good endodontist.

Not having an established local dentist can make you an easy target, especially when you are just picking a name off a list. When you see the endodontist, take your list of names with you. If you like the way your handled in the endodontist's office, ask him/her who off that list he/she would send their mother to...another good way to find a good dentist. Then follow up with a new patient appointment and exam, so you can check out the office without being an emergency.

Good luck!

Gary Backlund DMD, MSD