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Periodontics/Pain in right front teeth and side of nose


Dear Dr. Scharf,
I saw the note from John regarding periodontal pain.  I have been having pain in upper right front teeth and at the side of the right nostril(when touched)for several months.  Eating is painful. I feel the pain nearly all the time.  It had receded somewhat, but then got worse after a dental cleaning.  My dentist ran films twice and said there is no swelling, abscess, or dark area.  My endodontist took pictures and said everything looked fine.  
I have started brushing very gently with a soft brush using sensodyne type toothpaste. I read about periodontal ligament pain in John's letter, and am wondering if this is what I have.  What can I do to stop these symptoms? Is it a nerve or the ligament? Is it tension or stress related?

Thank you,

Hi Elizabeth:

Unfortunately I cannot diagnose your problem from  your symptoms.  Pain like you describe can be from a number of things including non dental problems such as sinus disease and neuralgia.  In my experience endontists are experts at determining the cause of the type of pain you are having. You may want to try another endodontist or a periodonitist to help with a diagnosis. If that turns up nothing then a visit to an MD and a neurologist may be in order.  Unfortunately sometimes  these diagnoses can only be made by eliminating the possibilities one at a time.  I know that can be very frustrating.

Good luck
Dr. Scharf  


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David Scharf


I am a board Certified periodontist which means that I am an expert in treating gum disease (periodontal disease) and placing dental implants. I can answer questions related to treating gum disease, bleeding gums, maintaining healthy gums, and structural issues with the gums such as recession, to gummy a smile, crown lengthening etc. I am also certified in Laser Periodontal therapy which allows me to treat gum disease with a laser rather than a scalpel. I can address those questions as well.


I have been practicing periodontics and placing dental implants since 1990. I have treated thousands of patients for both gum disease and dental implants. I currently an a Clinical Assistant Professor in the Department of Periodontics and Implant Dentistry at the nations largest dental school.

Journal of the American Dental Association, Journal of Periodontology, International Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxilofacial Implants

BA/DMD Boston University Cum Laud. Certificate of Advanced Graduate Study in Periodontics fro New York University. Board Certification in Periodontics 1995

Awards and Honors
e was elected to Omicron Kappa Upsilon (the "Phi Beta Kappa" for dentists), and received the Boston University award for Excellence in Periodontology, the Boston University Predoctoral Prosthetic Award for Excellence in Prosthetics, and the Academy of General Dentistry Outstanding Senior Student Award, the Boston University Operative Dentistry Special Achievement Award, and the Quintessence Publishing Company Outstanding Senior Award for Excellence in Clinical Practice. Following dental school, Dr. Scharf completed a year long General Practice Residency at The Long Island College Hospital in Brooklyn, New York. As a resident at this top New York program, he gained extensive clinical experience in such fields as prothodontics, periodontics, endodontics, orthodontics, oral surgery, management of the medically compromised patient, and general dentistry. This experience was completed by clinical rotations in the departments of general medicine, anesthesia, and emergency medicine.

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