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Constant "mystery" toothache
JohnStavrou posted:
I have had continuous dull pain in one of my lower lateral incisors for a month or so now. I can't think of anything that started it off, it was just "there" one day.

On a scale of 1 to 10, the pain factor would be a 3 or 4 at most (I've felt a 9 or so from infected wisdom teeth before!).

On the initial visit to my dentist to have it checked out, he took an x-ray and there was no sign of decay/cavity. He did a clean (there was a small amount of calculus) and told me to give it a couple weeks and come back to him if it still hurts.

... which I did last week as it was still bothering me. This time he did a "bite test" and noticed that I was biting down on that one particular tooth heavily (thinking that may be causing the pain) so he performed an occlusal adjustment on the tooth to take load off it when I bite/chew.

Unfortunately the tooth is still the same a few days later and I'm thinking the problem is not with my bite.

He did also mention initially that it may need a root canal, but wasn't too willing to go to that extent as there were none of the other "common" symptoms of that being the case (aside from the pain obviously) ... no cavity, no sign of infection, the tooth responds well to a "cold sensitivity" test, and there is no additional pain when he tapped on it with his metal dentist tool thing.

It doesn't wake me up in the middle of the night, it doesn't flare up when I'm eating and doesn't seem to increase in pain with hot/cold/sugary foods (if anything I don't notice it as much when eating). It just kind of hurts on the same level all the time although some days it's a bit more/less than others but the pain is always there (although it's slightly less when I wake up in the morning).

Any ideas what's going on here ? Appreciate any advice, thanks.
Zev Kaufman, DDS responded:
Dear JohnStavrou:

I am sorry to hear of your trouble. The best advise that I can give you is to do NOTHING unless you have a DIAGNOSIS and ETIOLOGY (cause for the pain). I have seen unnecessary treatment, including root canals and extraction, done over the years, with the original problem never being solved.

Go and get a second opinion from the expert in this area: the Endodontist. You might have a sub-clinical fracture in the tooth that is undetectable on an X-ray at this time.

Do nothing until you know what it is that causing the pain.

Another set of eyes and a brain cannot and will not hurt.

Best of luck,
Dr. Zev Kaufman

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