I had a toothache about a month ago on my lower molar and ended up needing a root canal. My tooth felt a little better after but has not completely settled down. Last weekend the pain got much worse, so much so that it scared me, and felt like it was the tooth next to the molar that was hurting. I went back to the endodontist that did the root canal, and he took x-rays of my bottom teeth on the side that was hurting. He told me that there was nothing wrong with any of my teeth on that side, and even removing all of them wouldn’t help with the pain. He suggested that I see a neurologist. What would be your advice?

Sherri from North Dakota

Sherri,

It’s hard for me to give my advice without doing an examination, but I will help any way I can.

It is not uncommon for pain to feel like it’s coming from a tooth and for there to be nothing wrong with that tooth. Here are some possibilities for pain like this:

• One of the possibilities is that it’s referred pain. For example, you can have an upper tooth infected, but it feels like it is a lower tooth that hurts. The referred pain doesn’t cross side from one side of your mouth to the other but can from upper to lower and can definitely feel like it’s the tooth next to it.
• A second possibility is some type of neuralgia, a nerve problem that feels like a toothache. It can happen and isn’t rare, so your endodontist could be right in sending you to a neurologist.
• A third possibility is some other type of pain. For example, a sinus infection can feel like a toothache. This is because the maxillary sinus is often close to the roots of upper teeth, and the infection puts pressure on those roots and, therefore, feels like a toothache. Again, it could be referred pain to the lower tooth as well. There are also other health problems that can feel like a toothache.

It is possible to determine that a tooth and its root are healthy from carefully examining the x-rays. The x-rays would show if the root canal wasn’t healing properly.

Again, it’s hard without personally doing an examination, but I would listen to your endodontist.

Another thing to keep in mind is that some dentists aren’t very sensitive to patients or good listeners. So, if you have the feeling like he doesn’t really care and is just trying to get rid of you, I would recommend getting a second opinion. It would be worth the drive if there isn’t another endodontist in your town. Also, make sure it is a blind second opinion, meaning DO NOT tell the second endodontist the whole story or the name of your original endodontist. You don’t want to say anything about the diagnosis you’ve been told other than you had a root canal a month ago, and now you have pain flaring up. If they ask you for more of the story, just be honest and say you want a blind second opinion. They don’t need anything other than the basics of the story, their eyes, their knowledge, and x-rays to come to a diagnosis. You also don’t want the complication of the endodontists knowing each other, which would color their opinion.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.