Identifying the true cause of the pain in my teeth (longish)

I'm 54. I don't smoke, never have. Three days ago, I started getting some, not very distressful, but annoying pain, it seemed in the 2nd and 1st molar on the bottom left (my left). There is no 3rd molar. Yesterday and today I seemed to be getting quite severe pain from either the 2nd and 1st premolar. Pain at times gave me a peicing (but not constant) ear ache and a headache.

On the 2nd and 1st molar and on the 2nd premolar, but not 1st premolar, there is some wear near the base of the teeth, probably due to over zealous brushing. So, of course, before the greater pain of yesterday and today, it looked like maybe the cause of the intitial pain was something to do with the wear, near the base of the teeth. Although the intial pain did not seem associated with any stimulous, such as brushing, hot, cold, sweet, sour. It just seemed to be there, on and off. There is a bit of receeding gum next to the 2nd molar and the odd dark spot (tartar?)

2nd molar is worn at top of tooth, enamel completly worn away, but otherwise seems healthy.  Dentist has not capped it, does not seem worried about it. 6 months ago, 1st molar had a deep cavity drilled and filled with amalgum, rebuilt one side of tooth in that operation.  2nd molar cavity filled with the white stuff, decay was on one side.  In both cases drills went near the nerve. That is why, when subject to cold and hot, I get some sharp pain in the 1st molar and 2nd premolar. But, I've been living with that for 6 months and is livable with.

I slept okay overnight, then today the pain came again seemingly, from what I could tell, from the 2nd and 1st premolars. I discovered that if I "applied" cool water to the bottom left, that takes the pain away for some minutes, then it bulids, so I need to sip some cool water again. I was doing this all day, then decided to go to the dentist.

..........

[Jerome Tsang, DDS]

Yes, your dentist is correct that it could potentially be referred pain.  The fact that cold helps to relieve the pain indicates its an irreversible pulpitis and will need a root canal.  I would recommend a cold test to find the source of pain rather than a novocaine method though.  

[richard5298]

(Continued)

The task was to psyche out which tooth is causing the pain. Dentist injects cocain between 2nd and 1st premolar. Pain, that seemingly is coming from one of these premolars, does not go away. Cocain injected near 1st premolar, pain goes away. Dentist thinks source of trouble is now located (1st premolar) he thinks it's infected, and wants to do root canal or remove tooth. I decline. Because even though he talks about transferred pain, and highlights the results of thge cocain experiment, I'm not won over completely about what is causing the pain.

Okay, here I am now, I'm still sipping cool water when pain builds. Cool water is simply removing the pain.

I've been moving my jaw around and wonder if now  there might be some kind of additional TMJ problem that I've brought on in the last 3 days moving my jaw around. Some pain does now seem to be coming from the joint, the side of the face. That represents a kind of added complication. But, the cool water near the teeth does remove pain I am getting.

I feel baffled myself about what to think about the true sourse of pain I am currently experiencing.  Can anyone please estimate, from experience, what might be happenning? Is my dentist spot-on, or is there scope for a misdiagnosis here? Thanks.

[richard5298]

Cold water - relieves pain. Pupitis?  Also I read:"Pulpitis can often create so much pressure on the tooth nerve that the individual will have trouble locating the source of the pain, confusing it with neighboring teeth, called referred pain."  So, could be classic case of pulpatis, and that my dentist was correct. :c)

[zerorayne]

if you can find where the pain is coming from put some temparin max repair its like a puddy i have used it when my pain was bad and some pain meds seems to work .. rinsing your mouth out with mouth wash (thats only very temp)

[richard5298]

My dentist did not proscribe Amoxcillin 250mg, but I prescibed myself a course that I had in my medical box hanging around. I know, antibiotics are not normaly proscribed for irrversible pulpitis. But, anyway, I don't have any pain now. I do not know if that signifies anything. But, I guess, if I have irreversible pulpitis, I will still have it. I am scheduled to halve a talk with my dentist later and we will get to the bottom of this.

[Jerome Tsang, DDS]

Irreversible pulpitis can lead to necrotic pulp or necrosis which the nerve dies and there's no more pain.  A root canal would be indicated at that point too.