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Mysterious top molar pain
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Mysterious top molar pain

I have mysterious pain in a back top molar that no one can figure out.  The pain began about a month after having the opposing (shattered and infected) molar extracted.  It has pulp tested normally, is normal on x-ray, and shows no signs of decay or cracks (according to two dentists and two endodontists).  The extracted molar has now been replaced with an implant and this top tooth now hurts to chew on.  It doesn't hurt to eat mildly crunchy things, but it does hurt to eat something thick and chewy like Italian bread.  It used to hurt to push on it with a finger, but it doesn't hurt to do that anymore.  It sometimes hurts to push it from the side.  It mostly just feels sore--not really a sharp pain like when my bottom tooth was cracked.  Do you have any ideas for what this could be and what type of dentist I should visit?  I can't afford to keep having endodontists tell me there's nothing wrong.  Is it possibly referred TMJ pain?

Thank you for your time.
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Avatar_dr_m_tn
It doesn't sound like TMJ referred pain but I do not have any great insight in what it could be.If you were my patient I would probably tell you to either wait until the discomfort became more severe or if it is very uncomfortable then you must consider doing the root canal therapy.
7 Comments
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Avatar_n_tn
im confused if you are saying the "implanted tooth" hurts or the molar next to it. if it is the implant sorry i dont know that much about implants. if it is your natural tooth the pushing from the side  pain suggests a problem. sometimes with cracks (if that were the problem) you cant always figure it out easily. there are tests however the dds can do to try to figure it out. sorry i dont have an answer, nobody can do that on here good luck
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Avatar_n_tn
Sorry for the confusion--it's the tooth above the implanted one.  So it's a natural tooth.  The implant is fine, at least so far!  :)

It's been like this for over 6 months, off and on, with no real worsening or anything like that.  I think there's been a slight improvement in that it no longer hurts when I push on it, but it does still hurt to chew on.  I don't know what to do considering that the dentist and endodontists don't think I need a crown or root canal.  I'm tempted just to pull it to relieve the emotional stress.
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Avatar_n_tn
Oh, and it doesn't always hurt to push from the side.  Right now it feels fine.  However, say I had some of that thick Italian bread for lunch and my tooth started to feel sore to chew on.  Once it's already sore, it sometimes hurts to push it from the side.
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Avatar_n_tn
is there a periodontal problem? meaning are there pockets around this tooth? mobility? does it hurt to bite or when you release your bite?
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Avatar_n_tn
The dentists all checked for pocketing and found nothing.  I can't really tell whether it hurts on the release of biting (I know it hurts to bite down) but I can definitely say it doesn't feel like my cracked tooth did.  I'm not going to pretend like it's not possible, but it definitely feels different, and I'm not sure how I could have cracked a tooth that didn't even have a tooth underneath it to crack on!  :)
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Avatar_n_tn
I had similar pain - it ended up being hairline fractures in the tooth below gumline and not visible on any x-rays or by eye. I also had the feeling of looseness and intermitent pain for nearly 1.5 years until it really got bad in about 2 days time and then had to have it taken out at 6:30PM on a Saturday night! My (NEW) dentist says this is common and we ALL know that many things do not show on x-rays MRIS etc.. etc.. I once had an entire rotater cuff tear missed on an MRI simply due to the view taken. Even though there was every indication that it was a rotater cuff tear an no other explanation, several doctors put me through hell for over three years by not following thier instincts. This has resulted now in permanent muscle and nerve damage and chronic pain due to constant muscle spasms and attempts at PT that did more harm even after surgery to repair tear. My tooth was the same way - no infection nothing else that it really could be and I clench teeth at night very hard. If you have pain consistent with a cracked tooth then absent anything else, it probably is a cracked tooth. Looks like a duck, quacks like a duck, what might it be!??? ON my shoulder as well as my tooth I finally found common sense in two doctors who implemented the duck theory immediately. Also never forget it is your choice to just have it yanked out - it hurts - get rid of it. If it turns out not to be the tooth then you have eliminated one more thing - bbut I betcha it a cracked tooth. Good luck!
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Jerome Tsang, DDSBlank
Irvine Modern Dentistry
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