Toothache or sinus infection or ?

[jk636]

I am a 64 year old healthly male. I went to the dentist with a toothache. After x- rays, probing, and visual inspection, the dentist made an occusal adjustment to a tooth (second from rear, bottom right side). One day later, the pain still persists. Also have sensitive scalp on right side and intermittent earache. What could be  causing this?

[lis510]

I having pain near and surrounding extentended to all elft side , but dr. says due to infection on the 2nd last wisdom tooth ( last one already removed )
since 3 weeks. I took X-ray, medication of Flaggin, Augmention,I-brufin etc for the last 3 weeks. Pain doesn't go , when it subsided last 2 days back, dentist extracted it.
Pain still there
Kindly advise
Lisy

[jk636]

Just wanted to share latest chapter of my treatment. Went back to my dentist Monday morning. I pinpointed pain to #32 which was a wisdom tooth I didn't have extracted as a kid.(Goonos, you may be interested in this) It had been capped many years ago and didn't show a crack or other problem. More x-rays (thanks to the inventors of digital x-ray technology} showed what appeared to be infection under tooth. My dentist gave me a choice of extraction or root canal/draining of infection with the risk of the latter choice maybe not fixing the problem long term. Since the bite on this tooth from the one above was only partial, I opted for the extraction. My dentist referred me to an oral surgeon I got to see immediately. The surgeon asked if I wanted IV sedation or a local anesthetic. Since I already had food in my stomach, I didn't want to wait 6 or more hrs for the IV method and choose the old fashioned route instead. (The prospect of getting rid of pain now or hours later can greatly influence a decision). It took six needles full of lidicane to numb the area sufficiently. Then came the "cow horn" forceps (Texas slang for cowper). This procedure essentially ended one of the worst 8 days of pain I have experienced in my 64 yrs on this planet. The hole in my jaw is big enough for a yard of gravel-- but fair tradeoff for no pain. The socket apprears to be healing with the associated normal discomfort. I'm following post op recommendations--salt water rinse, soft foods, etc. I was pleasantly surprised last evening when both of my Dr's called to check on how I was doing. I told them I felt GREAT-- which I did. (For any dentist reading this, it was very reassuring to receive a call from the dentist themselves-- not a staff person--following the procedure. Anyone living in the the San Antonio area who would like to know who these fine dentists are, please post a note to me and how I can reach you. I will gladly give you their name & number.

[scottma]

If there is no decay or crack identified on the offending tooth, further investigation of the source of pain is warrented. Please keep in mind that not all tooth ache is dental origin.In brief, there are muscular toothache, sinus toothace, neurovascular tooth ache, cardiac tooth ache,etc. If dental pulp is healthy, root canal is contraindicated.
    Assuming sentitive scalp refers to tingling, burning sensation , which is commonly associated with nerve entrapment. If it's caused by nerve entrapment, cold tend to relieve the discomfort. If sensitive scalp refers to tenderness, which is commonly associated with myofascial trigger pont referred pain, which is commonly relieved by moist heat.
    Tmj symptoms are not limited to tmj pain and restriction of joint movement. Many head, neck, and upper shoulder pains are associated with tmj dysfunction.
    If there is no organic cause of ear symprom identified by ENT, a knowledgeable ENt tends to refer the patient to tmj specialist for evaluation and treatment.

[jk636]

Thanks again. Sorry, must have misled you on when symptoms started. Scalp soreness and intermitent earache started before occlusal adjustment. Scalp is still sensitive on rt side but not as bad as it was yesterday. Also, earache hasn't returned. (Hopefully the azithromicin is helping). Bottom rt rear molar has gotten super-sensitive; have been taking vicodin to relieve pain. Suspect this molar is reason for the big pain. I plan to see dentist asap to fix (have to wait until Monday as he is closed Friday) Possible root canal?? Could sensitive scalp be related to separate problem? (My suspicion). My jaw hinge area doesn't hurt; should it if tmj? (I will try to research tmj to better understand the situation).

[scottma]

Your previous description, sensitive scalp, is more related to myofascial trigger point of certain muscles, I do'nt remember which specific muscle, I need some time to find out from textbook. However, myofascial trigger point of head and neck musculatures are strongly associated with tmd. In addition,your description revealed that symptoms started after occlusal adjustment of lower right first molar. which is also related to tmd. If intermittent earache is associated with jaw functioning, such as chewing, and there is no ear pathology identified by ent, ear symptom is probably caused by tmd.

[jk636]

P.S. I forgot to tell you I suggested a possible tmj problem to my Dr. He checked my jaw movement and ruled it out. My pain center is still around bottom rt back molar with sensitivity from top of my head (scalp) down to neck area on rt side only.
Haven't had pain like this since I was a kid - broken leg.

[jk636]

Thanks for your response. I went back to my dentist this a.m. He did an x-ray of all my teeth which showed some inflamation in vacinity of last molar, bottom rt. Poked, probed etc. Seemed to think problem was other than tooth-- possible ear infection or sinus infection. He gave me two perscriptions. I then went to see my primary care Dr. who examined upper respiratory system. He seems to think I have a sinus infection but said it could also be start of shingles. He converted my dentist's perscriptions to vicodin, azithromycin, & MucinexD. Still much pain 12 hrs. later. Hope this stuff works. Your comments? jk636

[scottma]

If there is no structural pathology identified, it could be associated with tmd. Seeing a tmj specialist is advised.