cleaning concern

i have had a regular cleaning and my teeth feel painful and sensitive to touch. i also feel my bite is off because when i bite down i am hitting teeth i never used to. i do not want to go back to the dentist,i am just asking what you feel as a dr. what could be going on here,i was feeling maybe when she polished the teeth being that she was new she used the wrong instrument,is that possible and would this cause this discomfort? if so what do you do from this point on to get better?please answer, my teeth are really bothering me and please do not tell me to visit the dentist,just looking for your professional advice!!!! thank you! it has been 6 days so far

[Jerome Tsang, DDS]

Well, its hard for me to figure out what happened.  Normally a cleaning doesn't disrupt a bite although it can result in some sensitivity if the gums were severely inflamed and the cleaning irritated the gums.  

Try some sensodyne tooth paste for the sensitivity.  Unfortunately the bite needs to be checked and adjusted possibly although I can't figure out how the bite could be off after a cleaning unless you were open for a long time and your TMJ is irritated/sore and causing your jaw to shift slightly.  If so, try to ice the TMJ area, stretch it out, softer diet and take some anti-inflammatories (that are safe for you, I don't know your medical status).

[suszy123456789]

well,i have great teeth,no medical issues,i thought if she ,on accident,buffed them down,that would cause my bite to be off because the teeth would be shorter,am i correct or not?i do not have tmj and never did! i just want to know ,if something could of happened and how do i get better? i was wondering if i have an infection but my gums look good and there is not any sign of really red areas,if thats what i look for? thank you and if something like that happened would my bite adjust on it's own?

[Jerome Tsang, DDS]

Hm.  The prophy paste that we use should not shave down your teeth in any significant way.  Actually, the major concern for me with the prophy paste is that they go too fast and it can generate heat and hurt the tooth but not polish it down.  

If she used the wrong instrument, depending on the instrument, I could see it happening but I would imagine the polishing cup and a burr used for drilling look obviously different and should not have occurred.  

If the muscles are sore or stretched out, yes, it would return on its own after some time.  You just need to rest it.

[suszy123456789]

dr. Jerome Tsang, i only have three other questions,is there any other tool that looks like a polishing cup that could of done this? if teeth were shortened,would that cause bite to be off and sensitivity,will that correct itself? and like you said if she went to fast and caused heat and hurt the teeth,will that correct itself? could that be what is going on here?

[Jerome Tsang, DDS]

Heat wouldn't cause the bite to be off I don't think.  I wouldn't expect that.

As for an instrument that looks like a polishing cup.  Its possible she may have used a polishing cup designed for removing excess white filling material which is more abrasive.  

The teeth may shift and move and correct itself eventually.  Have you brought up your concerns with your dentist at all?  It would be best to talk to the actual dentist to have them remedy your concerns.

[suszy123456789]

dr.jerome tsang,i did not tell my doctor because i have been going there for 12 years with out any issues. i like them all there and i feel my concern is pointing a finger at the new dental hygienist,i just want this to go on its own,if it heals then i don't look like a fool!!!!!! i can't blame her if i don't know for certain,so what am i to do?????? i will just give it time and hope it clears on it's own! if she did use that polishing cup,wouldn't that cut up my gums? i guess the more questions i ask are pointless,now i just have to trust that it will heal or search for a new dentist at this point, thank you for taking time out of your busy schedule!

[suszy123456789]

one more thing,if she did use the wrong polishing cup,how is your teeth corrected? will my dentist be able to tell?

[Jerome Tsang, DDS]

No, you should address your concerns with your dentist.  If they're a good dentist and I assume they are since you've been going to them for 12 years, then your relationship with them is important and whatever is happening could be fixed quite easily.  I imagine if the bite is off, they may need to adjust the other side slightly to balance the bite.

[suszy123456789]

well,i read up on tmj,i never had that before but it sounds like what i have,my left side under my ear wich is my jaw is hurting now!!!!!!! i tryed to find out what caused my bite to be off or how tmj starts and i cant find anything on the net,do you please think you can answer those questions? where did this all start,could a rough cleaning cause this?

[suszy123456789]

dr.Jerome tsang,i feel my bite is off because my teeth were shortened BY  ACCIDENT from a new hygienist,and in return now my bite has been disturbed and it is now causing tmj! i read there is not any cures, if i came to you with this scenario and you felt it was true,what would you do for me and what advice would you give? dr. i thank you and i cant go back to him feeling the way i do,if there is no cure,i just rather not go see him anymore or his staff!!!!!!!!!!!!!!

[Jerome Tsang, DDS]

Well you'll never really know what is going on without addressing the issue with your original dentist since they may have possibly cause the problem.  I understand you don't trust them because of what happened but they may know how to fix the problem as well.  If anything, they may be able to provide you a proper referral to a TMJ doctor in your area.  

[suszy123456789]

hi dr.Jerome Tsang,i went back and he was very helpful,he looked at my bite,told me they are aligned ok,nothing hitting. he also told me i have a cross bite. he suggested 2 things ,i still have a wisdom tooth that could of got a little disturbed from the cleaning and it has to come out on the left side where the pain and ear pain is, or from clenching  my teeth i injured my jaw causing tmj! i am giving it 2 more weeks to heal on its own if it doesn't i am going to get an ex-ray and take it from there. this is one of those things that just happens with no explanation! he was very nice and i am glad i went back,hope this resolves,thank you

[suszy123456789]

dr.,out of the two diagnoses,which one are you leaning towards?

[Jerome Tsang, DDS]

It could be either but keeping an eye on it and then taking action sounds like a good plan for now.

[suszy123456789]

dr., i am going in for an ex-ray on Tuesday,my question is, can a wisdom tooth that is under the gum be able to stay there ,as long as it doesn't cause any pain,without being removed for a lifetime? also,instead of pulling it out,can they just cut away the gum and allow it to come out?

[Jerome Tsang, DDS]

It could potentially stay down there forever without any problems.  Depending on the direction of the tooth, the removal of the gum may help but it could also just open up a hole for food to get stuck in which I think would be the more likely outcome.  

[suszy123456789]

my jaw and ear have gone away,but dr. i still have some sensitivity and i noticed i have some transparent areas on my teeth,could my enamel be off causing this? if so was it from the cleaning? what do i do now?i went to the dentist for the jaw and now i dont want to go for this,help

[Jerome Tsang, DDS]

Glad the jaw is getting better.  If you have some sensitivity, try some sensitivity toothpaste such as Sensodyne.  If not, you can ask for a prescription toothpaste for it.  A cleaning shouldn't remove any enamel to that effect.  If it did, the enamel was compromised to begin with.

[suszy123456789]

well,i did bleach my teeth and use all those whitening toothpastes for years! my teeth are extremely white! i only have one cavity in my whole mouth!  i used rembrandt,which worked great but it was strong!  now if the enamel is off ,how can i tell at home! if it is i will go back  to the dentist but i don't want to unless i am sure!what would be the signs other than sensitive teeth??? i don't get pain in the tooth,i just feel constantly like i was flossing to the point where i was pushing really  hard!!!!!!!!!!!!!!!!!!!!!! i feel like my gums are sore all the time,i am confused because i don't have pain in teeth just gums feel awful sore! please ,just tell me what are signs of enamel being off and if i feel that is whats going on i will talk to the dentist,i am already embarrassed over the tmj,it healed thank god!

[Jerome Tsang, DDS]

Well, it doesn't sound like your enamel is falling off.  And I'm fairly certain that if it was, the hygienist or dentist would've noticed it at your last checkup and cleaning which wasn't too long ago.  What type of floss are you using?  It sounds like the gums are traumatized from your flossing.  Try using a waxed floss if you aren't already and gently clean the area.  Plaque is soft so it doesn't take much to remove it.

[suszy123456789]

it has been 5 weeks and jaw has cleared up,i have a burny,dull,achy pain in my 3 teeth on the left side,i have an appt. to get x-rays with the dentist. i was researching and read about periodontal ligament inflammation,could that be going on? will an x-ray show that? i cant believe all this from a cleaning,i am trying to stay positive but part of me is very upset at my dentist office!!!!! just would like your advice thank you dr.Jerome Tsang,DDS

[suszy123456789]

dr. i just got back from the dentist,he told me i might have the start of an abscess,i have to wait one more week,he doesn't want to take the x-ray to soon! one cleaning then all this.... just wondering if the cleaning could of triggered this,maybe unsterile instruments,or something? just curious,i don't have a filling or any type of decay or had any trauma to the tooth!!!!!! thank you

[Jerome Tsang, DDS]

Why doesn't he want to take x-rays?  I find it odd he wants to wait another week?  Perhaps to see if it resolves itself?

Is this left side the same side with the wisdom tooth that was potentially causing problems?

[suszy123456789]

he said the abscess might be in the beginning stage and wants to wait to insure it shows up! no,the wisdom is on the left and the three front teeth that ache are on the right! the only thing that makes me feel that it cant be an abscess is because there isn't any cavities in the tooth or fillings,in all of them. there is minimal swelling if any and when he tapped i didn't feel allot of pain,i felt a little.perhaps he is waiting to let it get worse to insure we catch it. that wisdom cleared up along with the jaw,my only other guess from educating myself would be,my bite got knocked off during the cleaning,then i was clenching at night and from pressure and trying to locate the correct bite caused them to get hurt,or inflamed. i just can't understand why it isn't going away, if that is the case. however,i do recall A METALLIC taste about 4 weeks before the cleaning,i don't know if that could of been the start,so,i guess if you can answer this for me it would help me to understand, How long can a tooth be infected before it gets an abscess or becomes swollen? also ,what do you feel about my educated guess? and if i did inflame or irritate a nerve how long to get that back to normal? waiting for my x-ray i guess

[suszy123456789]

also dr,please answer me about the periodontal ligament being inflamed,if clenching causes this and does it heal,and how long? thank you again

[Jerome Tsang, DDS]

Oh, waiting for an abscess to form could take awhile.  Swelling could occur in days or it could take years.  Sometimes they don't show up on an x-ray for months.  Did your dentist do a cold test to test the nerve functionality of each tooth?  That would give a good indication of how the pulp/nerve is doing.  

Sometimes the nerve can die from trauma and not necessarily from a cavity.  This could include a blow to the teeth (could be years ago), heat, clenching/grinding, etc.

If the periodontal ligament is inflamed, it needs time to just calm down.  But the irritant thats causing it needs to be removed first.  I don't know exactly how long but usually if its an acute case which is occurred quite rapidly, it should resolve quite rapidly as well.  It should go away in a week or so.  There should at least be some improvement in a week.

If your educated guess is right, then as the TMJ and bite correct itself, the irritation in the front will start to resolve itself too.

[suszy123456789]

I'm all confused,do people stay in pain for years until an abscess forms? i have to wait months till i get my tooth to show an active infection? cant that hurt my body or other teeth ,having an infection that long? or will the infection show up on an x-ray?no,he did not do a cold test,what is that? this has just been a very unpleasant experience!!!! i do not wish to jump into a root canal,if my tooth will resolve with time! thank you i go for my x-ray on the 6th of april!just say the x-ray shows nothing, PLEASE INFORM ME WHAT YOU WOULD TELL YOUR PATIENT TO DO?

[suszy123456789]

ALSO YOU MENTIONED HEAT,CAN THAT CAUSE A NERVE TO DIE,I REMEMBER YOU SAID THE POLISHERS GET HOT AND CAN HURT THE TOOTH DURING A CLEANING! WHAT KIND OF HURT DOES IT CAUSE? IS IT REVERSABLE?

[Jerome Tsang, DDS]

When I say heat, usually its more of a result of drilling than polishing.  That's part of the reason why we use water with our drills to cool it off due to the heat from friction.  Yes, injury from heat like anything else can be reversible.  

I'm sorry you're confused.  I understand your frustration because there's nothing obviously wrong with your tooth (like it broke or a big cavity) but its hurting you.  Have you tried taking any anti-inflammatories such as Motrin/Ibuprofen or Tylenol?  Does your bite feel off anymore?  

[suszy123456789]

yes,advil,my bite still feels off a little,it feels like my back teeth were shortened some how!!!!!!!!!!!!!but i never had any problems with tmj or my bite before. i may never find out what is wrong,i am very upset and the worst part is i nor my dentist at this point knows what is going on. that's why i thought maybe you might have an idea!how about an infection in and under the gums,but my gums arn't red or swollen? have you ever heard of this type of situation after a cleaning? does tmj just come on someone with out any symptoms through the yrs.? dr. i want to thank you for all the time you have spent writing back,i know your very busy!

[grannienannie]

Ive been to three dentist. the first did a front crown,and i told him to check the work he done,he was my dentist for more than 4 years,I trusted him and when i kept asking for him to check it cause something didnt seem right...he said if my work is not good enough go somewhere else...I did and headaches was getting worse...he said the doctor did a great job... i told hin to check just for my security...but the head aches worsen with every month that passed, one day the headache was so bad i brought 4 bags of ice just to stop the pain and nothing would help i was over dosing for the pain to stop..I felt a pop in the top of my gum no tooth was there now..and i asked the second dentist to cut the gum...i begged and he did and nothinng but pus came out..no explaination...he dont want to be involved..with was going on...go to another dentist he said...I did i asked the third dentist to check the crown...and again its fine...but you can see it dont look right in the xray..no it fine she said...she did a filling in the front and a couple of weeks later my face blew up on the right side that was ten months ago and my face is still numb on and off and my eye is swelled shut..i go to the dentist i brush, floss, no bad breath, my gums dont bleed either but for these past few years after having that root canal i been in the hospital more than 30 times for an infection the doctors could not find.

[Jerome Tsang, DDS]

I've had a patient come back once after a cleaning and she couldn't open her jaw very wide and she was getting pain in the TMJ area.  I told her to take some anti-inflammatories, stretching exercises, soft diet and to ice it once in awhile to relieve the area and she came back a week or so later with no problems.  I think she was open too wide for too long during her cleaning.  I haven't had anything similar to what you're experiencing.  I would try to be patient and see how it progresses at this point.  There's no need to do anything if its not worsening at this time.  I would take a wait and see approach because you don't want treatment on something that'll heal up on its own.

[Jerome Tsang, DDS]

You had a root canal done on the front tooth already?  From reading your question, it seems that there was no root canal done at all.  

[suszy123456789]

dr.,now i rinsed my mouth with straight hydrogen peroxide thinking that would help and my gums and tongue burn,do i need to contact my dentist or will this pass? i am just trying to get my tooth better......

[Jerome Tsang, DDS]

Wait.  You burned your tongue with hydrogen peroxide?  Is it a severe burn that's pretty deep or more of a superficial burn?

You may want to contact your dentist and get a prescription for it.  He may prescribe some pain meds, steroids to help with the burn or even something to help coat the tissue to prevent any more irritation.  

It will probably heal on its own in about one to two week but the prescriptions may help with the symptoms of the burn.

[suszy123456789]

dr.,i don't want anymore things to take or do!!!!!!!!!!!!!!!! lol i thought i was doing something good by rinsing my mouth out with hydrogen peroxide i didn't add water because i guess i was  to know that half and half parts with water. this is just one more thing i have to deal with, now i just want to leave my MOUTH ALONE, no more peroxide,baking soda, no more cleanings,DONE DONE DONE!!!!!!!!!!! i am just going to wait for an abcess (abscess) and then deal with that at the dentist,if i dont get one than i will deal with the pain on my own.............................  i dont know much about teeth or tmj because i never had any issues till now so waiting is the best ,what will happen will happen!!!!! thank you for your help

[Jerome Tsang, DDS]

Again, sorry for your frustration.  Give it some time and see if it heals.  I would recommend trying to avoid eating any part that is ache-y and see how it does over the course the week.  Try to go back to as normal a hygiene routine as you had before.  Are the teeth feeling any better?

[suszy123456789]

thank you,it is just an on and off thing,my bite is off then it feels like it's getting better than my three teeth hurt, i have no idea!

[Jerome Tsang, DDS]

Give it some time.  Hopefully it'll heal on its own.  Just be gentle with it.

[suszy123456789]

dr. Jerome tsang, well,i woke up with a headache and extreme jaw pain. my dentist said i clench and grind and it is tmj.how could this of been triggered by a cleaning????  dr. what do i do know??? he said to get a mouth guard,i don't see how that is going to stop the grinding,i have to stop the grinding and i think my jaw joint will heal,right??? ANY ADVICE AT THIS POINT WILL HELP, is this something that never goes away??

[suszy123456789]

ps. i refuse to take any kind of pain pills except for advil and is there any natural remedies that you would suggest to heal the jaw and stop the grinding???

[Jerome Tsang, DDS]

My initial reaction would be to put you in a nightguard too if you're grinding often.  The nightguard helps to prevent the extra wear and tear from grinding that you do at night.  Grinding can be very destructive as you can add alot of pressure while you're asleep and don't know it.  

Also, sometimes with a nightguard, when you start to clench, it can trigger a part of your pain and "wake" you up from clenching when it notices somethings in the way and stop the clenching.

Try to ice the area down if its sore and try to stretch it out from time to time.  I would also recommend a softer diet

[suszy123456789]

dr.,i forgot to ask, can you over use a fluoride rinse like act? i was using it and didnt read the directions which cleary states once a day,i was using morning and night,just wondering? thanks

[Jerome Tsang, DDS]

Ya you could possibly.  Its definitely more dangerous if you swallow it, rinsing with it should be okay but I would recommend once a day.

[suszy123456789]

well,i was wondering  why my teeth in the cracks were looking brown and stained,i just read that act and crest pro health care,along with others might cause tooth discoloration......so,i got nervous and stuck a crest whitening strip on the dark spots, this is bad,what damage did i cause? can you mix fluoride with bleaching? please answer i am so scared,now i have the tmj,this is awful.......

[Jerome Tsang, DDS]

No, the bleaching and fluoride mixed together (not literally at the same time) is okay.  Sometimes after an in-office bleaching, you can apply fluoride to reduce possibility of sensitivity.  I wouldn't do too much with your teeth though until they resolve themselves.  Are the symptoms getting better or worse?

[suszy123456789]

symptoms are getting better as far as the tmj! THATS ON AND OFF,I CAN DEAL WITH THAT. the fluoride rinse made my teeth yellow,that bothered me alot,so i bleached them,my 3 teeth that were hurting resolved.now i just want them whiter like before!

[Jerome Tsang, DDS]

I would say that the yellowing of your teeth aren't the highest priority for now.  I would definitely leave it alone for now just because you've been through alot of other things right now and I would prefer if you give it some extra time to fully recover before you bleach them.  I don't think that bleaching would really affect the healing but with your unusual situation, I wouldn't want to do anything that may trigger a problem at this point.

[suszy123456789]

my dental hygentist said,in order to get rid of those stains i have to sand blast and buff them again,i want to do this but am scared of sensitivity again,i cant stay this way though! i cant have my teeth dark,i spent to much money and time in whitening them and am very upset with act rinse!!!! if i do this is this better than bleaching them for now? have you ever heard of this mouth wash causing this to others and if so does this go away with a cleaning? what a nightmare!!!!!!!!! please answer my questions before monday because i am scheduled for my cleaning at 4!!!!!!! thank you

[Jerome Tsang, DDS]

Hm.  The prophy jet isn't such too bad from my own personal experience and with the patients I have.  Its a little sandy tasting and it stings a little bit like when you take a shower and the water comes out kind of hard.  It shouldn't take more than a few minutes.  I didn't have any sensitivity after it.  I don't imagine you should either.  Ask your dentist about your particular situation but I would say it would be okay.