RE: 3 years of suffering.. lower right canine, root canalled- but constant pain in root/socket/bone.

[Gemini]

Dear Pearl Dental,


RE: Pain in LR canine for 3 years – now focussing on root/socket/bone

I cannot carry on any longer with this pain. I pray that you are able to help me.

Prior to orthodontic work which started in August 2006, I never had a single second of pain or problems with my teeth. Work was cosmetic, to straighten upper centre incisors and lateral incisors. Bite was fine.

Following orthodontic work (finished Jan 2009) I have been left with almost constant pain at LR canine root/socket/bone.

Had sectional brace to upper right (healthy upper right 1st premolar removed before brace in 08.2006). Teeth /jaw area tightened with brace (2007/08) which made upper right teeth area too small to fit over teeth below, and protruding lower right canine. I was left in agony for 2.5 years, which started towards end of brace treatment, with a malocclusion (traumatic occlusion). During this time the lower canine was too large for the space (toxicly obstructive) and caused radial pain along whole jaw, down into jaw below canine and up into skull near upper canine.

This included at least a year with undiagnosed rotting nerves in both right canines.. (teeth became devitalized due to trauma/contact) After being prescribed antibiotics as nerves so necrotic, finally had 2 root canals in May 2010.

Now still have almost constant pain in lower right canine, at root/socket/bone. Like infection pain, sitting on nerve..could there be a crack somewhere where bacteria has got in? After 3 years of LR canine being forced, moved and filed (orthodontics and then severe occlusion), it’s not rocket science that tooth/socket/bone is traumatized and bacteria got in (I could hear bone/tendons straining and cracking a lot during this time).

Went back to endodontist, he said ‘root canal is ok’ and referred me to Maxillo-facial consultant with suspected neuralgia. MFU consultant said it’s probably not neurological and couldn’t see any cracks (NHS standard x-ray..). Suggested splint.. I know this won’t help. Moving and straining the teeth around again will not help. Bite is now good and teeth have been moved enough. That would be like putting a plaster on a thorn. All the radial pain stopped when the canine was finally in a less obstructive position and had been filed so it was slimmer (i.e. less depth). (Both right canines and roots are larger than left ones).

I cannot live like this. I have been left in poverty through not working for 4.5 years due to this. Only just speaking better, bite much better but have the pain. LR canine was shaved a lot (and other right side teeth)to try to make it fit in the space and not contact UR canine. Anti-inflammatory painkillers help a bit but make me sleepy. Worried about internal damage after having to take painkillers for so long.

Can sleep, eat, thank God - but have this pain 90% of the time. No other tooth/root/socket/bone hurts like that when pressed (pain still there of course when not pressed). Pain can be as if there is still a nerve in the tooth (I know it has been removed) but I understand that nerve pain in connective tissue can be indistinguishable from pain which feels like it is coming from the tooth..

I have been sent from one person to the next and back round again for 3 years. I have been left trapped in the system. The simple fact is that something has happened in LR canine root/socket/bone/tissue. I have heard of ‘dental osteomyelitis’ but believe I would have swelling/even worse problems/symptoms in this area if it were.

I also need a hygienist as although I try to keep everything clean and floss, there is build up of plaque which must be affecting my gums and oral health..

I need an x-ray/ultrasound which will pick up any cracks/inflammation/infection/whatever is going on/ in tooth root/socket/bone..
I have had advice from an top expert that normal x-rays can’t always pick up cracks/problems in teeth/cavities/tissues/bone.

I can’t take any more pain and being misdiagnosed and passed on and on. I am desperate for someone to sort this out and free me of pain so I can get on with my life. Imagine living with an intolerable thorn in your jaw for 3 years.

Before all of this, I never even looked at that canine or felt it for a second..

My question to you:
Please can you urgently recommend (OR WHAT DO YOU THINK THIS COULD BE OR WHAT WOULD YOU DO?) an oral surgeon/maxillo-facial person- specialist in London or South East, preferably Surrey/Sussex for someone to actually diagnose this correctly and operate/sort it out before I get suicidal.
Thank you.

Ms Hobson

[Dr Mohsen J. Esfahani]

Thank you for your post.

From your account it seems that you have complex problems that will require multi-disciplinary assessment and treatment and these facilities are probably best provided in a hospital environment. I would recommend that you speak to your dentist and ask your dentist for a possibility of him referring you to a large teaching hospital where these multi-disciplinary facilities are readily available under one roof and so that your problem can be assessed and if necessary treated by multiple specialists in a team.

[Gemini]

Well, got rid of the problem for you.. so I'm passed on round and round again.. My dentist delayed so long in getting the root canals done that I had to have emergency treatment (very expensive whereas my dentist should have done it on Denplan). He then rejected me from his practice saying I did not respect his advice.. So I do not have a dentist. It is never as easy as 'ask your dentist'. I was let down 4 times by the hospital MFU dept who dismissed the major occlusion and then misdiagnosed the rotting nerve. If I try to get a referral to eg. The Eastman Dental Hospital, it could take months. I will have lost the will to live by then. No doubt you won't post this reply as it means someone isn't getting the answer they wanted or the desperate help they wanted. Sometimes, people are passed around for years left in agony, slipping through the net and utterly let down by the dental system in this country. I wish I was in USA where they have proper expertise. Basically my dentist should have referred me to a teaching hospital at least 2 years ago.. I don't have the strength to carry on with this pain.