How to deal with dental abnormality

Joined
May 25, 2016
Messages
2
About January of this year I began to experience some pain in my lower, right rearmost tooth. There was on and off again intense pain with cold liquids only. No pain with warm, hot food or pressure. I went into my general dentist office to have it examined. He did not find any abnormalities and conducted a few tests including placing of ice in affected area, biting down on a wooden stick like instrument, taping with dental probe. I did feel some minor pain on the bite down test as I opened my mouth.

My dentist said he could not see any signs of cavities or other abnormalities and suggested the sensitivity and pain may be due to grinding. I was advised to wear a night guard. No x-rays were taken. I started to wear the night guard and the pain subsided and I stopped wearing it when the pain and sensitivity went away. Throughout the next few months as the pain periodically returned I would wear the guard for several days and the symptoms seem to go away.

April came and I came in for a routine cleaning still with the on and off again sensitivity. I was examined by the dentist who did not find anything wrong. I took a routine single x-ray of all of my teeth as viewed from the front during this visit (I believe this is called a panoramic x-ray) . Several weeks passed after this and I noticed greatly increased sensitivity to cold and severity of pain as well as pain starting without any stimulus. I also woke up several times at night from the pain. Then it escalated to a point when I was chewing a piece of gum and there was a very sharp shooting pain like nothing I had felt before. There was a sharp pain, decreasing slightly till there was a less severe but painful sensation that lasted almost 30 minutes. I attempted to identify the source of pain and bit down as lightly as I could in that same region, the sharp pain started again but now did not subside for hours until finally I took an ibuprofen and drowsy Nyquil to knock myself out. I scheduled an appointment 2 days later to see my dentist.

My dentist again could not locate any signs of the pain and referred me to an endodontist. The endodontist began the examination with a routine blood pressure test that revealed my blood pressure was extremely high and that she could not run the tests on me for fear of causing me pain that could result in triggering a heart attack or stroke. I had 4 blood pressure checks which there each about 10 minutes apart. The first two results using a wrist device on my left wrist was: 148/104 and 164/112, two more test resting with an arm cuff device was 198/127 and 169/101. I was surprised although I have had a history of higher blood pressure but not as high as the 198/127 result. I was feeling fine up till that moment except the tooth problem, I am 28, and wasn't nervous by the visit.

Anyway, on the recommendation of the endodontist, she did perform a 3D x-ray. The results of which revealed in her opinion the presence of a "large cavity" on tooth number 2, my top right, rearmost tooth. I was surprised by this finding as it was not the tooth I suspected. The endodontist explained the ability of pain to originate from different regions in the mouth but travel to different parts. It just so happened that day I did experience a spike in pain in that very tooth. She also said a root canal would be necessary and possibly an extraction. She also detected the presence of a sinus infection in the region of that tooth and prescribed amoxillian to counter this. Again, up to this point I had not experienced any symptoms other than the pain related to the tooth.

Several days later, today, I was able to speak to my dentist about this whole situation. He now determined from examination of the 3D x-ray that the tooth was subject to the condition of "resorption." He stated that previous x-rays of that tooth in 2013 and 2014 did not reveal anything. He recommended that I attempt to perform the root canal to try to save the tooth but that there was a high probability that an extraction would ultimately be necessary. The best case scenario would be that the root canal would be successful and it would be toped off with a crown. Worst case, the root canal is done or not, it fails, an extraction is necessary, and a bone and sinus graph is then required to do a dental implant.

Under the circumstances should my general dentist have been able to identify this problem sooner? If this diagnosis is correct, would his recommendation be a reasonable course of action? What questions should I ask him or what other issues should I consider? I plan to seek a second opinion from another endodontist about other possibilities. Your help and advice is much appreciated. Thank you for reading through all of this.
 
Joined
May 25, 2016
Messages
2
So far I did see another endodontist who also confirmed that a root canal is necessary. However, I can not proceed pending a lowering of my blood pressure to a level that the endodontist will accept.
 

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