Cant fathom what the pain is

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Hi. I’ve been having tooth pain for 8 weeks now. Above my 2 front teeth and in them. Seen a dentist 4 times and been to doctors 3. Been referred to dental hospital and awaiting an appointment. Dentist says they can’t see anything wrong. My gums feel inflamed and I’m struggling to sleep . My doctor has put me on gabapentin 100mg 3 times a day and I’ve been on them 2 weeks with no improvement. My doctor also put me on metronidazole for 7 days to see if that may clear anything up so I’ve taken 9 of 21 but don’t feel any effect yet. I haven’t had an X-ray for around 5 weeks. Can an x ray change in this time and show up something with the pain getting worse. It’s like a really strong tooth sensitivity pain. I’m also using duraphat 5000. The 2 front teeth have a see through bit on the bottom of it and little staining where u can see the dentin.
Please can someone give me some advice. As I’m at a loss what to do.
Thank you
 
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IMG_1066.jpeg
 

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Dr M

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You don't appear to have any large cavities. The chip gives an indication that you might grind on your teeth. Would need to see an x-ray to determine if the nerve is involved or not.
 

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The chip in my tooth was done by a glass bottle when I was 18 and I’m now nearly 40. I never took a picture of the xray but when I see the dental hospital I will. Thank you
 

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This has appeared on my gum in the last few days above where all the pain is. I have a dental hospital appointment on 25th sept and am on 400mg of gabapentin 3 times a day and I still have pain.
IMG_1590.jpeg
 

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Dr M

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This almost looks like a draining sinus, which is an indication of an abscess on the tooth. If you are in severe pain, see if you can contact your medical GP for a prescription for some anti-inflammatory medication and/or antibiotics. The Gabapentin alone will not suffice.
 

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Dr M

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This is a good sign. Might be an area then where you injured yourself previously without knowing it. I would still just go to the dentist, especially if you haven't been in a while, in order to make sure everything is in order.
 

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Been to dentist again . No change on X-ray. She said that’s not saying there isn’t anything wrong with the tooth or the nerve it’s just that a 2D x ray cannot see it. She is getting me an appointment for a panoramic scan and she thinks I will have a cone beam ct scan when I’m seen in September at the dental hospital. She prescribed me a week of amoxicillin to see if this helps at all and if it doesn’t we can tell the dental hospital everything we’ve tried that hasn’t worked.
 

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Still awaiting the results of the cone beam scan I had at the hospital 2 weeks ago. Was awoke with pain in the night in a tooth that’s had a couple of fillings In and has had sealant on 3 times. Does this look like it needs a root canal or a new filling. It looks dark coloured inside to.
IMG_2310.jpeg
IMG_2301.jpeg
 

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Dr M

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Would need to take an x-ray to confirm the presence of decay and to see how deep the existing filling is.
 

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Still having pain and I’m now on 900mg 3 x a day of gabapentin and 200mg 3x a day of carbamazepine. Just noticed what looks like a crack in my tooth where the pain and sensitivity all started. It’s not a craze line. Could this be the cause of all my problems?
Please someone help? Thanks.
 

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Dr M

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On the x-ray provided, it seems like the pre-molar has an existing filling, that is either touching the nerve or very close to it. I would recommend doing pulp vitality tests on the pre-molar, to test for irreversible pulpits. Pain from this tooth, might be to referred to other teeth in this region. The canine might have a distal cavity, but I would need a better x-ray to confirm this. It does not seem to be near the nerve though.
 

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Thank you for youre reply. I already had that tooth out on the xray above . The photo on the last bit of the thread is just the front tooth where all my pain started from.
Thanks
 

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