Constant pain after hygienist

[bobbybly]

I have constant pain since visiting a hygienist this time last year. It hurts on the back of my lower front teeth at the gum line. It is especially bad when :
1. I eat spicy food
2. I eat anything with vinegar
3. I am exercising
4. I touch this area with a toothbrush

I have had xrays and they say pulps are regressed and there are pulp stones in these teeth, but no treatment is necessary? Some dental trauma to one of the teeth, but again no treatment proposed. Have visited periodontiset endodontist, general dentist, maxillofacial surgeon. Taking painkillers from the doctor instead but they wear off and pain comes back.

Any advice?

 

[Dr M]

Any photos of your teeth or x-rays that you could share? Need more information

 

[bobbybly]

Before

After

 

[bobbybly]

X ray and close up

 

[bobbybly]

Any idea on this?

 

[Dr M]

Although nothing is obvious, the sensitivity might be due to enamel loss on your teeth. Enamel loss on your teeth, exposes the dentin layer, which is prone to sensitivity. The reason why it might be more obvious after your visit to the hygienist, is that she might have cleaned off a layer of calculus, which covered the tooth, providing some relief to the sensitivity. This calculus layer had to be removed unfortunately, otherwise you sit with a host of other issues.
Best option would be to use a sensitivity toothpaste like Sensodyne. Rub it on the teeth after brushing and leave it on. It won't take it away completely, but should make it manageable. You can brush with it as well.

 

[bobbybly]

Thanks this is helpful. I have tried all of the above but still in constant pain day and night. It is especially bad when I exercise or touch the area. I have also been on amitryptiline from the GP for the pain which is quite severe at times, but this has not sorted it either. Are there any other options

One other question: I can't actually see any calculus on the back of the lower front teeth in the before photos? Can you? I can see some orangey stuff on the front but nothing on the back? What does calculus actually look like?

Many thanks!

 

[Dr M]

The photos are not taken at the correct angle in order to see calculus, but you can google photos.

 

[MattKW]

Your photos reveal "cupping" erosion of tooth enamel, usually seen in people who have acidic foods or drinks , e.g. soft drinks, sports drinks, citrus fruits, wine, vinegar (acetic acid). While it is common to have sensitive teeth after a cleaning, it should settle within a few days, esp with use of desensitising toothpaste.
However, if you have an acidic diet, it will give you hell. I remember the terrible pain I had after a day of wine-tasting when I followed up with salt-and-vinegar chips (crisps).
Go back to plain water or milk for a couple of weeks and keep using desensitising toothpaste. Spit it out but don't rinse.