Gum pain stumping Dentist, Periodontist, and Endodontist

[Andrewl]

I started getting pain in my gums between my front teeth about 6 months ago. My dentist initially found what she thought was a small corn hull below the gum line. After removal, while slightly better, low grade pain persisted. After a few months, a periodontist performed a deep clean in that area and found a bit more debris and plaque. Felt better for about 5 days after procedure. Then my gums exploded with intense swelling and pain. Periodontist had me take Amoxicillin, which helped but did not fully resolve the pain after 7 days. I then started getting intense itching after finishing the antibiotics. Periodontist had me take Clobetsol topically for two weeks. That helped the itching but still have continued pain in the same area. NSAIDs do not help much with the pain. The dentist and Endodontist see a small pocket in my tooth below the gumline on the CT, but the tooth itself is not presenting as having a cavity or pulsitis (not responsive to tapping and normal cold test). None of the doctors can figure out why I am still having pain after so many months. The pain mostly subsides when sleeping, and chewing gum is usually helpful to relive some pain during the day. Nothing else works. Any ideas? Could it be an infection that Amoxicillin has been unable to treat? Or a viral or fungal infection?

 

[Dr M]

Do you have any clinical photos or x-rays that you could share?

 

[Dr Sunali dental Solution]

The presence of a small pocket in your tooth below the gum line could indicate a periodontal abscess or a periapical abscess (infection at the root tip). Even if there are no visible cavities or signs of pulpal inflammation (pulpitis), it is possible for bacteria to infiltrate deeper structures, leading to chronic pain and discomfort. The use of Amoxicillin was appropriate for addressing any bacterial infection
if the source of infection persists (e.g., due to residual debris or an unresolved abscess), symptoms may continue despite antibiotic treatment.
Your ongoing symptoms likely stem from a combination of factors including possible residual infection, allergic reactions post-antibiotic treatment, and structural concerns related to your teeth and gums.

An infection could be a contributing factor to your ongoing pain, it is crucial to explore all possible avenues—including musculoskeletal issues and nerve involvement—to arrive at a comprehensive diagnosis and treatment plan.