Tooth Pain, Cavities, X-rays - Need Advice Please

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Jan 17, 2019
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Hello! (Please see x-rays below, in the next message)

Recap - I have been having pain in my teeth, particularly my second to last tooth on my lower right. Also have some pain in my top teeth, close to the gums, on the same right side. I have had pain in my teeth for a few months now. Dentist thinks it's all from grinding my teeth. I have been wearing a mouth guard at night for months (since the pain started) but the pain is still there, particularly on the bottom tooth (second to the last, on the right). The pain sometimes wakes me up at night. It is not excruciating pain, but it is quite painful and it is there in the background 90% of the time. Hurts spontaneously. Hurts a lot after I eat. I should probably mention that I also had pain in my head before, i.e. when this all started a few months ago... but once I started wearing my mouth guard the pain in my head reduced significantly. Now it's mostly just the tooth/mouth pain that I'm dealing with. The tooth pain also radiates to my ear, sometimes also to my temple. And it sometimes wakes me up at night.

I saw another dentist today and took a set of full mouth x-rays. He said he could see nothing that would be causing all this pain other than grinding. Says I have a couple of "tiny cavities" on top of the lower teeth (last and second to the last), but he said even if I get those cavities filled, I will still experience this pain, since those small cavities are not big enough to be causing this kind of pain. He thinks I should just keep wearing the mouth guard and swish around with fluoride rinse a couple of times a day to help the teeth settle down.

I am not sure if I should fill the small cavities on the troublesome tooth (and the one right next to it) now or not. If my mouth is in this much pain supposedly just from grinding, I am wondering if I should just wait for everything to hopefully settle down before doing anything else? So, I am leaning towards not filling the cavities yet since I don't want my teeth to go through more trauma and become an even bigger issue. On the other hand, the pain is very concerning, very distracting... and I am concerned that perhaps what looks like small cavities might be something much bigger that's just not showing up on the x-ray? When I take ibuprofen, the pain subsides... but I am concerned about taking ibuprofen almost daily for such a long time.

What else can I do? I had considered a CBCT scan to look for hidden infections, but decided against it after getting advice here, and I opted for regular x-rays of my entire mouth instead.

Could all this horrible pain really just be from grinding, or could there be more to it than this? Is there any other way to rule anything more serious out? If you have any advice for me, I would really appreciate it!

Please see x-rays attached in the next message.

Thank you very much!!
 
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FullMouthXraysFromJan24.jpg
 

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honestdoc

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Don't fill the small cavities. They haven't penetrated through the enamel and can be reversed. I'm going to agree with the 2 dentists that the pain may be related to your grinding and or clenching. When your jaws are at rest, the teeth should be about 1/4 inch or 1/2 cm apart. According to experts, your teeth only touch about 20 minutes each day including all meals and function. Do you have a custom bite guard? I recommend hard on outside and soft on inside. It will force your jaws to be at rest (no more headaches). You might have to wear it more often during the day.

Do you have unresolved stress. If so, you may continue to have grinding/clenching pain. Try to manage the stress as best as possible.
 

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Joined
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Don't fill the small cavities. They haven't penetrated through the enamel and can be reversed. I'm going to agree with the 2 dentists that the pain may be related to your grinding and or clenching. When your jaws are at rest, the teeth should be about 1/4 inch or 1/2 cm apart. According to experts, your teeth only touch about 20 minutes each day including all meals and function. Do you have a custom bite guard? I recommend hard on outside and soft on inside. It will force your jaws to be at rest (no more headaches). You might have to wear it more often during the day.

Do you have unresolved stress. If so, you may continue to have grinding/clenching pain. Try to manage the stress as best as possible.

Thank you so much honestdoc. Yes, I have a custom bite guard. Right now I only wear it at night. So maybe for now I should wear it all day as well? Or is there any disadvantage to wearing the mouth guard all day if I am able? I honestly can't really tell when I am clenching or grinding. I will try to worry/stress less:). I really hope everything is resolved soon. PS Did you look at my x-rays as well? No cavities/infections on there as far as you can tell? Would the cavities show up on the x-rays if they had penetrated through the enamel? Thank you so very much once again. Really appreciate it!
 

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honestdoc

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Thank you so much honestdoc. Yes, I have a custom bite guard. Right now I only wear it at night. So maybe for now I should wear it all day as well? Or is there any disadvantage to wearing the mouth guard all day if I am able? I honestly can't really tell when I am clenching or grinding. I will try to worry/stress less:). I really hope everything is resolved soon. PS Did you look at my x-rays as well? No cavities/infections on there as far as you can tell? Would the cavities show up on the x-rays if they had penetrated through the enamel? Thank you so very much once again. Really appreciate it!
The disadvantage to wearing the bite guard during the day is that it is hard to communicate like in meetings, etc. If you don't need to speak to others, by all means, wear it. Your x-rays look good. I see tiny cavities barely there and they can be reminineralized (healed or not get bigger). I have 3 cavities that barely penetrated through enamel and have been watching them for 25 years! I also grind and clench and experience random pain as well. It took about 5 years for my pain to fully subside along with other changes in stress mgt.
 

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The disadvantage to wearing the bite guard during the day is that it is hard to communicate like in meetings, etc. If you don't need to speak to others, by all means, wear it. Your x-rays look good. I see tiny cavities barely there and they can be reminineralized (healed or not get bigger). I have 3 cavities that barely penetrated through enamel and have been watching them for 25 years! I also grind and clench and experience random pain as well. It took about 5 years for my pain to fully subside along with other changes in stress mgt.

Oh wow. Thank you so much. This is so encouraging. Yes I work alone a lot of the time so I can afford to wear it throughout the day. I will definitely try that! Yay to remineralization/healing/not getting bigger. I am all for that and I will try my best to make that happen by taking care of my teeth better and eating xylitol.

I am so glad to hear your pain fully subsided, and that those 3 small cavities have remained under control. Very happy for you! Will hope for the best for myself as well. Thank you so much once again for the advice and encouragement, much appreciated!
 

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Forgot to mention I also have on and off pain on the bottom left tooth, I think second to the last tooth as well, which is right next to the tooth I had the large filling on ages ago. The pain comes and goes, has done that for years I think. But it's nowhere near as painful as the right side of my mouth. Thanks:)
 

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