Toothache for weeks

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My hubby has now had toothache for over 9 weeks and due to the current situation is hitting walls with no NHS medical services and no idea what to do.

Started initially with bleeding gums both top and bottom on left handside. Used corsadyl for a bit and sorted the bleeding.

Then started a few weeks later with toothpain in front insisor (prev capped and root canal about 12 yrs ago). Still has this pain after 9 weeks. Initially couldn’t see a dentist due to lockdown and even once opened only gave phone advise they gave antibiotics and he was told to take paracetamol. Didn’t work by this time they were willing to do xray nothing showing up so they gave stronger antibiotics. These seemed to start the pain to get worse and made him feel a lot worse.
now bottom teeth have started which dentist says need to brush harder but gums are physically receded in last week or so and pain worsening plus sudden onset of fatigue over last few weeks comes over like a wave to extreme just smallest thing creates major tiredness. Plus bad taste in mouth and at one point felt like fluid leaking from teeth.

Doctors won’t physically see him we eventually got bloods done but nothing out of norm other than white platelets and neutrophils doubled compared to last test but still in ranges.

Had to see a private dentist still can’t see anything on xrays and we have booked for root canal in case a crack in tooth causing but can’t do until September as busy.

My husband is now struggling and doesn’t think he can go on with it so the only option looks like to start pulling teeth but seems drastic as we don’t know which as both top and bottom now a problem which seems very unlucky if this has all happened together.

Worried in case an infection spreading but just don’t know what to do and who to contact as NHS dentist and doctors not dealing with and looks a while before they will.

Feel totally lost with it all and the stress is getting worse each day.

Any ideas if had something similar. Does anyone know if abcess can be missed on xray although now had a further xray since the pain got worse and still nothing showing.

Really starting to worry now as seems to be worsening but not classed as an emergency unless his face swells and can’t breathe apparently. Then they will just pull it - with one being a front tooth it’s difficult.
 

Dr M

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Good day

A tooth can have secondary infection, even though the tooth has had a root canal treatment done on it. The root canal could be short filled, or there could be a lack of apical seal or a lot of other similar reasons. It could also have a crack, which might be difficult to pick up on a conventional x-ray, and might require some more sophisticated scans, such as a CBCT.
The increase in white cells and neutrophils, indicate that there is some infection and that the body is mounting an immune response.
The bleeding gums, could also be an indication of a severe gingivits, which could also lead to pain, a bad smell and/or taste in the mouth, as well as swelling in certain areas.
Do you perhaps have photos of his teeth/gums and a photo of his x-rays that were taken? It is difficult to give more of an opinion, since more information is needed.
 

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Thank you so much for your reply unfortunately we do not have the xrays but may be able to sort a photo.

The gum issue seems to have suddenly started since the second antibiotics. Seems really bad luck to get the top and bottom teeth at the same time is it likely one may be connected to the other?

There hasn’t been any bad breathe or smell only the taste.

If a tooth/cap is cracked is a further root canal likely to work or is it normally extracted?

Do patients normally suffer such fatigue with these things literally gone from being a fairly fit individual to having to rest after doing something simple like having a shower or putting on a pair of socks.

Sorry for all the questions and do appreciate your help.
We have recontacted his dentist again and they have agreed to do a deep clean and prescribed some form of prescription toothpaste for the gum issue. So fingers crossed on that part but even if that works we still have the top tooth issue.

He has always flossed and cleaned with electric toothbrush quite well so quite frustrating that it’s all happening now at a difficult time.

Thank you again your comments are very much appreciated.
 

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Dr M

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A photo will help a lot.
Usually a gum issue might require a deep cleaning to be done, so it is good that his dentist will do that.
If a tooth is cracked, it depends on how deep the crack goes. If the crack extends into the root of the tooth, then the tooth will have to be extracted unfortunately.
It is strange that he is suffering from fatigue. Usually tooth related issues, won't cause such fatigue, especially after a simple task like putting on a pair of socks. I think it is best he goes to see a medical doctor regarding this issue.
 

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Thank you again for taking the time to reply. Couldn’t persuade him to do a photo.

He has now had a deep clean around the area but still currently same level of pain and fatigue. We expect it will need to settle for a couple of days. The dentist has advised to come back in 2 weeks she noticed a weak area on a tooth but not the one in pain. Her option is to remove the nerve and then at some time in future extract the tooth but not yet as will be s long time before able to replace it.
If the top tooth still an issue then will look to refer to hospital but who knows how long a wait that will be. We are starting to think it must be a fine crack not showing up.
Had blood tests that came back ok and Doctors don’t seem to want to know at the minute to progress anything further.

will see in next 48 hours if anything settles from the deep clean.
 

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There is also problems related to sinus, that could give a lot of pain and sometimes looks like there's something wrong with the upper teeth. I think the CBCT could help you in solving that mistery, along with a visit to an endodontist (because of the tooth with root canal). They have a microscope that helps a lot to find cracks that are difficult to spot with the naked eye, even in the X-ray. Mixing different types of medication could also give that fatigue problem, along with stress of dealing with the constant pain.
 

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Hi Husband still with pain and nothing yet found to be able to sort it. Paid for a cbct scan and nothing showing up.

The one thing he has constantly noted is fluid leaking through into his mouth with a bad taste as though from the teeth. He has mentioned this now to both the NHS and the private dentist and both noted as though never heard of anything like that.

We have read about a sinus tract that can develop to drain pus from a chronic infection has anyone ever had or heard of this and would know how it is identified. There are no infections showing up still on xrays, would such tracts show on one?

Intraoral sinus tracts (Dental fistulous tracts.

no obvious pimples showing on the gums.
 

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