Wisdom tooth extraction. Is this need to be removed soon? Attaching xray.

[Stackflow]

I have removed my 3 wisdom teeth before. I have one remaining wisdom tooth. I have right side jaw pain chronic for 3 years with no relief.
I did upper right wisdom tooth removal only after this jaw pain started. Since the dentist thought my upper right wisdom tooth is causing the jaw pain.
Unfortunately it didn't help. Still have jaw pain.

So I just dragged this other extraction. Dentist said I have to remove this left upper wisdom tooth too.
Is this need to be removed soon? Will that cause more jaw pain?

Is this tooth close to sinus??
Attaching images of 2019 & 2022.
Jaw pain since 2020.
Any changes in my jaw joint and condyles in these 2 x-rays?
I have extracted#30 only because of this jaw pain. No issues on it
though

 

[MattKW]

No rush to have upper left wisdom removed. Very unlikely to be related to any jaw pain. And you had #30 removed due to jaw pain??? Looks like it had been fine.
What do you mean by jaw pain?

S	Site	Where is the pain? Or the maximal site of the pain. "Jaw pain" is a vague term.
O	Onset	When did the pain start, and was it sudden or gradual? Include also whether it is getting worse, unchanging, getting better?
C	Character	What is the pain like? An ache? Stabbing?
R	Radiation	Does the pain radiate anywhere? i.e. spread anywhere
A	Associations	Any other signs or symptoms associated with the pain?
T	Time course	Does the pain follow any pattern? Morning, night-time...
E	Exacerbating / relieving factors	Does anything change the pain? Eating, hot, cold, painkillers,...
S	Severity	How bad is the pain?

 

[Stackflow]

No rush to have upper left wisdom removed. Very unlikely to be related to any jaw pain. And you had #30 removed due to jaw pain??? Looks like it had been fine.
What do you mean by jaw pain?

S	Site	Where is the pain? Or the maximal site of the pain. "Jaw pain" is a vague term.
O	Onset	When did the pain start, and was it sudden or gradual? Include also whether it is getting worse, unchanging, getting better?
C	Character	What is the pain like? An ache? Stabbing?
R	Radiation	Does the pain radiate anywhere? i.e. spread anywhere
A	Associations	Any other signs or symptoms associated with the pain?
T	Time course	Does the pain follow any pattern? Morning, night-time...
E	Exacerbating / relieving factors	Does anything change the pain? Eating, hot, cold, painkillers,...
S	Severity	How bad is the pain?

Thanks for the response @MattKW .

Yes I removed #30 only because of jaw pain. I regret it though , because they suspect that tooth is the reason for my jaw pain.

My jaw pain is in the mandible end lower jaw near the ear where the lower jaw line ends. I have this for 3 years now.
I went to my dentist when this started. He took an pan xray and said everything fine.

Then he tapped on all teeth on this side. Tooth 30 was painful for tapping. Kind of very sensitive and I just shrink my eyes. And he gave tooth stick to bite on and it was sensitive too.

So he said I might have some issues on 30. I didn't go in with tooth pain at all. And I was eating on it totally fine until that visit.

I went to dentist after seeing an ENT for this pain. ENT did nasal endoscopy and said no issues. So went to dentist to check jaw.

But he spotted this tooth 30 issue. Took CBCT scan and nothing found. He said I can see Endodontist. Went to Endo the following week . This is all before 3 years. Then Endo did cold test and tooth was alive. But sensitive for tapping and biting pressure. So he said he will do exploratory root canal and see inside.

Did it and nothing found and no relief. Same symptoms. I have severe jaw pain near the jaw end. But my bad, since the root canal, tooth 30 started hurting which wasn't hurting before that. It was hurting only for tapping and biting before that RCT.

Then had another cbct scan. Nothing seen. The Endo forced me to get crown immediately to see if it helps. Spent thousands of dollars on it and got perm crown the following month. No relief and pain was so much on that molar. It's like pressure on it always and hurts to even touch.

Changed the Endo and saw new Endo. Took another cbct scan. Nothing seen. He said I can try retreat root canal.

So did retreat root canal on it and no changes. My bad , nothing helped. He retreated again in 2 months. And retreated again in 6 months. So 3 retreats tried till 2022.

No relief and taken another cbct. Nothing seen.

But it was so painful in the gums and tooth area. It was also hurting in 31 gums. It was so much painful in 31 gums and I used to scream when they probe those gums. But periodontist said gums ok. But I screamed in his dental chair when he probed it but he dismissed me.


Ended up pulling 30 in July 2022 and my bad, I still have all symptoms just minus the tooth. I have pain in tooth socket gum area. And severe pain in 31 gums.

I went back to surgeon several times since pain in the jaw where mandible ends. Same spot. Pain just came back once anesthesia wears off. So called them the next day and same jaw pain. So surgeon said it could be dry socket and poked my socket and removed the stitches. No food debris or nothing in it. It was healing well

He put clove paste and asked me to come on day 5 and day 7 after ext. Digged again and put clove paste. No changes at all. My pain was the same. Taken several rounds of antibiotics.

I still have pain. I saw him till October and he dismissed me saying xray looks ok.

I have severe pain in tooth 31 gums now. It hurts for touching, brushing and probing just makes me scream and jump out of dental chair.

I extracted this tooth only because it was painful for touching tapping and biting pressure.

My dentist and Endodontist did another treatment called occlusion adjustments and they grinded all my teeth as they thought occlusion issue could be reason for jaw pain. They grinded all my teeth and bite is totally off. I can't eat anything solid now. I can't eat anything at all on right side.

On the left side, after these bite adjustments, I couldn't eat anything solid and totally on soft diet for 3 years.
My bite is off and not meeting together and touching down even.

I have also seen TMJ specialist, ENT, neurologist for this. Taken MRI and CT of jaw and neck as well. Attaching x-rays before and after root canal and extraction. Few more images In comment.

Do you see anything wrong on my jaw, tooth 30 and tooth 31. Now I have severe pain in 31 and I went to dentist and Endodontist for this. No answers. Don't want to end up pulling that too. Any issues seen on 31? Severe gum pain.

 

[Stackflow]

More xrays

 

[MattKW]

I suggest you find a Pain Clinic attached to a major teaching hospital. There is no point pursuing it from a strictly dental point of view.

 

[Stackflow]

I suggest you find a Pain Clinic attached to a major teaching hospital. There is no point pursuing it from a strictly dental point of view.

Ok Dr. I did see a pain management clinic and pain management specialist tried different nerve medicines on me in the last 2 years. I saw him in 2021. He said he is more focused on my symptoms control rather than finding the root cause or diagnosis.
I have tried amitriptyline gabapentin Cymbalta Lyrica and currently taking tegretol. He said if it's nerve pain , I should get some relief with these medications.

I have seen orofacial pain specialist TMJ specialist and they said it's like Myofascial syndrome and tried many muscle relaxers and physical therapy. I did more than an year of physical therapy and dry needling.nothing helped.

Now they said my bite is off and could be causing pain. I am arguing that my bite was fine when this started and it got changed only after those bite grinding adjustments and the crown on 30.

Because my dentist did lots of adjustments on 30 crown when it was placed and adjusted other molars and other teeth so many times. He took tooth 30 out of occlusion by purpose and tried that if it helps with pain. Since it didn't help, Then he adjusted all other teeth to it's height.

I still have same pain in the lower jaw line and constant since day 1 for 3 years now. Now I have severe pain In gums of tooth 31. Do you see any issues on #31? I have severe throbbing pain in that gum. It hurts for touching brushing etc. Looks inflamed.

I recently saw an TMJ specialist and he reviewed my MRI and cbct scan. My MRI report says normal discs but I have got different opinions on my MRI. One oral surgeon said it's anterior displacement without reduction. Other surgeon said normal. Another tmj specialist whom I saw recently said my condyles are positioned different than normal. And that could be the reason for pain.

My cbct scan report shows condyles laterally positioned and I asked the tmj specialist who ordered the scan. He said that could be my normal anatomy and dismissed me to see chiropractor. He wanted me to see chiropractor and get neck adjustments. I have pain in the side of the neck on the right side and back /base of neck. So he said chiropractor adjustments required.

I am very scared to go to chiropractor because of their adjustments and didn't go yet. Just avoiding going there.

Right now, I am still with dental issues @MattKW. Issues in my 31 tooth as gum pain is severe, bite issues because of occlusion adjustments and this tongue herpes thing which I have. Constant primary pain is in the lower jaw where mandible ends. I even checked about eagles syndrome with ENT.

I also have high inflammation CRP blood work since 2021. So seeing rheumatologist for that. My CRP is high since then. He is testing me every 3 months and the recent CRP blood work was high too. Don't know why it's still high.

Whether condyles or disc issues cause these type of pain for so long ? And affect tooth and gums? I feel like I did an unnecessary extraction of #30. That was so painful and throbbing to touch tap and pressure. But nothing seen on xrays and cbct scans. Ended up pulling it.

I don't want to end up pulling 31 too. Don't know why that gum is so painful. My Endodontist said I have occlusion trauma on that tooth as my dentist adjusted 30 so much and took out of occlusion 3 years ago and 31 has to take all pressure. That was the only tooth touches if I bite down. So he adjusted it again in November.

Since then the tooth is so sharp and still bite feels uneven. I am scared to get more adjustments because my old dentist (I even changed my dentist because of this) did several bite adjustments visit and I saw him for 8 weeks for this grinding on all teeth in 2021.

I feel it's not done correctly and made a mess of bite issues. I can't chew down on anything. And can't even bite on fries. No solid foods. Feel like I can't exert enough force to bite on those.

I feel bad for myself and this mess. Don't know what should be the next step. I moved to a new city and have to find new dentist and other specialists. So searching for a new dentist and oral surgeon to check this from square one. Everytime I feel I am progressing but after every appointment I feel like I am back to square one.
No diagnosis and relief.

Do you see any issues on my condyles or discs @MattKW doctor?

 

[MattKW]

Are you serious? A TMJ specialist suggested you see a chiropractor. How would neck adjustments help with an area served by cranial nerves? I think you're having a go of me. End of conversation.

 

[Stackflow]

Are you serious? A TMJ specialist suggested you see a chiropractor. How would neck adjustments help with an area served by cranial nerves? I think you're having a go of me. End of conversation.

I am sorry if you misunderstood my statements.
Tmj specialist is an orofacial pain specialist and one of the very specialized doctor in the US. He took CBCT scan for me of the jaw and send it for reporting. Report came out and it says condyles position laterally and Dr feel that it's my normal anatomy.
he tried to give his splint to use for my teeth for my jaw pain. We tried it and it didn't help. So he said he works with upper cervical chiropractor doctors who does check only C1 and C2. Nothing else on the neck. So he wanted me to check if I have any issue in my c1 and c2. He said he had lots of patients who had issues in the cranial discs c1 and c2 and had my similar symptoms sir.

SO he recommended upper cervical chiro. They are specialized in the US for only c1 and c2.

SOrry if I said anything wrong.