Thank you so much @Isaiah_40_31.
Yes, I understand ES surgery is a major one and even I can’t think about it. Very nervous and scary to think about it.
I will try hard to get ct scan order from my PCP. Got the physical schedule only for December. Have to wait till then.
Hope she agree to do a ct scan. She might push me to do mri as well.
Talking about eagles symptoms, does more than one piece of styloids process is considered as Eagles? My cbct report says it’s segmented. Not sure though as I can’t trust that radiologist so much. I am trying to push my cbct in the software and I try to post the 3d video here.
Thanks @Jules.
Yes, I am so frustrated that I am going in circles since may and no solution yet. Not even the solution, I will be ok if I know the problem atleast.
This neurologist is not very satisfying. She said TN will not cause pain in the lower jaw under ear. She wanted me to try the medicine and see if it helps. She want me to do mri brain with contrast as well. I am holding up with mri for now.
Dentist suspect a tooth root fracture from the tooth cbct scan. He is not certain though. He want me to try extraction and see if it helps. He said even after extraction, if I have same symptoms , the tooth has been ruled out and I can focus on other things. This was his statement. I was totally frustrated to hear this. I have to spend 6k on implant if I extract. If that solves the pain, then well and good. If it doesn’t I will end up in another huge dental procedure. He said it’s difficult to diagnose tooth fracture in root and we can go only by guess.
I have severe sore pain since this crown placed. Even for the temporary. Got the permanent yesterday and it’s very sore on that gum and tooth still. I don’t know if this is normal after the crown. Very sore and sometimes sharp pain. Dentist told me to watch out for 2 to 3 weeks. If it doesn’t help with jaw pain, he want me to extract that tooth.
I am taking carbamazepine half a tablet. It’s been a week now. It just gives some itchiness after taking the medicine. No rashes. Dr asked me to stop the medicine if itchiness increases.
I really don’t want to pull this tooth out. It’s been 6 months since this started. I am going to dentist since june. No solution yet. It’s like nothing been ruled out in my case. Everything is like possible from every provider and no one is certain though. I really want someone to order ct scan to check this out. I didn’t try tmj treatment yet. Don’t know if that will help me or not.
Really this group and you people are so amazing. @Isaiah_40_31, @Jules, @Snapple2020. Thanks a lot. What would you do if you were me in this case?
Thanks @Snapple2020. Yes I am going to ask my PCP about ct scan. She is the one who always refuse to do unnecessary imaging. So it will be difficult though. But I am not going to give up. Will ask her that I need that. I haven’t talked to any provider aggressively before. I will be very polite and calm during my visit all the time.
I am going in circles, yeah. Nothing helps.
I don’t know why my dentist say like that. He is the one who said we can try crown and see if it helps. He immediately said yesterday that to see for 2 weeks. If it doesn’t improve , we can remove the tooth. It’s not tmj or anything, don’t waste Money on tmj treatment. Get your tooth extracted and see if it helps. He is not certain though about the fracture. He took CbcT scan for that tooth in June. He suspect a minor fracture in that tooth root. It’s not visible in
x-ray . So, I don’t know if the tooth root fracture is like this and not easily diagnosable. I have been doing unnecessary dental procedure since June. Upper Wisdom tooth extraction, root canal, crown. Nothing works. Don’t want to pull the tooth unnecessarily. implant costs are pretty expensive. If that extraction is the only solution, I would have done immediately. If there is no certain answer, it makes me very confusing. Don’t know what to do next. It’s paining though everyday. After this crown work, that tooth area is hurting a lot too. Previously , it wasn’t. Only the lower jaw and neck. Now that tooth and gum as well.
My CBCT showed segmented but CT of neck showed otherwise. In the end on surgery it was all connected. Even CT of neck is only slices of neck and software interprets what is between. There are limitations to all radiology and an expert in reading them for ES is critical.
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Dentist sounds like he is grasping at straws trying to figure it out. Not an expert. Many of us have been thru the dental and root canal stuff. Im heading in tomorrow for yet another cap and suspect another root canal. I have TN and TMJ. If its been root canaled, why extract unless it is decayed?
I dont think jaw and neck is from fracture. Just doesnt fit. Many of us have walked this path. Hang in there. keep pushing for Ct scan of neck.
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Thank you @Snapple2020.
My tooth is not decayed. Not even a mild cavity on that tooth. It’s completely healthy and normal. Endodontist first told me to try crown as she saw some crack lines on that tooth. But during the evaluation, I felt sensitivity to cold and bite on one spot on that tooth. So she recommended root canal. I would have postponed this root canal. But I was scared if that tooth root fracture will cause more issue if not treated.
Even after root canal, the same symptoms. My Endo doesn’t want me to extract the tooth. My dentist want me to extract the tooth ad he suspect a tooth root fracture. Looks like it’s difficult to diagnose tooth root fracture. It’s below the gum lines.
I don’t know if I did this rct unnecessarily. I hope it is unnecessary. After the rct, the Endo said she couldn’t see any fracture after she open the tooth. But dentist is suspecting a minor fracture in tooth root from Cbct. Don’t know if I can trust my dentist and do the extraction. Already, I have trusted him and did this rct and crown. Feel bad that I am doing unnecessary things for the healthy tooth. Not sure about this fracture thing. This is very frustrating. I contacted many dentist and none of them are sure about the diagnosis.
Well, I understand your dilemma. I would tend to lean on the opinion of endo due to their higher level of expertise and the fact they are in there and looking closely for other issues. Id get 2nd opinion before extraction from another dentist at minimum.
I’m heading into dentist this am for another prep for crown. This upper molar is driving me bat %#%# and it is nerve related. The two next to it have been root canal. In the past, I have had root canals to make this stuff go away. Its been over 10 years since last one. I’m leaning in that direction again however I have an appt with a leading TMJ/TMJD specialist in Seattle on Dec 3rd, the day I fly out for my 2nd ES surgery on other side from this problem tooth.
Thus very well could be TN stuff but I have been having a series of injections in jaw,etc and this thing is just not going away. I know I have osteoarthritis in jaw. I will see what TMJ specialist says. I know he sometimes flushes TMJ joint with certain solutions. I may consider having a gamma knife type nerve killing to stop this nerve pain. This specialist was highly recommended by another person here after going to local oral health center who essentially sticks to traditional treatment such as appliances,etc. I went to that same center and found them useless. they were the ones who didnt bother to bring up the calcified ligaments on CBCT 5 years ago or did they think when I brought up eagles, would it cause the neck/ear pain. This is a major university setting! Getting to the right doctors and getting correct diagnostic testing is crucial. In your case, you need a CT scan of neck. Keep focused on that and dont give up.
I will share my findings with this new TMJ specialist and maybe it will help. Until then I will keep plugging along pursuing every avenue. That includes moving on to new docs if I need to. Listen to your gut.
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New,
I learned a few things from this dentist visit this am. Ive been complaining about this tooth and nerve pain since summer. They took an xray and didnt see anything wrong back then. This is 3rd molar from back on upper left. The back 2 have root canals. Because I just had one crown redone (from partial to full) due to decay under crown, I asked him to take a look again and consider starting on this side as it was getting worse.
As it turns out, the one with a root canal and partial crown was showing new signs of decay coming out. This in a matter of months. We went ahead with starting on this one. Dentist said the problem with this tooth was referring to adjacent tooth that I was having the nerve pain at. The tooth we prepped for crown did end up having a small fracture on the edge of partial crown. It could not be seen on xay because gold crown blocking it. This is where decay had worked in and working out to gum. When biting down on this partial crown, it was causing too much flex at the fracture and affecting adjacent teeth. So no it wasnt all in my head I was having pain! 
He mentioned before starting, Im curious what Jules say about this, that trigeminal nerve issues in teeth usually present in lower molars. He didnt think mine on upper was TN. As it turns out it wasnt but well see in a couples weeks after I get permanent one and this all calms down.
He mentioned how endodontists have mega microscopic cameras and can see so much detail. This is why I wonder if your dentist says you may have a root fracture, why endo could not see something like this with their high powered cameras? I would talk more to your endo.
It is possible you have an adjacent tooth causing this pain for you? Just a thought.
Moral to story for me? after spending $$$$ over the years…don’t ever get a partial crown on any molars. I guess this is an old style of dentistry to try and save as much of original enamel as possible. As you get older, the tooth that is exposed just starts to decay and fracture with age. So you end up paying for 2 crowns instead of one. Ive got a few more of these to do at start of year. AT least I am learning what the problem is and try and be proactive to fix before it gets so bad.
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Thank you so much @Snapple2020.
I am so glad that your dental appointment went well and you got some proper diagnosis.
Talking about molar root canal, are you talking about wisdom tooth? You didn’t remove it?
Did you do get the crown for upper or lower tooth today?
And you see the fracture in that same tooth? How did they diagnose the fracture if it’s not visible on x-ray? Did they take cbct scan?
So, have you been told to extract this fracture tooth? Did you have pain or any symptoms on that tooth before?
So, what are the dental diagnosis you got today? Does it gives you nerve pain? You have TN? So, is the pain from your tooth or TN?
In my case, I did talk to my Endo. She didn’t take a cbct scan though. My dentist did and he suspect a tooth root fracture from that scan only. But the Endo didn’t take one. She said , she rely on clinical findings only. She said she didn’t see any fracture when she open the tooth. She said I have crack lines on my tooth and crown would help. I don’t know if I did this rct unnecessarily.
She told me that I need rct since they tooth is sensitive to cold and bite on one spot in that tooth. It hurts to bite down on one spot during bite test. She said I can do RCT and I went for it. I even discussed with my Endo and dentist before crown. Dentist want me to do extraction as I have same lower jaw pain and neck pain. Endo said , she would not recommend extraction and said crown would help.
But the only issue is, Endo didn’t take or see my cbct scan .my dentist took one and he suspect tooth fracture from that scan only. I don’t know if endo is missing it. She told me to come back to her office if I need one cbct. But she also said that , that cbct won’t show up anything and I mostly rely on clinical findings. Even if it shows anything, I would not extract it. So don’t waste your money for another cbct scan. This was her reply.
So , I went ahead with crown. It’s been 2 days after permanent crown and I feel so sore and it hurts still. Hope it will resolve sooner. He want me to wait for 3 weeks and then extract it.
I am not sure about adjacent tooth. Yesterday the dentist staff told me that I have cavity on upper right tooth and want me to come back for filling. It’s on tht same side. Other than that, they didn’t mention anything about other tooth.
Since 2 weeks after this crown work started , I feel some sore and burning pain in the lower jaw near the premolars tooth area. Exactly under my mouth. I am not sure if this is because of any tooth or this crown. I have this sore pain since 2 weeks.
I don’t know if I should extract and see if it helps. I don’t know whom to trust…endo or dentist.
Are you extracting your fractured tooth? How did they diagnose and what’s the treatment? Is that fracture tooth is your today visit for?
No, not wisdom tooth. I had all those taken out when I was about 20.
I got crown on upper molar, 2nd from the back. It was the 3rd from back (cuspid) that was giving me nerve pain mostly above the tooth deep in the gum. Dentist does not think this is TN causing pain although I do know I have TN and TMJ. Ill know for sure in a couple weeks once this all calms down. Im still pretty numb and starting to defrost.
It makes sense that your tooth sensitivity to cold, etc would require a Rct. I just dont think a tooth would cause jaw and neck pain…that really is more in the ES symptoms.
I do not need to extract fractured tooth because of where the fracture was located. He took off old partial crown and ground down all the bad areas of decay and fracture area - it looks kinda like a stub. He then did what they call a “build-up” which is prep for crown. They put a new and full crown over the top of the build up. They found the small fracture when they removed the partial crown. Didn’t know it was there until they opened it up. We decided to go with this tooth today because of worsening pain and also seeing new decay forming at gum line. We were supposed to do a different one today. The plan changed.
This fracture was on a tooth that had a root canal. That fracture and decay caused pain in tooth next to it.
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Hi Newuserhere,
Yes, more than one piece of styloid or styloid & partially calcified stylohyoid ligament (which also looks like more than one piece of styloid) are considered ES especially when ES symptoms are present.
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Thank you @Snapple2020.
So, you had work done in the cuspid next to the molar.
I am glad that your fracture was visible and they repaired it with the crown. I don’t know if my crown is partial or full crown. Poor me. I didn’t ask that at all.
When you say nerve pain down the gum line. What was that mean? Does it indicates cavity or fracture or TN?
Because, I have pain in the lower jaw right side deep down the gum. In the lower jaw line. One near the tooth #30 which I had rct and crown. And another under my mouth. It’s very sore and sometimes sharp like pain in the jaw line deep down the gum. I don’t know why.
Does it indicate fracture? Both the pain started since this core build up work and temporary crown done. Even after permanent crown, I feel the same pain.
In the another tooth under the mouth too. It hurts to touch the spot under the mouth and have a blister there. Like a pimple/heat blister and paining a lot. Bruised a little. I thought as swelling. But it’s same since last 2 weeks. So guess it should be bruised.
Not sure if this sore pain in the jaw line is because of that. It’s very sore constantly. Don’t know if any issues in these front teeth. Very sore in that tooth #30 area as well.
New decay forming at gum line means the cavity under your partial crown??
So, your TN doesn’t cause any pain in any of the tooth?
How was the pain next to that tooth? Was it sore? I have constant sore pain in the jaw line under the mouth. It’s very sore and hurts . Don’t know if it’s because of that blister or the tooth. It’s the same sore pain in the gum where I had crown this week.
Thank you @Isaiah_40_31. I am still trying to get a proper video of my cbct scan. I got my annual scheduled with my PCP on December 2nd week. That’s the earliest available. Before that I am preparing myself to learn more about it.
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Hello new.
You should be able to look at your tooth (teeth) and see if it is a partial crown (only covering a portion of tooth). My molars are all gold partial crowns instead of ceramic so it is easy to see. Yes, new decay on gum line was from decay in tooth (under partial crown) that was working its way out and spreading. It got in there from the fracture on edge of crown.
It was a molar that had RC and partial crown they repaired. Dentist says that was causing pain in the cuspid (referred pain). It was nerve pain that felt like it was in gums above tooth. It was achy and irritating nervey like. Kinda hard to describe.
Well your pix helps alot. I can only share a possibility based on my experience. I had a front lower tooth rc because it broke off in back.(this was long time ago). After RCT and fix, it started to swell and was painful. It turns out there was an abcess in the root and infection. I wonder if you have something like that going on? This all developed after root canal?
Im not a doctor or dentist but I was given antibiotics to take care of this. I cannot remember if they had to open it up again, and clean it out in addition. It has just been too many years. I have not forgot the pain though.
If this is worsening, it might be worth another CBCT or xray to see if something is brewing in there. I dont know if this hurts or helps.
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Thank you @Snapple2020. I somehow missed the notification for this reply and didn’t see it.
Thanks for your inputs. I don’t think I have abscess. Dentist took an x-ray after the permanent crown placement and didn’t say anything about it. I did go back to my dentist last week since I have same sore pain in the tooth and gum and all the lower jaw line.
He did some bite adjustments as I felt the upper and lower molars that side hit so hard and tight. I felt so tight and stiff. But he said, no marks found with bite paper. He then adjusted upper molar too a little.
He is so concerned this time and wondering why no changes in my symptoms after the permanent crown. So he asked me to consider extraction and see if it helps. He suspect there might be a fracture and want me to go back to Endodontist for the confirmation. It’s like going round and round. Very frustrating. Endo didn’t suggest extraction earlier and asked me to go for crown. So have to go back to him and ask about the fracture.
I didn’t schedule mri with and without contrast yet. Neurologist said, don’t do any surgical procedure before checking / trying this nerve medicine and mri.
Dentist said, try this extraction before you do any medical tests. You can try extraction and see if it helps. If it doesn’t, you can check other things. This was his statement. I am so confused and tired. Don’t know how to proceed with. It’s constant burning pain in the jaw under ear and neck. Exactly one spot under the ear is hurting and hurts to touch.
Does antibiotics after rct helps in your case? I visited my Endo in September after the rct. He prescribed antibiotics for a week that time since he said I have some inflammation and that tooth hurts while tapping. I got the antibiotics. Took it for 2 days and it gave me Stomach upset. So I stopped it.
My dentist did tapping on that tooth last week. I have the same pain and discomfort, tenderness on that tooth while tapping. What does it Indicate? I don’t know if that full course of antibiotics dosage would have helped if I have taken fully. I am planning to see the Endo again. Don’t know what he is going to say. He didn’t see my cbct yet. So will request him to see the cbct to get the diagnosis. Don’t want to keep going round and round.
My dentist referred me to micro neuro dentist who is an oral surgeon. He said to check with them if any nerve injury or any nerve issues. He said, their office will send patients to him if they suspect nerve pain. Since I have burning pain, the Dentist said I can consult with him once. I did see an neurologist MD before. He ordered MRI brain. I didn’t go for it yet. Don’t know if this micro neuro dentist visit will help.
Hi Newuserhere,
Nerve irritation can cause inflammation but so can infection. A round of antibiotics would help rule out infection that might be hidden, but I would think it would have gotten much worse by now if it was an infection. Please let your doctor know the antibiotic prescribed upset your stomach. A different one should work just as well & might not cause the stomach problem. Also, taking the antibiotic when your stomach is full can help.
If your problem is strictly a nerve problem, the antibiotic won’t change anything but the nerve pain medication should help. If it itsn’t working yet, talk to your doctor about slightly increasing the dose or ask about taking it more often.
Keep pushing for the CT scan of your neck to look at your styloids & stylohyoid ligaments. That will be your best chance at seeing if ES is at fault for your pain or not.
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Thank you @Isaiah_40_31.
I am taking nerve medicine half tablet of 200mg on and off for last 3 weeks. I didn’t take it continuously. I will try that continuously for few weeks and see if it helps. The pain is worse, so I take it on and off. Some days I take ibuprofen and skip the nerve medicine.
I will ask the Endodontist about other antibiotics. I don’t know if I should extract the tooth and see if it helps. I have to rule out eagles and TN before that. But dentist say, eliminating tooth is easy, so try that out first.
I didn’t get anyone yet to give an order for neck CT. I have to ask my PCP during my physical next week. I don’t have much hope on her as she always neglects.
Any idea how long does it take for nerve inflammation to calm down?
Last time when I saw my Endo for a follow-up after RCT, he tapped on that tooth and it hurts. So he said inflammation has to come down. So, take antibiotics (penicillin vk) for 7 days 4 tablets a day. I took it for 2 days and it hurts my stomach. So I stopped and didn’t inform him about it.
Going back to Endo today to check the tooth. I feel like going in rounds for this issue. I really going to request him to give the proper diagnosis this time if the tooth is causing my pain. I have been to his office many times for this issue and Everytime he say tmj is the reason. I don’t know what I am missing.
Is it advised to do extraction or take mri, CT to rule out TN, eagles before extraction?
I agree with Isaiah,
Taking the full round of antibiotics could have addressed any potential infection. Some nerve medications need to be taken regularly and could take up to 2-3 weeks to kick in fully. Taking medications as directed is important to get good results so you can determine how to move forward. I suggest revisiting antibiotics and tell the doc they upset stomach so he can give rx for something else. Perhaps combined with a round of steroids to get inflammation down?
I think we all have suggested to push to get CT scan to rule out ES before extraction.
Its been 3 weeks since I had dental work and yesterday had permanent crown seated. It has not made a difference in my nerve pain and I think the dental work inflamed my TMJ. I am seeing a TMJ specialist Thursday to explore the cause.
Here is a link I posted on another thread:
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Thank you @Snapple2020.
I do agree that antibiotics has to be taken as directed to see some improvement.
I have taken antibiotics for a week in may, June , July and steroid pack in July for this issue.
Endo prescribed 4 times a day antibiotics for 7 days in September last week. I took it for 2 days and it gave stomach upset. Then I stopped. I took it again last week one tablet a day for 3 days just to see if it hurts my stomach and it gives diarrhea after 3rd day. So stopped again. I am scared to take more antibiotics as it becomes bacteria resistant.
I will ask the Endo if I need any antibiotics or steroid pack. I do feel that I have inflammation as I have pain and tenderness in that tooth while biting and tapping. I am taking the nerve medicine as well.
I don’t know if too much of antibiotics hurts our stomach in the long run? I took for 3 days 3 tablets last week. I really need some relief from this. Been going in rounds and frustrated.
I am going to Endo today to rule out this tooth issue. If he say I need to extract, I can proceed further with that. Going to request him to take a look at my tooth cbct scan. I have to take mri and ct as well. Don’t know which one I can do first. Hope pcp can order me ct scan. Pcp got the visit summary from the ent and it says bilateral styloids normal. He saw my tmj cbct scan and sent this summary to my PCP.
I don’t know if pcp will agree for further ct scan. I have been calling around few ent office who can see eagles patients or diagnosis.
I am wondering if this is from the tooth or eagles or tmjd or TN. I have been to tmj specialist and he said it’s muscular. Everyone say it’s a possibility of that particular issue and not certain though. So difficult to move further. Going around doctor offices since may.
