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Question:
Non-Specific Tooth Pain: A few weeks ago, I caught myself bruxing in my sleep.
The next day, when drinking coffee, I experienced sharp sensitivity to heat in my lower right teeth. I went to the dentist the next day to have my teeth checked out.
So far I have seen five different dentists, including endodontists about the problem. Each examined, took x-rays, tested each tooth, checked for cracks, etc.
They could not find the problem in my teeth, even though they understand that I have pain from that area along with lymph node swelling. I was given muscle relaxants and a mouthguard.
I was told by the endodontists that they do not recommend performing endo therapy and that I should see a neurologist. What should I do? ...Visitor from OH
Answer:
It sounds like the dentists have done a thorough job of looking for problems. I am a little surprised that nobody suggested antibiotics for the lymph node swelling.
I would probably try an NTI appliance in your case, since nothing else seems to be helping you. The NTI is a small acryllic device that fits over your upper 4 front teeth, or one that fits over your lower front teeth.
The following is quoted from the inventor of this device, Dr. James Boyd:
The NTI is a tension suppression system that uses the body’s natural reflex protection when being used during waking hours. At night it prevents and reduces the muscular component of migraine, chronic headache and jaw disorders by preventing parafunctional contacting of the canine and molar teeth. It represents a major improvement over splints and night guards in treating and preventing clenching, grinding, bruxing, stiff neck, tooth sensitivity, tension headaches and TMD.
The device is a small, clear, taco shell-shaped appliance that fits over the upper two front teeth. Attached on the incisal edges of the taco shell is a bump or a bar that extends anteriorally and posteriorally to provide the point stop.
NTI stands for Nociceptive Trigeminal Inhibition. This is a technical way of saying the jaw opening is a reflex, and this device provides a way to suppress the elevating muscles of mastication.
I would recommend that you look for somebody who treats TMJ and also provides the NTI to see if this might be applicable for you. I would see this person before I saw a neurologist.
I don't know what kind of muscle relaxants you are taking, but would stay on them at least at bedtime for about 2 weeks to break the cycle of bruxing.
I will also suggest a non-narcotic drug combination of 2 extra strength Tylenol with 2 Advil at the same time every 4-6 hours as needed for pain relief. I don't know why this combination works, but it is very powerful for many of my TMJ patients.
Your pain to heat still makes me think of a developing endo problem. Pain to heat that is relieved by cold is a sure sign of a dying nerve in a tooth. Sometimes it is difficult to diagnose when pain is present, so it may take a little time to be able to tell if you need a root canal. If the problem is from the nerve of a tooth, antibiotics should take away the pain.
Hope this helps you.
Corinne Scalzitti, DMD, MAGD
Austin Reconstructive Implant Dentistry
3900 RR 620 South
Austin, Texas TX 78738
(512) 263-3330
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