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Lingering Toothache – Is It A Sprained Ligament?

Author: Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain

Date: May 1, 2014

Fortunately for those of us who have experienced a lingering toothache, relief typically follows a visit to the dentist. Whether a filling, a crown (cap) or root canal therapy was necessary, pain reduction is common within 24-48 hours. But when a toothache won’t go away in spite of the fact that the tooth pulp is healthy based on examination and x- ray investigation, believe it or not, it may be due to a sprained ligament.

To understand how a toothache can be the result of a sprained ligament, a quick review off the anatomy of a tooth is essential:

Every tooth in the mouth is anchored to the bone in which it sits by a structure called the periodontal ligament or PDL. This ligament is no different than any other ligament in the body, and when healthy, is responsible for maintaining the tooth in a stable position. This ligament, which is mainly composed of water, also acts as a shock absorber. The PDL is teeming with nerve endings, which gives it a great capacity to guide our chewing movements and tell the brain how much force to exert based upon the consistency of food in the mouth.

In addition, the PDL is the “GPS system” of the oral cavity and is so fine-tuned in its functioning that it can find a small fish bone in the midst of a mouthful of food. This capability helps protect the teeth and the surrounding soft tissues from injury that could otherwise occur during normal function.

  • Tooth pain is typically the first symptom of a PDL sprain. Common ways that sprains happen are:
  • Biting on food that is harder than anticipated
  • Impact from an expanding airbag
  • Chin trauma that forced the teeth together
  • An accidental collision with a baby’s head
  • Dental or oral surgery
  • Daytime overuse such as nail biting or pencil chewing
  • Nighttime clenching or tooth grinding (bruxism)

Once sprained, these ligaments may take some time to heal simply because it is difficult, if not impossible, to avoid using the tooth or teeth involved during chewing, speaking, and even at times, swallowing. Over time if the PDL is continually insulted, the tiny nerve endings in the ligament will become sensitized (similar to being sunburned) and as a result pain levels will increase and often spread to the surrounding gum tissue and neighboring teeth. And, if daytime overuse behaviors continue and/or sleep bruxism persists, the pain will likely continue.

Because this problem is not in the tooth pulp, or due to compromise of hard tooth structure, any dental efforts to fix the problem will likely lead to even more exacerbation of the pain. Like all ligaments if a sprain occurs, rest and support are often needed in order for healing to occur.

The key therefore is to identify why the sprain occurred before treatment is planned. If due to a single and identifiable event, time is the best therapy as healing will usually occur. Taking an anti-inflammatory medication like Advil or Aleve for five to seven days can also help along with avoidance of chewing on the painful tooth. If you suspect that night clenching or grinding of the teeth is the cause, then the use of an oral appliance  while sleeping may be the best remedy.

At times trauma to a tooth may cause ligament pain that lingers and becomes chronic due to nerve endings that begin to fire spontaneously even when provoked by normal daily activities like speaking, swallowing and eating even soft foods. These situations may  require medications that work to quiet irritable nerve endings. The most important thing to remember is that these problems are not solved by root canal therapy and this direction of care should be avoided.

Live or work in New York City or on Long Island? You can schedule a consultation with me here or call 212-265-0110

DISCLAIMER: The advice offered in response to your questions is intended to be informational only and generic in nature. Namely, we in no way offer a definitive diagnosis or specific treatment recommendation for your particular situation. Our intent is solely educational and our responses to your actual questions serve as a springboard to discussion of a variety of dental topics that come up in a day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified professional.

40 replies on “Lingering Toothache – Is It A Sprained Ligament?”

Thank you so much! I have a gold crown and a couple months ago I was under a lot of stress and my jaw tightened up. I woke up with my teethe clenched. My tooth hurt terribly. Even taking a breath in hurt it. The tooth above the sore tooth also has a gold crown but I had a root canal in that tooth years ago so it was not painful from clenching. Anyhow, I don’t normally clench and have worked with a physical therapist and have jaw therapy I do before going to bed if I feel like my jaw is tight. I have clenched some here and there since the original injury and the tooth will have some pain but not near as bad as the first time. It still feels like the crown is too tight though. My dentist has talked about a root canal if it doesn’t get better. I don’t want another root canal. I’ve read they are terrible for your health. Again Thank you for the clear explanation. I take very good care of my teethe and had just had them checked and feel sure it is not infected. My dentist agrees and feels sure I “sprained” it.

I was currently diagnosed with “:=Bruised tooth syndrome” My dentist made an adjustment correct my bite. This was 10 days ago. Although the pain has subsided substantially, I still have some pain and still cannot chew medium type foods (not soft or hard) The ligment under this tooth is still swollen all the way down to my jaw. My question is, how loing will rhis take to heal on its own? My dentist said about a week but, it’s been 10 days.

Hi Toml

These problems are stubborn, and in my experience, can sometimes take upwards of a month to get better.

Good luck and feel better,

Dr. Tanenbaum

I had a RCT 3 weeks ago and since then it feels bruised and aching the whole time. Sore, painful and a deep severe ache. The endo has checked the X-rays and done a CBCT which are clear completely. Could ligament and tissue inflammation cause issues like this sort of pain to linger for weeks after a major RCT?
Thankyou

Dear Samuel, Yes, the ligament may well be irritated and it may take weeks to months to settle down. Best of luck, Dr. T.

A month ago I bit into some burnt French fries and a hamburger. I felt a pain in my lower front tooth. Number 24. I went to the dentist who first thought I needed a root canal, then after a CT Scan, said I could have a possible crack in the bone. After several weeks, I went to an endodontist for another opinion. He at first said I did need a root canal, but after further tests,said I have 60 percent life in the tooth, so should perhaps get another opinion. We agreed to wait a month to see what happens. The pain seemed to get better, but recently has been achy again. More so after eating. I don’t know what to do.

Discuss with your dentist: perhaps anti-inflammatory medications and if pain persists, a 1/2mm vacuform appliance worn during the day may help.

Good luck!

Dr. Tanenbaum

I have a crown on #8 (No RCT, vital pulp) and 3 weeks ago i hit it accidentally hit it pretty hard with a glass drinking glass. I did a cone beam scan and the tooth doesn’t had a root fracture or any physical damage to the crown or core. I have had lingering dull pain around the gum line that is irritated if I try to use the tooth. I guess “itchy” would be a good description. I am suspect of the PDL being the culprit, but i am getting somewhat discouraged after 3 weeks of lingering pain. What else could be going on here?

Remember, the PDL is teaming with sensory nerve endings so that along with inflammation, there could be some neuropathic sensitization that causes the lingering symptoms. I would ask your dentist about medications such as nortriptyline that could be helpful. Thanks for reading, Dr. T.

Hello,
My dull ache pain started in Dec 2021 on the upper right side tooth #2 or 3. I felt it was due because i have been eating solely on that side since April 2021 when tooth 14 & 15 on opposite side got root canals. Since those teeth got root canal they have always hurt me, fast forward to now (may 2022) both of those teeth have been extracted and im strictly eating on my right side. I have seen two endos and both said no RC is needed. The PDL has widened around both tooth 2 and 3, but 3 looks like theres widening in the furcation area. I have invested in a bite stabilizer or splint since march 2022 and it still bothers me! I have gotten my bite adjusted several times . help! what can i do? I have been eating soft foods for several months now. what are my options? how can i heal or fix this? I would say ive given it a solid 3 months to heal and no relief. would i need to extract the tooth? I have done CBCT scan and no infection or RC is needed. The only thing i can think of is possible hairline fracture, but not enough to hurt when biting or chewing and not enough to wake me up at night. please help. Im scared if i remove these two molars im really going to have issues since then all my upper molars would be missing. Thank you Jenn

This sounds as if it could be the ligaments in the extracted teeth and now the sensitive teeth are giving rise to your pain. Not an easy problem as you can see. There may be some medications that can help, but you would need to consult with someone with training in these difficult orofacial pain problems. Go to the American Academy of Orofacial Pain website to find a doctor in your area. Look for one who has the designation: Diplomate. Best of luck!

Hello! Have been searching for an article like this and see from above I’m not alone… which is nice. My story with this type of tooth pain starts back in April of 2020. The pain started as a dull, almost itchy/burning ache in my front lower teeth and gums. Mainly front (#25, 24 but also affects 27, 26, 23, 22 as well). I could also feel pain in my chin below said teeth that would come and go. Almost like a bruise healing. After the pain started to get worse, I went to my dentist. Initial x-rays and visit showed that I needed a RTC on #25 (previously had an RTC on #24 back in Jan of 2019). I had the RTC done and the pain was still present even after healing from RTC procedure. I went back to the endo for follow up and they suggested to re-do RTC on #24 from 2019 to make sure all was good. Had that procedure done…. still did not change.

After several more visits with the endo and then back to my dentist, they suggested to make a mouthguard that would buffer the contact in the front teeth as we talked about clenching/teeth grinding. This was also done as they removed a permanent retainer from when I had braces in my teen years. At this point, it’s October 2020. I continued to wear the guard for several months and the pain did subside with occasional relapses. In March of 2021, the pain returned and was once again chronic. I visited an endo as well as a periodontist to check my gums (all was good). The endo I visited did a full 360 x-ray to check for any hairline fractures that could be causing the pain but nothing was revealed.

At this point, I just continued to wear the guard at night and around June 0f 2021… the pain stopped with almost no relapses at all. It was as if it was fully healed. This lasted until about January 0f 2022 and it began to come back slowly and eventually back to original pain.

I went to a new dentist and they did a deep cleaning of my teeth and also did a scan to fit me for a new mouth guard that would only be on the top teeth as my original one was on both. After the deep cleaning, teeth felt better but still experienced pain. I then started to wear the new mouthguard and it proved to make things worse. Pain is now present in my back upper jaw as well when opening my mouth. I will be visiting my dentist for a follow up in a week here to discuss next steps, but will also visit the link you provided the last commenter above to find local members of the AAOP in my area. Apologies for the novel but figured I’d post here as the pain truly has been a terrible experience and would eventually like to get back to some normality.

Dear Martin, I’m sorry to read about your suffering. Without being able to examine you in person, I have to GUESS that what you’re experiencing is neuropathic pain because it emerges episodically and then lingers persistently in your tooth structures, such as the periodontal ligament or supporting bone. These are not easy problems to solve, as you have discovered. It MAY relate to the overall functioning of your neuroimmune system influenced by a wide array of factors, leading to lower pain thresholds and the experience of pain. Solutions MIGHT be found with medications. In some cases, this type of pain abates and/or disappears for no apparent reason. In the meantime, look for an AAOP Diplomate for insights and strategies. If you can’t find a provider close by, know that many orofacial pain specialists now see patients through telemedicine. So, don’t give up! Best of luck, Dr. T.

Hi there, thank you for writing this article. I am hoping that this is an answer for what I have been experiencing. I underwent a lot of teeth reconstruction about ten months ago, having many teeth worn away (genetics, bruxism, decay) and subsequently replaced with crowns and bridges. In the last 6 weeks, I have been experiencing dull pain around some of the front teeth and sensitivity in the gums, however most startlingly is these odd sensations I get when eating or drinking, it feels like a bubble or clicking feeling, sometimes more of a light shock, and of course startles and stops me in my tracks me every time – especially when speaking to someone it can be quite distracting and sends me into a panic because I worry a crown is starting to come out.

The timeline of this coincides with an accidental slap to the mouth from my niece, which I felt more so on one tooth specifically. I took a visit to the dentist who x-rayed, examined and cleaned. She said all was fine but the feeling still persists and sensitivity has gotten worse (perhaps due to the cleaning?).

I would really appreciate your thoughts on this – hoping it has a simple explanation, particularly around the sensations mentioned. Thank you so much in advance.

Dear Laura, The odd sensations are transmitted from the tooth to your brain where interpretation and reaction occur, making you worry. The transmitting tissue might be the ligament that binds the tooth to the bone and is like a GPS system, guiding the brain and muscle on how hard to bite on food or avoid something…our protection system. If this is the case, it may take months for this to clear up. For some patients, a class of medications that are low-dose tricyclic antidepressants has been helpful. Best of luck, Dr. T.

I think that PDL sprain may have been causing my pain on a root canaled tooth. It took 3 months to settle somewhat. I don’t think putting a crown on it will help. I feel like messing with it more is going to make it worse. The biting and brushing pain has stopped, but it can still be senstive to cold. Can cold sensitivity be the only symptom of PDL damage? Endo and dentist say the root canal looks good.

Yes, once the PDL is in a fragile state cold or a variety of other provocations can bring on the pain. Give it more time. Good luck!

Three months ago I bit down on a chocolate bar that turned out was expired and thus harder/brittle. It snapped down onto my lower teeth. At that point it didn’t feel like any kind of sharp pain, but rather I would describe it like my PDL got impacted and squished. Though I’m not 100% sure how that is supposed to feel. I just assume that a root fracture or something would be painful in a different way. I’ve moved and am yet to find a dentist where I live and am still doing research on that, so I haven’t yet seen anyone about it. For the most part after the first week or so it has felt fine. However, I’ve been avoiding biting down with it or using those teeth to tear food off, as it was my understanding that things like that can take weeks to months to heal. Lately I’ve started testing it by biting down on things like tortilla chips to test. It feels better than before, but in using it I can sometimes feel a sort of dull ache intermittently in what feels like the root/ligament area of the tooth that was impacted the most, and a mild sensitivity to cold at times. Is this normal for a healing PDL? Is it possible that it’s something else? I know I should get on with getting things checked out, but in the meantime any thoughts here are helpful. Thanks 🙂

Hi Lara,

There is no clear timeframe for these things to get better. However, if your symptoms persist and become concerning, I recommend you go to this website the American Academy of Orofacial Pain see if there’s a doctor with “Diplomate” status in your area. Good luck!

Hello,
Thank you so much for this article, I feel like I am not alone. In June, I was scheduled for a cavity filling in #2 and a root canal in #31. The night before my appointment, I bit into a cracker and felt a sharp shooting pain in #2, and just thought it was because of the cavity. I think now I must have bruised the tooth?

During the appt, I was unable to be numbed in #2 after multiple rounds of novocaine. It was painful and challenging. The cavity was filled that day but the root canal pushed back to the following week and completed. Since then, I have had off and on swelling, pain, numbness in the surrounding area of #2, roof of mouth, right side of tongue, ear, chin, mouth, knotting of muscles in jaw, and pain in #31. The bite was adjusted on #2 and seemed to help. All pain returned again. More consultations and x-rays, root canal on #31 was clear.

CT scan found an infection in an old root canal with a screw (20 years ago) in #3 which had spread to bone. No pain or symptoms in this tooth. All heat/cold/tapping on #2 proved inconclusive with no infection, but the “filling is close to the nerve and I may need RCT”.

#3 extracted in October. I’m Day 8 into healing, and the original #2 pain has come back on Day 7 with all original mentioned pain and feels “higher” than others with sensitivity on bite. The pain feels like it is alternates between #2 and #31, with #2 having precedence. I can pinpoint a spot with my tongue near the back insert point of tooth into the gum where it feels it is generating from. I’ve had so many procedures (plus a cleaning thrown in there too), I imagine the tooth is exhausted. The pain feels more around the tooth than in it, although I would describe it as a “pressure” like someone was squeezing the inside of the tooth, almost like you would feel someone constantly holding the tip of your index finger or big toe with variations in pain and referred areas.

Could this returning pain be PDL in #2 and the extraction is now making it worse again? Or would this signify finally a root canal needed? Does continued flaring of PDL mean it has gone past the point of self healing? Or on Day 7, after 3 months of procedures, can this be relatively expected and I should just try to relax and heal? I’m on antibiotics and NSAIDs. Would steroids help? There is a dark brown stain on #2 that is now visible since #3 was removed. Would this be trauma, or just buildup that was in-between those teeth?

I see the periodontist next week and have left a message for my dentist, but would be nice to have another opinion as all answers to this point are vague and I’m still in pain. Maybe I just need time. I don’t want another RCT.

Thanks for your time listening to my lengthy message and to help everyone, its really difficult to manage the pain and nice to know you take the time to listen.

Hi Eileen,

Unquestionably you have experienced a very difficult scenario with pain likely having multiple sources at this point in time. There may well be teeth that are compromised and require treatment. However, it must be remembered that adjacent to teeth are complex nerve networks that not only can be pain producers to a tooth site but to other tissues that are adjacent. In addition, pain can be referred to innocent structures, and muscles can be recruited into the story creating tension and additional sources of pain. The periodontal ligament as I have written about can also be part of the story and difficult to treat. You may want to look for an orofacial pain specialist in your area to get a broad perspective on your situation. Click here for the American Academy of Orofacial Pain’s directory and search by area. Look for a doctor with “Diplomate” status. Good luck.

Dr. Tanenbaum

Hi,
I had a root canal treatment a month and half ago to the lower first molar. I do not have sensitivity to hot or cold foods but I feel some kind of grabbing pain on pressure with a finger or tongue. I visited the dentist last week and she told me that the pdl seems to have widened. Root canal is perfect with no periapical lesion or signs of fracture. She asked me to wear splints at night. I am not sure if I clench my teeth at night but I started using those. They give me a wierd feeling until I eat my first meal. The grabbing pain seems to be more intense in the night. I stopped chewing food on the right side to give some rest. As for the history— I had a deep fissure on the lower first molar in 2018 and the inexperienced dentist did a faulty class 2 composite restoration. Since then I had pain when chewing hard foods. But was not sensitive to pressure or tender. I ignored and stopped eating on that side for 5 years. When I went down to the dentist last month in 2023, he said there seems to be little pdl widening and periapical lesion. He performed RCT and had to do crown legthening and placed crown subgingivally. None of my other teeth have pdl widening or cusp attrition except this one. Will the pdl get back to normal soon? Will I get to eat foods normally?

Without doing a clinical examination, or looking at x-rays, making a definitive diagnosis is difficult. One possibility is that this molar tooth may have been compromised for years and it could be why you avoided chewing on that side. Small internal fractures in teeth that are not seen on x-rays can create a widened PDL and treatment like a necessary root canal in some patients create more internal compromises that may lead to your current scenario. The ligament may be functioning at a low threshold and which could make any contact prompt the symptoms you were describing. Your dentist will provide the best advice. Good luck and thanks for reading!

Dr. T.

Thank you for looking into my question. Its been 3 months, I see a bit difference now. Not that much pain on the first bite but the tooth is still sensitive to pressure specially on the distal and center. I went to the dentist twice, she keeps correcting saying there is a probable high point. On comparing the radiographs for PDL widening, it improved on the mesial root while it seems to be still widened on the distal root and furcation. But when we see it clinically, the tooth is below the occlusal line or bite. I dont think there is a possibility for high point. She says there are no issues with the crown or root canal and no visible fractures. What happens if I keep chewing like this for a while despite of the problem? Will the tooth need to be removed and replaced with implant in the future? I am worried that no one is properly able to diagnose the situation.

Unfortunately, I don’t see an oro facial american board diplomate in the state I reside Nebraska.

Dear Monu,

I checked the directory as well. And, indeed, there are no orofacial pain specialists in Nebraska. You may want to check neighboring states. If that doesn’t work,
you might be able to get help from a neurologist. Look for one that specializes in headaches, if possible.

Best of luck!

Dr. Tanenbaum

Hi doctor,
I bit down hard on an olive pit, and my tooth suddenly became a little bit wobbly. It’s been 10 days now, the gum no longer is sore, but tooth still hasn’t firmed up. Is this normal?

Dear Johnny,

The best advice I can give you is to see a dentist as soon as possible. Good luck!

Dr. Tanenbaum

Hello! I found this post while researching my dental issue- thank you for posting.

I have been having quite a bit of pain around a crown lately that has always felt a bit weird from time to time. Recently, I noticed the tooth seemed loose and went in today to have it looked at by a new dentist. The tooth had originally had a root canal before the crown was put on. The tooth on the other side has a filling that is starting to leak that I will be getting repaired soon. I’m not sure what numbers they are but they are front- the one next to the canine (the crown) and the left immediate front tooth next to it are the ones I am referring to. Anyway, they took x-rays and said that he didn’t see any lesions in the root area nor could see anything that was obvious but did note that the ligaments have widened and asked if I had knocked into the tooth lately. I don’t recall specifically but it’s very possible. He also noted that I had some periodontal disease symptoms- which I had noted quite a bit of blood when I tried to floss around the crown. Some of the other teeth bleed but this one bleeds quite a bit lately.

For now, he wants me to “baby” the tooth and give it a few weeks to see if it heals on it’s own and we will do a cleaning but he didn’t have an appt. that works with my schedule for a month out. In the meantime, I have noticed that sometimes when I speak or eat a certain way, I have “bumped” that tooth and it sends a sharp pain through it. (It didn’t do this before) He also said he doesn’t think the tooth will come out on it’s own but I am about to start a new job (of course) and the worry along with the intense pain that I am feeling is not giving me a lot of confidence in this wait and see scenario. I can basically feel my heart beat pulsing through this tooth and it’s vey sensitive to cold foods/drinks. Ibuprofen and migraine meds (all I have in the house right now) are not helping the pain much so I may need a prescription.

My questions are: should I get a second opinion and another set of x-rays? I did see what he was talking about as far as the widening ligaments because we looked at them together…. but the severe pain and the fact that it’s mildly loose is freaking me out a little. I am afraid my crown will come off while I am at work etc. He said he was not wobbly enough to concern him but I am not as confident. I am tying to leave it alone of course

Secondly, I am afraid that I am going to keep bumping into it while speaking and chewing even though I am chewing on the other side. I also did feel some pain deep above it (like up far up under my lip)— could he have missed an infection on the x-ray? Or is this just part of the ligament pain from whatever trauma I may have caused?

Lastly, I don’t think he saw infection in the front tooth but did see the filling edges starting to get damaged- could this be causing the pain—like radiating and effecting this other tooth’s ligaments etc? Thank you!

– Christy

Dear Christy,

I’m sorry to hear that you’re having such problems. I recommend you get a second opinion.

Good luck!

Dr. Tanenbaum

Hello Dr. Tanenbaum,

I am very happy to have come across this article.

I recently had a root canal and crown placed on #15, my second to last molar on my upper right. As far as can be determined, the root canal took just fine, and I wasn’t experiencing any pain until placement of my permanent crown.

I do clench when I sleep to some extent, but it wasn’t until after a few weeks did I start experience dull pain on the crowned tooth. Specifically, when pressure was applied to the outside of the tooth, or if I were to grind and push so that pressure was being exerted upon the outside structure of the tooth.

My dentist is currently watching it, and has since taken x-rays to rule out infection, or a missed nerve in a failed RCT. As far as can be seen, all appears good, and there are no signs of swelling, redness, bad odor etc, just major sensitivity when chewing/eating, and most recently sensitivity to hot and cold.

It also must be noted that the mirrored molar on the opposite side of my mouth was extracted – I have no tooth there currently, and have had four adult teeth removed in my life, albeit I only have 23 teeth, and currently chew primarily on my right side, where the RCT and crown was placed.

Just today was the first I experienced any intolerable pain on that crowned tooth, feeling a steady heartbeat reverberating from the pain, and a shooting pain when drinking cold water, that radiated from the outside and up into my face/bone.

Sorry for the novel. Is what I’m experience likely periodontal ligament pain, or am I possibly facing a failed root canal? It feels specific to the outside of the crowned tooth, particularly even the front* outside quadrant of said tooth.

Flossing and brushing it is fine, but chewing on it depends on the day. Some days are fine, some cause a dull ache, and days where I’m eating something like chewy meat or harder foods resulted in extended, dull, aching pain.

My dentist is great, and is monitoring the tooth. He did adjust the crown, and drilled it down some, but this was just two days ago – I wonder if the occlusal on that crown wasn’t correct, and I bruised the ligament through repeated use?

Thank you very much for reading my concerns, I truly appreciate it.

Eavie D.

Eavie,

I’m sorry to hear about your troubles with your new crown. Because you were comfortable with the temporary but not with the permanent, you may want to discuss with your dentist putting a temporary back in and let it sit for about 3 mos. before replacing it with a permanent crown. Please note: Without me being able to examine you myself, my reply is simply a suggestion, not to be confused with a medical diagnosis or treatment plan.

Good luck!
Dr. T.

Hello, thank you for the information! Can I get your opinion on my situation? About three weeks ago I had an accident where I hit the bottom of my chin while lifting a box, that impact caused my mouth to close fairly quickly and as a result my mouth shut with some force. At first I did not feel any pain, I didn’t think anything of it, i did feel my teeth touch, particularly in the upper incisor area. Then after two days I started feeling this pain right around my top left central incisor #9. The pain is not sharp or stabbing in nature, it feels well above the gum line almost around the tooth instead of in the tooth, closer to my nose sometimes, it has this feeling like they just adjusted my braces after a visit, when I bite on it I do not feel any extra pain, if I tap on it I do not feel any extra pain, so far when I touch it with a cube of ice, it seems to respond like my other teeth and sensitivity does not linger around for more than a few seconds, tooth is not mobile. There is a very small surface chip almost more of a scratch on the rear of that tooth, I saw it with a mirror and the spot looks white and feels funny with my tongue, it is maybe 1mm in width, oval shaped, it might even simply be able to be polished out, it is definitely minimal in nature, that is about the only damage on that particular tooth, tooth color is the same, gum area does not look any different, no noticeable swelling, no bleeding. Pain as of right now is relatively the same since the pain started around March 1st, maybe a 3-5 out of a level 10 maximum, mostly minimal in nature, no increase in intensity, but no real relief either. I visited my general dentist one week after the impact and he said at that time he could not see anything unusual on the x ray, after visual examinations he says there are no immediate red flags, he told me to give it time and take it from there. On March 28 it is going to be one month since the impact with no real relief in sight, ibuprofen 600mg three times a day seems to help with the pain, but minimal relief for sure. The pain is not sharp, stabbing in nature, biting does not make it worse, the tooth is a little sensitive to cold, but not so much to heat, normal reaction to heat, it is a constant dull, achy type of pain that focuses mostly around the tooth well above the gum line, if I touch right around my nostril area I feel tenderness, slightest of pain, sometimes the pain even radiates to the maxillary sinus area on the left side. It sounds like a pdl sprain, bruised tooth, sprained tooth, but could this also be reversible or irreversible pulpitis in nature? Once in a while, not common, I get slight sensitivity that radiates toward the crown, but that is about the only sensitivity/pain that I feel on the tooth, it is mostly at the very top above the gum line in that dull, achy type of feeling, very similar pain that people describe when they have their braces tightened, no sharp pain, no stabbing pain, the pain does not wake me up at night, no real sensitivity to cold or heat, no extra pain when biting or tapping. Based on your experience, where can this pain be originating from? Also, when I do bite on it, which I try not to, there is some relief in pain, so if anything it gets better, but of course it does not, it simply lingers around. When I wake up in the morning, pain is less, but sometimes in that 4:00-8:00 time in the evening it increases a little bit, but then calms down before bedtime. Thank you for your time and information, I wish you were here in the Southern California area so I could pay you a visit, but thankfully I have found someone with diplomate status in Pasadena, Ca who i am hoping can help me out, Dr. Cebula with Pasadena orofacial pain associates. I appreciate your response and time, thank you.

Dear Alfred,

I’m sorry to hear about your troubles, but it looks like you may in good hands with the orofacial pain specialist you’ve found.
Best of luck!

Dr. Tanenbaum

Hello, it’s been almost 8 weeks now, overall things seem to be getting better, overall sensitivity and pain has gone down a notch, but pain is overall still in the 1-3 level, I visited my dentist after four weeks and he once again said no visible issues, he recommended to see a specialist of my choice for further examination. I guess I will simply give it more time and hope for the best.

I had a bad trauma to my mouth last April. Three teeth luxated. Splinted for about 6 weeks and then when splint came off the front two start tilted out of the bone. Horrible pain. We root canaled all three hit pain still persists. In August my periodontist did a gum flap procedure to fix what he said was damaged bone on my palate. My pain went through the roof after that procedure. Burning pain on the palate and bad pain now in all three teeth like someone is crushing them.

They put braces on me in October because they said the teeth being out of bone is causing the issues… They are in the process of tilting them back. My pain is terrible though. All day everyday. It feels like someone is crushing my three front teeth and burning behind them.

I’m considering pulling them all… But not sure if that will stop the pain. I just need some relief. I live in NJ and might come see you guys.

Could this be ligament pain? Bone pain? Teeth are all root canaled… When I chew the pain kind of gets better… So I chew gum all day long. It’s been so hard

Dear Lisa,

I’m sorry to hear about your suffering. It’s a complicated situation, for sure. You may want to talk to your current healthcare providers about the possibility of pain medication.
At this juncture, it would also be a good idea to see an orofacial pain specialist in your area. The American Board of Orofacial Pain has a directory that you can find by clicking this link: https://www.abop.net/search/custom.asp?id=2158

Best of luck and I hope you start feeling better soon,

Dr. Tanenbaum

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