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Persistent pain beyond sensitivityDear Dr. Reitz: I have several teeth in my mouth that are extremely sensitive. Not just to hot and cold, but even after I brush my teeth with toothpaste for sensitive teeth. These teeth almost ache; just like a headache but in my teeth. The pain goes away after an hour or so. One day it was so annoying I had to take an Advil. Is there anything I can put on my teeth to help with the sensitivity and pain? - Jan Dear Jan: Sensitive teeth can be very annoying and often difficult to diagnosis. Tooth pain that is temporary and initiated by cold, can often be diminished or eliminated using a toothpaste for sensitive teeth. The toothpaste works by sealing the pores in the roots, thereby eliminating the ability to conduct painful stimuli into the center of the tooth where the nerve resides. The process of desensitizing teeth with toothpaste can take months until complete relief is achieved. If you have been using toothpaste for sensitive teeth for more than a month, you should have already noticed a slight improvement. Pain lasting more than an hour that requires Advil sounds more severe than root sensitivity. It will be necessary to delineate the source of the pain, which may require a dentist's evaluation. Sometimes what feels like pain in upper teeth is actually originating from the sinus. Sinus pain is usually affected by pressure but not temperature. In addition, movement such as lying down in bed can intensify sinus pain. Another possible source of your pain is trauma from night grinding. If you grind your teeth while sleeping the teeth can become sensitive. Indications of night grinding include worn tooth surfaces and muscle soreness in the morning. An acrylic mouth splint fabricated by a dentist is the usual treatment for night grinding. When pain is severe enough to require medication the most likely cause is pulpitis of the nerve in the center of the tooth. When the nerve becomes infected or inflamed from decay or trauma it slowly dies and in the process elicits pain. Once the nerve begins to die the pulpitis cannot be stopped, your only remedy is to have endodontic treatment (root canal therapy) preformed on the offending tooth. Pulpitis and the subsequent death of the tooth can both be very painful. Since, it's very unusual for several teeth to be inflamed at the same time; I suspect you are suffering from a combination of problems, which may require a combination of treatments. If the source of your pain is not obvious to your dentist, finding a solution may be a matter of trial and error. The Dentist's Chair appears Saturdays. The column is written by John Reitz, DDS, and does not represent the opinion of the Pennsylvania State Dental Board. Dr Reitz answers questions from readers. E-mail them via his Web site at reitzdds.com or mail to John Reitz, DDS, 30 Commerce Drive, Wyomissing PA 19610. John
V. Reitz, D.D.S., F.A.G.D. Copyright
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