Dear Doctor Hall,
I am intrigued but also worried by a persistent sore point between by last molar top right and the next molar. The gum, not the tooth, is incredibly sensitive and always hurts after eating with a throbbing pain. The pain goes away completely after about 30 minutes-1 hour (better after tooth brushing) after eating and doesn’t return until I eat something again. This has been going on for over a year with a very slight improvement (pain not as bad as 12 months ago) No problem with hot and cold. My dentist has examined it twice and x rayed and can find nothing. There was a root canal treatment on one of the teeth which may well have triggered something but seems to be nothing visibly wrong and the pain is not under or in the tooth but next to it. It is exactly the gum between the teeth which hurts, not the teeth themselves. The dentist advises removing the tooth if the pain doesn’t heal. Seems a pity as I don’t think it is the tooth itself causing the pain, but I might be wrong. Any idea what could be going on? All my other gums are fine. No sign of an abscess no bad breath just very painful on the gum specifically in the space between the two teeth. Comments much appreciated.
Michael W from Germany
(See Dr. Hall’s answer below.)
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You need a second opinion. Is there a periodontist (gum specialist) you can go to?
It really bothers me that your dentist wants to take out the tooth simply because he or she can’t figure out what is wrong. I suspect this wouldn’t be all that complicated for a dentist that knew a little more.
This is a gum problem. I’m pretty confident that the root canal in the one tooth has nothing to do with this. An x-ray of the tooth probably isn’t going to tell you much about the gums. I don’t know much about the status of dental practice in Germany, but even here in the U.S. where we have fairly high educational standards for dentists, some dentists pay very little attention to gum health.
Of course I can’t tell you for sure what is wrong without a personal examination. But the first thing I would check would be for pockets between these two teeth. This could be a periodontal abscess which would mean that there is a particularly deep pocket between these teeth. Food particles could end up here after you eat and when they disintegrate the pain goes away. It’s possible that a quality deep cleaning could solve your problem.
Do you floss? If you don’t, that could be a contributing factor here, because you would be much more likely to develop gum disease if you don’t floss. If you do floss, I’d be curious to know if flossing between these teeth, with a technique that gets the floss down into this pocket, has any effect on the pain.
Anyway, please don’t let this dentist take out your tooth, and see if you can find a dentist who knows what is wrong.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Michael Walker says
Thank you very much for taking the time and trouble to respond. Here is an update.
Basically you were right.Actually I do floss but even that is not enough it seems. The last time I was at the dentist she recommended an interdental brush. In fact, there is a deep pocket in the gum and unles I am very careful, food gets trapped there and that causes inflammation. I am now extremely careful brushing then flossing then using the interdental brush and as a result the inflammation has gone! At least so far five weeks with no inflammation.
Regarding German health protocols. Were I covered by the state health system the dentist would have been obliged to extract the tooth because if the problem is not resolved after x visits and x costs then the tooth has to be removed. As I pay myself I was in a position to say that I wanted to continue to try and keep the tooth. I think the dentist is extremely young and inexperienced but she is learning through people like me, haha! Anyway I think she will be pleased when I go for a check up next time. She definitely wants my tooth to survive now that she has realised that I didn’t want to give up. Thanks very much for your time, and yes it was almost certainly a gum issue. Weird that the pocket is so deep, never known anything like it. I can brush and floss and everything is clean except in that part of my gum.