Dental pain!
November 5, 2019 2:20 PM   Subscribe

I am having extremely distracting dental pain. Please help me solidify or change my plan.

The pain is on the left side, upper and lower. It is coming in waves now after it subsided during a massage this afternoon. I’m in pretty deep grief over my brother’s death. The five year anniversary of that is here and hit pretty hard. I know the body keeps the score, hence the massage. I have a regular appointment with my therapist tomorrow, group therapy on Thursday evening, and a just scheduled dental appointment for Thursday at 2pm. I have a molar that we’ve been babying along for about 17 years so I would not be surprised if the pith was as dead and causing pain along the trigeminal nerve.

I am spending all of my energy riding these waves of pain. I didn’t sleep well last night.

I was at a conference yesterday and this morning, doing a lot of talking. Over the weekend I was catsitting and I’m allergic to cats, so I took a lot of different antihistamines (staggered through the days).

I’ve been using Tylenol 3x a day and drinking warm tea. I’ve been meditating and trying to let myself cry. I can’t relax enough for the tears to come. My therapist and I are working on feeling my feelings and doing less avoiding. I’ve taken a few baths and am about to have another.

My neck definitely feels tight, but so does my whole body.

What else should I be considering?
posted by bilabial to Health & Fitness (20 answers total)
Google “emergency dentist” and go there ASAP. You will get nothing out of therapy if you’re in that much pain. Maybe they have evening hours, do it now, do it yesterday.

I’m so very sorry about your loss.
posted by chesty_a_arthur at 2:23 PM on November 5, 2019 [18 favorites]

Have you tried clove oil yet? it is a remarkable oral anesthetic. Also over the counter Oral pain relief might get you to through to the dentist appointment if you can't get one sooner, although I am strongly recommending you call your dentist ASAP and ask to be seen tomorrow.

I'm sorry for your loss.
posted by larthegreat at 2:27 PM on November 5, 2019 [3 favorites]

To manage the pain until you can get into a dentist, try taking both Tylenol and Advil every four hours - 500mg of Tylenol and 400mg of Advil to start, but you can go up to 1000mg and 600mg respectively. It's important to take it regularly to keep the pain as low as possible and not just when you feel pain because by then it will ramp up again.

Source, dental (and other) surgeries I've had, but also this. This is the preferred pain management regimen over opiods these days and it's quite effective.

I'm sorry for your loss.
posted by urbanlenny at 2:44 PM on November 5, 2019 [5 favorites]

Called the dentist back, they still don’t have anything tomorrow. I’m in a waiting list for last minute cancellation. I also had a video call with my GP office and they’re getting me in tomorrow at 12:30 for an exam.

I put a heating pad on my face and that’s calming.
posted by bilabial at 2:45 PM on November 5, 2019

Yes to staying on top of the pain meds. Also you might try Orajel rubbed generously on the gums around the painful tooth. Might have just been placebo effect but I felt like it helped a bit when I had awful tooth pain earlier this year, until my dentist could see me.
posted by Stacey at 2:57 PM on November 5, 2019 [3 favorites]

Yes to the eugenol (clove oil), you can get it in "toothache kits" at the drugstore. You want to use the tiny tweezers and cotton that come in the kit to get it right on the spot because it's fierce stuff. It works, though. (Like, dentists use it too, as part of pain management. Some extractions get packed with gauze/packing soaked in it. It basically short-circuits the nerves.)

Also, take a sudafed, the real pseudoephedrine type behind the counter. You would be shocked the number of toothaches (even lower jaw) that are 20% crappy tooth and 80% sinus pressure on the nerve connected to the crappy tooth. That you had some subsidence during a massage makes this a definite possible variable.
posted by Lyn Never at 3:06 PM on November 5, 2019 [1 favorite]

Other things to consider: that your physical symptoms are very real, even if they are tied to your grief. Check yourself for a fever. Have a friend or a delivery service bring you clove oil and any Advil/Tylenol if you don't have those. As long as there's no contraindications in your personal medical history, take the Advil/Tylenol combo described above. Write down what you take and when you take it so you don't have to try to remember. Set an alarm (even in the middle of the night) to wake up and take your next dose. I second the suggestion to try pseudoephedrine as well.

I'm sorry for your loss and your pain.
posted by purple_bird at 3:25 PM on November 5, 2019

If you can take ibuprofen or another NSAID in addition to the Tylenol, that may also help with the pain. Nthing trying a topical anesthetic like Anbesol or OraJel, though if the damage isn't surface-level, it may not help.
posted by Aleyn at 3:40 PM on November 5, 2019

You can also call your dentist and ask for an emergency prescription for, like, exactly 3 Vicodin to get you through.
posted by phunniemee at 3:43 PM on November 5, 2019

you can go up to 1000mg and 600mg respectively.

Please do NOT do this. the initial recommendation of 500/400 every six hours is okay, but 4 grams of tylenol in a day will start to harm your liver pretty quickly for little extra benefit.

Also: almost no medicine is worth losing sleep to take. if you are sleeping through your pain, stay asleep, the rest will do you more good. morning, lunchtime, dinner time, bedtime are close enough for 4 doses a day to be effective for most pain meds.
posted by OHenryPacey at 3:44 PM on November 5, 2019

Not sure this is your problem but I had bad upper and lower tooth pain 6 months ago and it turned out to be a sinus infection. I went to the dentist and he poked around and took xrays and told me it wasn’t my teeth and I didn’t believe him. But I went to my GP and she poked around and agreed and the antibiotics she gave me made the pain go away in less than a day.

Good luck!
posted by overhauser at 4:28 PM on November 5, 2019

I cried. A lot. And my face feels mostly fine now. I will be keeping all my appointments just in case. And the heating pad is nearby and I’ll also have some more Tylenol before I sleep because stress contributes to inflammation. No fever - I checked.

Thank you all. Grief sucks. I’ll have so much to talk about in therapy tomorrow. (Not that there is ever a shortage.)

If the pain returns I’ll get some clove oil and OraJel and apply generously.
posted by bilabial at 4:38 PM on November 5, 2019 [1 favorite]

sucks that you're going through this - but keep a careful eye on your temperature as well as the pain, if there are any signs of infection, try to get to an emergency doctor or dentist asap - tooth infections can spread to other sensitive areas quickly and become life-threatening. Hope you feel better soon.
posted by 5_13_23_42_69_666 at 4:55 PM on November 5, 2019

Seconding other people, close friend was hospitalized due to an infection from neglected dental issues.
posted by booooooze at 7:04 AM on November 6, 2019

You can also call your dentist and ask for an emergency prescription for, like, exactly 3 Vicodin to get you through.

Yes. I was exactly where you were on my 24th birthday, and I went to the ER 12 hours before my dental appointment because I literally (and I do mean literally) did not think I would survive until I saw my dentist.

Please consider the option of pain killers.
posted by sideshow at 7:31 AM on November 6, 2019

Dentist is squeezing me in at 9am. The pain is intermittent, intense, and is triggered by things like eating soup, drinking, cold/wind, too much talking, but also happens randomly.

GP has ruled out sinus and ear infection tooth movement and gumline abscess. I have a neurology appointment on Monday and am on cancellation list for any provider at any location in the neurology practice.

This is exhausting. I’m keeping a heating pad on my face and alternating Tylenol and ibuprofen as directed by my doctor. I’ve started tracking timing and activities.
posted by bilabial at 5:12 PM on November 6, 2019

This sounds like when I needed a root canal + crown. It would be ok for a while, and then I'd eat; it wouldn't hurt terribly while I ate, but an hour or two later, it was back with a vengeance. The endodontist later explained that you have some nerves that are fast, but they die very quickly; the ones that die slowly (i.e. are still rotting in your face) are also very slow to transmit sensation.

(If insurance allows it, can you look for endodontists in your area with openings?)

I also had a mild stuffy nose a few nights before; maybe that got masked by your antihistamines? Finally, the pain is definitely both upper and lower despite the bad tooth only being in one side.

My dentist almost missed this, btw; she thought it was just a cavity. I had to say that the tooth continued to hurt, and then she did a cold test (very cold swab on an adjacent good tooth, ow; cold swab on necrotic tooth, nothing). Contrary to popular usage, root canals don't hurt, and they make the hurting stop.
posted by batter_my_heart at 11:44 PM on November 6, 2019

Not dental. Dentist is glad I’m seeing neurologist so soon. Neurologist moved me from 9 on Monday to 8:30.

This is a great use of the radical acceptance skills I’ve learned in therapy. The pain is showing up, and I can’t really know when. Trying to run from it really makes it worse. I just have to sit with it for the few minutes that it’s really bad.

I’ve started describing it by asking “have you ever slammed your hand in a door?” Usually people say ya with a wince. And I respond, “this is like if you did that a third time.” Apparently people find that horrifying. (I don’t need to go into the details of how I know what three successive door slammings feel like, but it’s orobably actually related to why I might have an inflammatory nerve condition.)
posted by bilabial at 6:16 AM on November 9, 2019

It’s trigeminal neuralgia. I’m going to make this one resolved. Thanks everyone, we have a plan.
posted by bilabial at 8:12 AM on November 11, 2019 [1 favorite]

To follow up since it's been a few months, I received a prescription for medication, which improved the situation within two hours of my first dose. I took the medicine for a few weeks, then stepped the dose down over another few weeks. If I recall correctly I had one bout of the pain while tapering off. Since then I have discontinued the medication except when I get the pain again. In those instances, I take one small dose of the medicine, and if the pain returns, take another. That has happened three or four times. I carry the medication with me nearly all the time, as the pain is so intense it is debilitating if it continues.

At the peak it was happening several times an hour, often more than ten times some hours. If you are having pain like this and have found the question in your search, please see your doctor as soon as possible. The sooner you catch trigeminal neuralgia and begin treatment, the more likely it is to be resolved. Some people never have the pain again after the first encounter with it. Some people can never get rid of it. Some people, like me, deal with it intermittently. I'm so glad I was able to be seen and was taken seriously by every provider who saw me. I know that this is not common for many people who are not cis men.
posted by bilabial at 10:11 PM on March 5, 2020

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