On Saturday I had a headache in the front right side of my head. It came a few hours after carrying some heavy items. After ice and rest it went away.
A few hours later after laying down I awoke with terrible blinding pain in my upper left teeth it was a 9 out of 10. Because there was some pain in my left shoulder my GF/eventual fiance took me to the ER because at 1am there is no where else to go.
My initial EKG was negative and so was the heart enzyme test. The pain went away after I was given an aspirin and a nitro pill. I stayed overnight and was released after 3 consecutive tests showed no heart death enzymes.
Next day I had terrible pain again in the same tooth area so I left work to go home. On the way I felt my heart racing so I stopped at my PCP to ask them to check my rate and pressure. They REFUSED to and told me to go to the ER where I went again.
I presented my situation and another EKG came back normal. They diagnosed me as having anxiety and tooth pain and gave me a Demerol pill and a shot off something. I had someone pick me up to go to my dentist who after taking xrays said I needed to see a periodontast. I got a sane day appointment and went.
He did some tests and confirmed my gum issues but said I needed a root canal first and I was released.
Two days later (yesterday) I had the root canal. I am having less pain on that side but it still hurts epically if I eat. Liquid no longer has an effect.
The ER gave me Penicillin, Ibuprofen, and Ocycodone with acetaminophen.
I have only taken a few of the ocy when the pain strikes and its too soon for the ibuprofen
I am almost out of the ibuprofen but I plan on buying the OTC ones and taking an equivalent dose because I still have pain by the #10 tooth.
My GF is convinced it is a heart issue because the nitro helped.
I did see a cardiologist today who did an EKG which is normal as scheduled me for a echocardiogram and Stress test for a week from Wed.
What can I do about the pain I still have
who do I contact if it doesn’t get better? The DMD who did the canal said it may be a nerve in the face causing the issue
how likely is it that I am right and everything was caused by the tooth issue vs my girlfriends thought that it is a heart issue?
Do you have a stuffy nose? Does it feel like your upper teeth being pushed out of your head? Barring the root canal thing, it could just be a sinus infection. If you’ve never had one they’re easily mistaken for a horrible cold, but they won’t go away without antibiotics and they make you feel like you got punched in the jaw (at least if it’s in the maxillary sinus). Your PCP may be able to diagnose that, but if you have an ENT and you want to toss money at the problem, it may be worth a visit.
It could also be two things, such as a migraine and something else. Or just stress manifesting as physical pain.
But if you have cold-like symptoms, my first guess would be a sinus infection.
You took a nitro pill AND an aspirin. The aspirin may have been what ended your pain, by decreasing the pressure caused by surrounding inflammation on the nerve (from the dental issue).
Of course you are anxious – fear of the next blinding pain will do that. Your racing heart may be a physiological reaction to this.
A tooth infection can cause heart problems, but you are now under the care of a cardiologist and they don’t seem to suspect this, so unless you get any test results to the contrary, it sounds like the tooth situation may well be your whole problem.
Do yourself a favor and use as few of those narcotic painkillers as you can.
It is possible to grit your teeth so severely while you sleep that the next day, the pain is debilitating. I have done it. Went to a Doc-In-A-Box convinced that I had a tooth abscess.
I would prefer not to use the narcotics at all but my GF suggests I do when the pain returns beefier my next allowed dose of the ibuprofen.
I did mention to her that I thought that it could have been the aspirin but she downplayed it saying the dose they face was too low to do anything but act as a blood thinner.
I had a friend that sounded like he was chewing on gravel when he was sleeping. When we first met him (this was in college), we’d wake him up and tell him to knock it off. It was as loud as someone snoring, you could here it from other rooms. We quickly realized (like a snorer), it was of no use. How he was any teeth left, I don’t know.
Having said that, I’m guessing what Sattua meant was ‘clench your jaw’ (and if he/she didn’t it’s still a valid question). It doesn’t make any sound and it still makes your jaw pretty sore the next morning for the first few hours. Though, at least for me, I can usually tell if that’s why my face hurts because clenching it again makes the pain slightly duller, as if it’s putting the muscles back to where they’ve been for the past few hours.
If you can break the oxycodone in half, try that. It can help to use both ibuprofen (which is an anti-inflammatory and helps with pain) and a narcotic painkiller for pain treatment because it’s a two-pronged treatment.
My first thought on reading the OP was “sinuses”. Not a doctor, but lots of experiences with sinus infections and “sinus attacks” which have pretty much the same symptoms but seem to be caused by allergens or even atmospheric conditions. One of the worst I’ve had was apparently caused by the air conditioning and pressurized cabin on a long flight. Symptoms were very much as you described. As I understand it the sinuses become swollen, possibly inflamed and exert pressure on various other facial nerves, causing intense pain.
I don’t have the answer you are looking for, but I wanted to add that although I agree with the previous poster about using as few narcotics as possible, there is another side of the coin.
It’s been demonstrated that patients who get enough pain relief actually heal faster than patients who just power through the pain. (I’m sorry I can’t find a cite, this is per my doctor). Also the earlier you take a narcotic, the more effective it is on pain, so you may end up using less if you take it immediately upon feeling pain.
Dependency is natural and will happen to everyone. Withdrawal is a bitch. Addiction, OTOH is much more rare, although obvi it happens. Talk to your doctor if you have trouble with withdrawal. There are several ways of getting help, and it doesn’t necessarily mean you are addicted.
One other suggestion I have is to jot down the dates and a short summary of the outcomes of all your doctor visits. You can remember it all now, but in a month you might forget and the timeline might be helpful history.
I’m also very impressed with you that you are taking your symptoms seriously and going back as needed. Far too many people ignore it.
Do NOT break your oxycodone in half without checking first with your doctor!!! Many pills of this nature are time-release, and cutting in half can deliver a very high dosage, very quickly, creating a lot of potential problems.
Another vote for clenching your jaw and/or grinding. In my early 20s, I had some of the worst pain of my life. I seriously thought I had something horribly, horribly wrong in my mouth - something that would require jaw surgery or something, it was THAT BAD.
When I finally got into the dentist after a couple days of horrible pain, she told me I was grinding or clenching. I completely didn’t believe her. How could that cause such pain? It made no sense to me.
But I took her advice, got a night guard, and paid attention during the day. Turns out, I did go around with my jaw clenched TIGHT. At the time I had a stressful job, and I never even knew I was doing it until I started paying attention.
I managed to train myself out of clenching during the day. Every once in a while now I’ll catch myself. But man-oh-man, was it ever painful while I was doing it.
Great advice on the written notes, also include symptoms, tests taken, medication and dosages, etc. This stuff starts to blur together with time, and if you see new doctors this information can be a tremendous help to get you an accurate diagnosis.
I’ve observed too many pill addicts to think of it as rare. Maybe healing slower is a smaller price to pay than dealing with narcotic addiction. I’m not saying no one should ever take them or that you should “power through” severe pain that can be avoided, but non-narcotic painkillers in prescription strengths can be very effective without the risk. Use of narcotic painkillers can lead to the sensation of pain with no physiological cause at the site, a pain that requires the narcotic to go away. No one expects this to happen to them or plans to get addicted to pain pills, but it seems usually to start with a proper and legal doctor-prescribed narcotic, so be cautious is all I’m saying. Also, it could potentially mask other symptoms that could lead you to a correct diagnosis as soon as possible.
I have no intention of breaking any pills. Ebola was ruled out as I have not left the country in the past 21 days. As for Anthrax I have not been in any pastures or seen Heavy Metal groups so that’s right out.
My dentist, the periodentist, and the person who did the root canal did not see any exhibits of grinding or clenching and I do sleep with my mouth open.
I am concerned that the problem was not with the tooth and when I run out of non narcotic pain killer I will be in trouble
Dentist here. First off as my old pathology prof used to say, “a patient can have as many diseases as he pleases”. It is always possible that there is more then one thing happening.
Some things I noticed. I know all situations are different but I’ve never known an ER to give oxycodone. Hyrocodone sure, they give it out like candy. Also the give antibiotics to anyone with any tooth pain but unless the pain is being caused by an infection(abscess) it won’t make a difference. Most dental pain isn’t from infection, even if the tooth needs a root canal it isn’t usually infected.
Your dentist didn’t think you needed a root canal and sent you to a periodontist. Two days later your dentist did a root canal on #10(upper left lateral incisor for those wishing to Know). I am a general dentist any will deffer to a periodontist on gum issues but am probably more knowledgeable on endodontic matters then they are. Just makes me wonder about your dentist.
A root canal is actually a pretty big deal as far as the body is concerned. The nerve that is cut is fair sized. Even though the tooth looses feeling right away the end of the cut nerve up in the bone can take several days to heal and feell better.
Since all the heart stuff is negative I’d be inclined to think it is still the tooth. It is real easy to check, have the dentist numb it up. If pain stops it is the tooth if not look for other sources of pain. Number 10 is easy to get dead solid numb. In my office I’d do it no charge since I had just done the root canal two days earlier.
As for sinuses, yes they can make teeth hurt but not generally #10, usually only maxillary posterior teeth. Using the tooth post root canal can be causing pain. As others have said clenching or grinding and also just regular chewing. The dentist can also check the occlusion and relieve it if necessary. As Sattua said many people clench without grinding.
A good OTC routine for dental pain is Three ibuprofen every six hours and two acetaminophen every six hours. Stagger them three hours apart so that you are taking something every three hours. Three Advil, three hours later three Tylenol, three hours later three Advil etc. Works great for most root canal pain. Also try heat, it helps in a lot of cases.
In my mind with the limited info I have I think you have tooth pain and your heart is okay. Go back to the dentist.
Also why would your PCP refuse to take your blood pressure. Seems odd. Is there info we don’t have?
Just an aside on how chewing can cause severe pain:
Over Oct and Nov I was struggling with severe earache on my right side. No infection, but I assumed it was sinus related as I was fairly congested. The doc prescribed some nasal sprays and decongestants, but it didn’t really help. The semester ended and I was home over Christmas and New Years and my ear was feeling much better. Beginning of Jan I started going into my office and lab a few times a week. Lo and behold my severe ear pain was back.
I figured it out. I keep a bag of wintergreen life savers in my office and crunch through 6 or more a day. I chew them on my right side. I have mild TMJ and all that crunching was hurrying my jaw which caused the incredible ear pain.
I’ve thrown them away and my ear is feeling much better!
The Er doctor wrote a script for Patrick’s-acetaminophen 5-325
My dentist doesn’t do root canals. He sends you to a specialist for that. The periodontist said I needed a canal and sent me to a specialist for that The cavity that we’ve been watching has been very small and they didn’t want to do any work on it until it got bigger but it appears the root was very close that cavity.
I think my PCP did not want to take my blood pressure because I had already gone to him with the results of my first ER visit the day before and he was concerned that it was a heart issue delaying me the office would be detrimental.
When I brushed my teeth today it hurt in the tooth that had the canal.
IvoryTowerDenizen, chewing can cause pain if the tooth has a spot that hits early in occlusion. Constant banging makes it hurt. Much like a small pebble in a shoe. Take a couple of steps with it and it isn’t a big deal but keep walking on it and it will sure make your foot hurt. If there is infection at the apex of the tooth it can push it up enough so that it hits too soon.
Can’t find Patrick’s-acetaminophen in my drug book. Of course I am just guessing but the ERs I’ve dealt with almost never give oxycodone v. hydrocodone.
Of course every dentist is different but I do a #10 endo in about 20 min and it is a bit over $500. Still you could call your dentist and ask him if you could stop by and have it anesthetized as an evaluation. Might charge for an office visit but shouldn’t be much. I’d think about it if it is still hurting Monday and you are still worried about tooth v. heart. Brushing, eating etc. causes the tooth to put pressure on the end of the cut nerve that is why it hurts. If the spontaneous pain is lessening that is a good sign.