I had a horrible toothache about a month ago and I went to the emergency dentist. He told me that my tooth was dying and that it needed a root canal. He did the treatment and I expected the pain to go away, but it never did. I went back to see him yesterday and he did an exam and x-rays and told me the tooth was fine. Worse yet, I think he suggested that the pain was in my head. He suggested that I go see a neurologist. This is nuts. My tooth hurts. Is there really anything a neurologist can do or was the emergency dentist just trying to get me out of his office?

Stephanie – Wyoming

Dear Stephanie,

Though it sounds like the emergency dentist may have been missing some chairside manner, he wasn’t pulling your leg, and he wasn’t necessarily telling you that the pain was in your head either, though it likely sounded that way.

A neurologist can investigate whether nerve damage is causing your pain. Though it doesn’t happen every day, it can happen and it sometimes feels just like a toothache.

There are also other causes for pain, such as sinus pressure or sinus infections. The roots of your teeth reach up quite far, so trouble of almost any kind with your sinus cavities can feel like a toothache, too. If this is the case, you’ll probably have other cold or allergy symptoms as well, and taking a decongestant and/or antibiotic will help. You’ll need to see your primary care physician for a diagnosis if you think this might be the case.

The emergency dentist should have been able to make a diagnosis based on his x-rays and an exam. If there was something wrong with the tooth, or if the root canal was not effective, he should have been able to tell. But, if he was in  hurry, he might have missed something or he might not have looked at the neighboring teeth. Sometimes teeth in the same arch or section of the mouth can refer pain to one another, so it will feel like one tooth is bothering you, but it’s really another that’s giving off distress signals.

The bottom line is that if you’re still in pain, you need to find someone to help you. You may want to book an appointment with another dentist in the area for a second opinion, but make sure you don’t give him any information about your prior diagnosis. This way, you can be sure you’re getting a straight answer, and you’ll know 100% that you should book the next appointment with your primary care physician or a neurologist. Best of luck to you.

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