HomeAnswersDentistrydental infectionsI have pain in my left molar area. Please help.

What could cause pain in the molar area despite medications?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At January 21, 2023
Reviewed AtJanuary 31, 2024

Patient's Query

Hi doctor,

My weight is 115 lbs, and I have several decaying teeth after seven years of using Vyvanse (medicine for hyperactivity disorder) and two pregnancies. I have always been an avid brusher and flosser, but I neglected to get my impacted wisdom teeth removed about five years ago. The molar next to my left canine tooth is broken in half and it has chipped off. I have almost always had pain and sensitivity in one tooth or another, so I used Anbesol and Sensodyne and continued to ignore them since I have no dental insurance and a low income. About five days ago, the pain started getting worse, and the numbing liquid and Ibuprofen no longer helped. I have gotten this a lot, but it would usually only last a couple of days, and I would be fine. This time it only got worse. The pain has grown to my jaw. I made the mistake of using a hot pack to soothe my jawbone, as that was the only way I could get some sleep along with some sleep aid. Later I read heat can make the by-product of gas expand and hurt things more, so I switched to using an ice pack. Two days after using the ice pack many hours a day, the pain is now bearable as long as I do not chew on the left side or put any pressure on my jaw or teeth. Still, I have to take several hundred milligrams of pain reliever several times a day.

My worry is now my jaw is what hurts the most. I can feel a huge buildup of pressure from the top of my chin to my ear. I can feel an enlarged spot around my jaw and neck where the broken and affected tooth is. I get a random numbness in my chin and lip multiple times daily, and I have never had this problem before. Am I risking letting some infection get to my bloodstream? I have already assumed I have an abscess which I have had before, just not as painful. Can I wait another week or two before seeing a dentist when I can afford to pay the dentist? Or do I need to go to the emergency room?

Thank you.

Hi,

Welcome to icliniq.com.

Your chief complaint and history suggest that you have irreversible pulpitis due to a decayed molar. You have already taken several medications for pain, but there is no effective cure. Before suggesting a proper treatment strategy, can you send an attachment photograph of the involved tooth?

Thank you.

The Probable causes

The Probable cause is decayed teeth.

Investigations to be done

Investigations to be done IOPAR (intra-oral periapical radiograph) of the involved tooth.

Differential diagnosis

Differential diagnoses are irreversible pulpitis, and acute periapical abscess.

Probable diagnosis

The probable diagnosis is acute pulpitis.

Treatment plan

The treatment plan includes a Tablet of Erythromycin 250 milligrams two times for five days. Tablet Ketorolac 10 milligrams SOS to be placed on the tooth or under the tongue. Take a tablet of Tramadol hydrochloride 25 milligrams two times for three days. Tablet Pantoprazole 40 milligrams once a day for one week. Toothpaste Thermoseal containing Fluorides in place of normal paste for three months.

Preventive measures

Preventive measures include 1)Rinsing mouth after eating. 2)salt gargles daily to control pain.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Soheel Hussain Zargar
Dr. Soheel Hussain Zargar

Dentistry

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