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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 44361
Experience:  Board Certified Physician
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Hi Had pain just above chin muscle and went to dentist.

Resolved Question:

Hi
Had pain just above chin muscle and went to dentist. Discovered pain was right where gum and teeth end and attach to jaw, right under the gum root. Also have same location of pain by back teeth. Dentist did x ray says bone loss. She said have root planning which I had today. The pain only started two week ago and now I'm in agony. I have read others experiences and peridontis and bone loss usually not painful. So why? What could this be? My teeth are normal, no mobility, just crowded.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

bone loss is painful because usually it exposes nerves under the teeth.

Dr. David :

did you have a root canal?

Dr. David :

there could be an infection there as well

Dr. David :

have you been on antibiotics?

Customer: No antibiotics. Dentist just took normal x ray and said I have bone loss
Dr. David :

that bone loss can exposure the nerve root.

Dr. David :

have you been setup for a root canal?

Customer: No as nothing said to be wrong with tooth. Why has gum disease progressed into root of gum, right underneath near jaw
Dr. David :

could be from you grinding your teeth if you have bone loss there.

Dr. David :

do you grind your teeth at night time?

Dr. David :

you could be

Dr. David :

you might need a bite teeth guard in your mouth at night

Dr. David :

to prevent you from grinding your teeth.

Customer: Yes I grind. And stress and smoking. But the pain iis not close to tooth but lower down directly under gum root
Dr. David :

smoking is no good and causes you to have worse healing

Dr. David :

are you willing to try to wear a plastic bite guard at night time

Dr. David :

and see if that helps?

Customer: I know. However I want to know about the location of the pain.
Dr. David :

the location is in the molar retromolar trigone area

Dr. David :

why did you rate poor service?

Customer: I need more specialist information relating to dental issues
Dr. David :

when you grind your teeth, you wear down the enamel of your molar and cause exposure of nerve under the tooth.

Customer: The location above chin and below gum root line is not that
Dr. David :

that location is the mandibular division of the facial nerve.

Customer: But grinding surely would not explain pain below gum behind chin
Customer: So why should gum disease cause more pain in that area that in teeth?!
Dr. David :

you could have referred pain from the TMJ joint from grinding which can cause pain there.

Customer: I definately have pain under the gum root in two places. It hurts deep under root of gum and hurts when I talk and chin moves
Dr. David :

the muscles of your massiter muscles which attaches to your lower mandible could also be inflamed and sore as well.

Dr. David :

when your chin moves, this moves your TMJ joint.

Customer: Yes tmj but I feel deep dental pain and dentist said bone loss
Dr. David :

xrays of the teeth do not show any information about nerves or muscles

Customer: Most people with bone loss from peridontis do not even know they have it
Dr. David :

an MRI scan of the floor of mouth and TMJ joint could show more information about if parts of your nerves are being pinched to cause pain.

Customer: We'll it showed bone loss in the area of my pain
Dr. David :

yes, an MRI scan check for bone loss and can check the muscles and nerves in the area

Dr. David :

and see what might be causing your pain.

Customer: It feels like very deep gum pain
Dr. David :

and is much better than a simple dental xray.

Dr. David :

you could have an abscess or a pinched nerve deep in the mandible area.

Customer: I can't pay for that or even demand it. Just wanted to know why gum disease would affect that location. Do you know why?
Dr. David :

gum disease usually allows bacteria deep into the gums.

Dr. David :

and if bacteria has gotten deep down into the gumline, there could be an abscess or hidden infection deep down.

Customer: So possible to feel pain below the gum roots far away from teeth
Dr. David :

yes.

Customer: How would dentist know whether I have infection or not?
Dr. David :

an MRI scan of the area

Dr. David :

or they could give you antibiotics and see if that helps.

Customer: So they can't tell from x ray?
Dr. David :

sometimes not.

Customer: Do you think I should be worried about jaw cancer?
Dr. David :

no.

Dr. David :

I am a cancer doctor.

Dr. David :

we don't tend to see jaw cancer in patients your age.

Customer: Does that produce a hole or lump? Or both?
Dr. David :

jaw cancer tends to grow and cause bleeding.

Customer: But Aldo causes bone loss?
Dr. David :

grinding your teeth over many years causes bone loss.

Customer: So without a lump I probably don't have jaw cancer?
Customer: I understand. Could the grinding affect any part of the jaw, including near the chin?!
Dr. David :

yes,

Dr. David :

grinding can cause misalignment of the jaw

Dr. David :

and cause pain in other areas.

Dr. David :

do you have any other questions?

Dr. David :

if done, please leave positive feedback below the chat box

Dr. David :

we only get credit for helping clients after positive feedback.

Customer: Yes please. I thought grinding would affect the jaw joints not bone between teeth and lower down
Customer: One more question, you might not know the answer, if jaw cancer causes tumour why does it also cause bone loss and a hole in the jaw?
Dr. David :

I treat patients who have throat and mouth cancers.

Dr. David :

typically the cancer starts in the soft tissues like the tonsilar fossa

Dr. David :

or base of tongue

Dr. David :

or vocal cords

Dr. David :

and if left untreated over months and months will grow into the bone

Customer: What happens when it grows into the bone?
Dr. David :

it causes some pain.

Dr. David :

but the mouth cancer usually is easily seen way before then.

Dr. David :

your dentist didn't see any evidence of mouth or bone cancer on your xray.

Customer: I understand but what about primary jaw cancer? Does it show a lump first or a hole first? Am worried I have a hole in the jaw bone
Dr. David :

your dentist would have seen that on a dental xray.

Customer: It was only. A bite wing x ray of few teeth at front lower jaw above front teeth and chin where pain is
Dr. David :

well you are not willing to get another CT or MRI scan.

Dr. David :

it sounds like you are letting your anxiety get out of control about worry of a mandibular bone cancer.

Customer: Do you think I should be concerned given pain sudden onset and told I have bone loss or is it just a common gum disease thing
Dr. David :

no, you should not be concerned about having a bone cancer

Customer: Would a bone cancer cause bone loss in two different places or unlikeyl
Dr. David :

unlikely.

Customer: Finally, how serious is bone loss below gum root? Is that serious peridontis? And lastly, what can they do next to treat the pain? Root planning is not going to solve this deep pain
Customer: Do you think I would be safer and wiser to get some antibiotics in case it is necrotising peridontis?
Dr. David :

you need to get a bite guard

Dr. David :

and take tylenol or advil for your pain

Dr. David :

and see if a course of antibiotics will help.

Customer: Is that a splint? Will I need bone grafting if bone pockets are causing pain
Customer: Penicillam
Dr. David :

no a bite guard is a plastic mouth piece which fits in your mouth at night time so when you grind your teeth your don't wear down your teeth.

Customer: the oral surgeon will not give me floor of mouth x ray as he says he has checked my mouth and it's fine no evidence of malignancy
Customer: But perhaps a jaw x ray I could ask based on tmj symptoms. I have has migraines eye pain and pain below and behind ear just recently after all the years of grinding. And now suddenly bone loss and pain. Weird
Dr. David :

yes, you can get a jaw xray.

Dr. David :

I would not stress about having a mouth cancer.

Dr. David :

and try the bite guard.

Dr. David :

hopefully that helps your TMJ inflammation and your pain

Dr. David :

good luck to you

Dr. David :

let me know if you have other questions.

Dr. David :

if done, please leave positive feedback

Dr. David :

thanks for using JustAnswer.com

Customer: Thanks. I think jaw cancer does produce a fast growing lump doesn't it? Thanks regarding tmj yes perhaps you right, maybe it causes the bone loss as well as gum disease etc..
Dr. David :

yes, jaw cancer causes a fast growing lump.

Dr. David :

you don't have to worry about cancer causing your pain.

Customer: Thanks for your help. Last and final question. If the pain Is from bone loss pockets below gum line, which they send me for bone grafting to relieve life long pain
Dr. David :

bone loss below the gum line would be very unlikely

Dr. David :

they would most likely not send you for bone grafting.

Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 44361
Experience: Board Certified Physician
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