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Nothing but the Tooth column: Jaw, collarbone pain could be related to filling

Dr. Richard Greenberg
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Mineral Daily News-Tribune

Columns share an author’s personal perspective.

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Q: Should I be worried that, a month after a filling, I have sensitivity in the jaw - shooting into my collarbone - and a headache? The dentist checked and said there was nothing wrong with the filling. The headache pain is now gone but I went back to the dentist and asked him to look at the first filling, and he said there was still no problem and to him, everything looked fine. I then went back again a few weeks later when the tooth sensitivity continued along with the pain in my collarbone. May I ask your opinion?

- Y.M.

A: Referred pain after any surgical procedure can often occur. This I believe is what you are describing.

When it comes to the head and neck area, the location and interaction of various nerves and their extensions can make your diagnosis and or possible treatment extremely difficult.

What I do find troubling is that your dentist gave you a rather brief and unsatisfactory answer and I believe you or any other patient deserves more. Dismissing your problem in what appears to be such a casual manner is not how a health professional should behave.

Developing a headache after a dental procedure is not uncommon. Surgical dentistry such as doing a restoration can be emotionally traumatic as well as traumatic to the tooth itself. Depending on where the tooth is located in your dentition and the corresponding nerve locations, it is certainly understandable. The fact that the headache portion has now resolved validates that the headache portion was just some type of transient trauma to your head, neck and/or tooth. Cutting into a tooth is not dissimilar to cutting into any part of one’s body and post- operative discomfort is often confronted. Usually, it abates as did your headache pain.

Your dentist or another, if you seek a second opinion, should be interested enough to perform some testing on the tooth as it is now. Is it sensitive to hot, cold, biting pressure, sweet and or possibly the touch of a metal instrument or tapping the tooth with that same instrument? Just looking and saying all is fine is not adequate. If need be, I have and know that other practitioners have as well, gone as far as taking the filling out and placing a sedative temporary filling to then see if there is a change in symptoms. There are times that we dental professionals can miss something and going back to check is at times necessary. No one is perfect. Taking a post-operative X-ray may be needed to rule out other factors such as nerve damage of even a root fracture. Suffice it to say that much more needs to be done by your dentist in a much more sincere and compassionate way.

It is also possible that the collarbone pain is totally unrelated to the dental procedure and if this seems to be the case then referral to your physician might be an appropriate action.

Lastly, I will say that after a dental surgical procedure it is possible to develop symptoms of discomfort radiating from the area in front of your earlobe that can become irritated when your mouth is open for an extended period of time. The dentist should rule out this group of causes referred to as TMD syndrome. If this is the cause and pain was referring to your neck and collarbone, there are treatments and or drug therapy that could possibly help.

The sum total of my advice is to pursue this further either with your present dentist or another to offer a second opinion. Remember that the chart records and films are always the property of you the patient and copies or originals are always available for you to take to another practitioner for that second opinion.

I would be very interested in how the problem resolves or not.

Dr. Richard Greenberg of Ipswich practiced dentistry for 45 years after having attended dental school at Columbia University, where he was later an associate clinical professor of restorative dentistry and facilitator of the course of ethics. Do you have a dental question or comment about the column? Email him at dr.richard@nothingbutthetooth.org.