In January, my dentist did a root canal on an upper right molar tooth. The tooth felt better afterward but has not been symptom free. Two weeks ago, I felt a flare-up of pain that felt like it affected the tooth next to the root canal tooth, and I have a headache, too. I returned to my dentist on Monday, and she took x-rays. She says that both teeth look fine. She suggested that I see a neurologist. I do not think my dentist is investigating enough. Why a neurologist?  Thank you. Bryson from Arkansas

Bryson,

Although Dr. Perry would need to examine your tooth and x-ray to give you an accurate diagnosis, we can offer insight that might help you decide what to do next.

Pain from a tooth that looks healthy

It is not uncommon to feel pain in a tooth that looks healthy in a visual examination and on an x-ray. Some causes of tooth pain include:

• Referred pain – Infection from a tooth can refer to an opposite upper or lower tooth. Or it can feel like the pain is coming from an adjacent tooth. But pain does not refer from one side of the mouth to the other.
• Neuralgia – Chronic nerve pain can transfer in your face, jaw, teeth, or gums. Although the condition is usually not the cause of a toothache and headache, a nerve problem can feel like a toothache. That is why your dentist recommended that you see a neurologist.
• Infection – A sinus infection can cause headaches and pain that feels like a toothache. The maxillary sinus is near the roots of upper teeth and can press on the roots, causing a toothache sensation. Sinus pain can also transfer to a lower tooth.
• Other health issues – Some conditions that can feel like a toothache and cause headaches include jaw pain, clenching or grinding your teeth, or gum disease. According to the American Migraine Foundation, TMJ (temporomandibular joint) disorders can contribute to chronic headaches.

If you feel that your dentist is not a good listener or rushed for a diagnosis, we suggest getting a second opinion. You can get a second opinion from another dentist or a root canal specialist (endodontist).

Are your tooth pain and headache a dental emergency?

Sudden or lingering toothache – If you have a sudden or lingering toothache and headache but no recent dental work, see a dentist right away. Toothaches are most often a symptom of infection.

Toothache after dental work – If you had root canal treatment or other dental work that seems to be your pain source, contact the dentist who completed the treatment. If the pain persists beyond the healing period or gets worse, consider it an emergency.

Dr. Ryan Perry, a Baton Rouge family dentist, sponsors this post.