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Why Can’t the Dentist Find the Source of My Toothache?

Man holding the side of his face, portraying dentist cannot find source of toothacheI don’t have a regular dentist, but for the past 2 months my tooth and gums have been hurting and getting worse. Last Wednesday a dentist took me as an emergency patient. After the exam he only gave me something for pain. He said that he wasn’t sure where the pain is coming from and I need to see a specialist. Why wouldn’t a dentist be able to figure out why I have a toothache? He just looked at my tooth. Would an x-ray have helped? Do I really need to see specialist, or can I look for another dentist? Thank you. Thomas


Thank you for your question.

Pain in your tooth can originate with an infection in the tooth, or with an infection in your gums. If an infection is both in your tooth and your gums, it would make it difficult for the emergency dentist to make that determination.

What Causes a Toothache?

  • Root canal infection – An infection in the root canal of a tooth can spread into the bone and tissue around the tooth, which help to support and stabilize the tooth. With a history of the progression of your pain, along with x-rays, a dentist can determine that the problem started in your tooth and spread to your gums and jawbone.
  • Gum infection – Another possibility is an infection that starts in the gums and spreads to the tooth. An advanced gum infection can spread into the tooth roots and up into the pulp of the tooth, causing a very painful toothache.
  • Gum and tooth infection – It is possible that both your gums and tooth are infected. If that’s the case, a dentist needs to carefully review the history of your toothache, take an x-ray of the tooth, and test the sensitivity of your tooth to pressure and temperature. Another dentist may be thorough enough to determine the cause of your pain. Otherwise, you may have to see an endodontist (root canal specialist) or a periodontist (specialist in the gums and supporting structure of the teeth).

The infection will continue to spread until it is treated, so please do not delay treatment. An experienced dentist can save the tooth and prevent the need for an extraction and implant.


Dr. Thomas Goebel, a Moline cosmetic dentist, sponsors this post.

My New Crowns Are Not White Enough

Woman expressing disappointed, portraying dental crowns not white enoughI got my teeth whitened before replacing four crowns on my front teeth. My dentist and I agreed to BL1 shade for the crowns, so I got my teeth super white. My dentist ordered the crowns a week before I finished the whitening treatment. When I tried the crowns on, they were not white enough to match my teeth.

My dentist sent the crowns back to the lab to get them whiter. I still think the shade is off, but now the crowns are turning yellow. I asked my dentist for a refund, but he wants to try again with the crowns. I hate going through this again. And now, my teeth are not as white as they were at first. If the crowns were not turning yellow, I would accept this mess. But new yellow crowns are not acceptable. What are my options? Thank you. Lydia from Cedar Rapids, IA



Thank you for your question.

If your crowns are truly ceramic and in good condition, they will not turn yellow. It is possible that something damaged the glaze on your crowns and caused discoloration.

What Can Cause Dental Crowns to Discolor?

Dental crowns may discolor if exposed to equipment or chemicals that damage the glaze. Some factors included:

  • Power polishing equipment – The Prophy Jet and other instruments work well on natural teeth but may damage the glaze on ceramic tooth restorations.
  • Acidulated fluoride – The acid can etch the glaze and leave your replacement teeth with a satin finish that attracts stains.

We recommend asking an expert cosmetic dentist to examine your crowns and determine why they are yellowing.

Challenges Matching Crowns to Super-White Teeth

It is challenging to match crowns to super-white teeth without advanced cosmetic dentistry training. You chose BL1 as the shade for your crowns, which is whiter than any shade of natural teeth. And in most cases, your teeth are so bright that they do not look natural. But you whitened your teeth before getting crowns, as you should, to ensure the crowns match your natural teeth.

Although teeth whitening can get your teeth brilliantly white, not everyone’s teeth will lighten to shade BL1. Without advanced cosmetic dentistry training, it is challenging for a dentist to match your crowns with your teeth. Unfortunately, your dentist requested your crowns before completing your at-home whitening allowing your tooth color to settle.

Although you may not achieve BL1 shade for your crowns and teeth, a cosmetic dentist will help you

get natural-looking results. Before requesting treatment from a cosmetic dentist, request a consultation. Ask to see before and after pictures of dental crowns on front teeth.


Dr. Thomas Goebel, a Moline, Illinois dentist, sponsors this post.