My tooth hurts when I am tired, but the dentist finds nothing

I was once asked this in the consulting room. My upper right molar is fine most of the time, but when work gets intense it hurts. When work returns to normal the pain goes. Do I still need dental treatment?

Some people are told their teeth are fine, yet the tooth hurts whenever they are tired. That is what I want to talk about today.

A painful tooth does not mean the cause is in the tooth

Tooth pain can come from the tooth itself, as with decay, but it can also come from tension in the surrounding muscles or from trigeminal neuralgia. When fatigue builds or stress rises, the muscles at the back of the neck and around the shoulders tighten, and that tension carries through to the muscles around the jaw and teeth. That may be why it hurts only when work is heavy and settles when things quieten down. This does not mean you should skip the dentist. You should have a dental examination to rule out a cause in the tooth itself. It is also worth checking whether there is a problem with the trigeminal nerve or the jaw joint. Knowing where the cause sits is what lets proper treatment begin.

Pain is a fire alarm

Pain acts as a fire alarm telling you something is wrong in the body. When there is a fire you must not simply switch off the alarm because it is loud. You put out the fire. In the same way, relying on treatment that only reduces pain lets the body deteriorate further. While you get through on painkillers the cause stays where it is, or progresses.

Why only some people hurt

There is one thing I want to draw out here. Stress is given as the cause, yet not everyone under stress develops pain. People doing the same work at the same intensity — some hurt, some are fine. The difference is this. When an asymmetrical body loses its own capacity to recover, pain repeats and does not resolve. A body already tilted cannot hold up under even a small load. So being free of symptoms during a quiet spell at work is not reassurance. The longer treatment is delayed, the further the alignment problem can go. A period without symptoms is not recovery; the load has simply eased for a while.

So what do we look at

Posture correction such as Chuna manual therapy and guided exercise therapy, which realigns a rotated cervical spine, can help not only with neck and shoulder pain but with the nerve pain connected to it, including tooth pain. The same applies to preventing recurrence. Posture treatment, though, has to be something you can see. At Jinju Dangdang we first record how you walk, how force lands on your feet, muscle mass and heat distribution, and then begin treatment. When treatment finishes we check again the same way. Whether the change before and after treatment can be verified, and whether the clinic has enough experience in corrective treatment. Wherever you are treated, I would check those two things.

In short

• If the dentist finds nothing and the tooth hurts only when you are tired, tension in the neck and shoulder muscles is worth suspecting
• Even so, have the dental examination first. A cause in the tooth itself has to be ruled out
• A period without symptoms does not mean it has resolved
• Do not rely for long on treatment that only reduces pain

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Have a confident day.
Thank you.