Tooth trouble - bite related? Pure TMS?

[Time2be]

Dear all, usually I am dealing with pelvic pain (bladder and urethral pain). I found good specialists that helped me to treat the cause (dysbiosis of the microbiome), but I know that there also is a TMS component. Why does my microbiome in the vagina get imbalanced? I think it has to do with stress or emotions that bother me.
However, now it's the teeth. I had two extractions in the last three weeks. I had severe tooth pain under a bridge, it was 35 years old. The bridge was loose and one tooth was full of decay, they could not save this tooth. The other part of the bridge is a tooth that I had trouble with 35 years ago and they didn't know really why. One dentist told me that the tooth was mobile. This is very likely considering my bite (deep bite). This tooth also had to be extracted because now it was really mobile. The bridge stabilized so to speak these teeth and I didn't have problems for the last 30 years (just the odd little pain on or two days, but not often). Probably this tooth was mobile all the time, you could see it at the root which did not have the ligament parts that should be there.
Well, problem is, I still have this pain, the same I had 35 years ago. It vanishes sometimes, also during the day. And I can calm it down with an ointment with lidocaine. I am so afraid that I have developed what is called atypical odontalgia! Two dentists and an oral surgeon told me that I have a mechanical problem there, which is caused by the deep bite. And it seems that getting older it is usually getting worse because there is too much pressure on the molars.
My guess is that there is a structural problem, but that the nerve system reacts inappropriate, so that the pain lingers longer than usual. I am waiting for an expert appointment with someone who is a specialist for atypical odontalgia. In a way this also is just a name for a neuroplastic reaction, that's my hunch.
And not so suprising that when I started to do really well bladder wise, something else shows up! It's like a never ending chain of pain and problems.
Any ideas? How do you experience or see the relationship of structural issues and the neuroplasticity dimension? For me it looks always so mixed and intertwined.

 

[Ellen]

How do you experience or see the relationship of structural issues and the neuroplasticity dimension? For me it looks always so mixed and intertwined.

I also experience it as mixed and intertwined. There is no way to separate MindBody completely in my opinion. It's individualized and changes over time. It is one system. It is like the Yin Yang symbol. I think the answer is to keep an open mind and delve into each incidence of symptoms with honesty and courage. One can choose to try to rule out the physical first by consulting a trusted medical professional or one can try to rule out a strictly psychological cause by using TMS recovery techniques, but it is seldom 100% one or the other. It is an exploration and each time symptoms appear is an opportunity to learn more about yourself.

You may find this thread helpful. https://www.tmswiki.org/forum/threads/recovery-remission-and-the-people-who-get-most-of-the-way-there.33865/ (Recovery, remission, and the people who get most of the way there)

 

[Time2be]

@Ellen , thank you for your answer and the thread, it covers exactly the questions and concerns I have. The most problematic issue for me is uncertainty, but we need to live with uncertainty. It’s a necessary part of our life. I learned to take breaks, just give me a break from bothering, googling, controlling, monitoring. I have a ACT therapist and letting go of control, accepting uncertainty is most important and at the same time the most difficult thing to do. In my situation right now, I just can wait and see whether the tooth pain settles by itself. There is of course the hope that it does because it went away for 30 years and will do that again.
With my bladder issues I learned how mixed things are, with the right treatment my ‘psychological work’ suddenly gave meaning.
Having breaks also means to me to accept that the situation with my very old parents who have dementia is just difficult. I am living far away and together with my sister we try to organize and help as much as we can. We want them to go into a nursery home, but my mother refuses. We cannot do more than we are already doing, I cannot take them to my place because I live in a different country with a different language. And my mother just wants to stay in her home, without saying it, she demands that I come home living with them, sacrificing everything I build up here in my life, career, friends. This is going on now for one and a half years. It surely contributes as a daily stressor.
Well, anyway, living with uncertainty is difficult.

 

[Adam Coloretti (coach)]

Dear all, usually I am dealing with pelvic pain (bladder and urethral pain). I found good specialists that helped me to treat the cause (dysbiosis of the microbiome), but I know that there also is a TMS component. Why does my microbiome in the vagina get imbalanced? I think it has to do with stress or emotions that bother me.

Hi! I definitely think from what you've said that there can be a few mindset shifts/understandings that can help you avoid this pattern of seeing everything as mixed going forward (which is going to lead to so much work and stress if other symptoms pop up, which is normal for a lot of us).

Firstly, I agree with you here that the microbiome is almost certainty impacted by stress or emotions to some degree. But I think you're getting mixed up when it comes to the distinction between something structurally caused and neuroplastic.

To begin with, the TMS guide (written by Dr Schubiner among others) is very skeptical to the idea that dysbiosis causes the symptoms claimed - "A range of symptoms has been attributed to this condition with little scientific evidence thus far". This opens up the possibility that it is an incidental finding (the guide is also skeptical as to the methods of testing for this and the treatments offered, but that's another point) - which means if correct that others out there would have the same finding with no symptoms (if that is the case to a meaningful degree, I don't mean a rare 1 out of 10,000 case who has no symptoms, as you could probably find that with all conditions, but if it's quite common then it's difficult to attribute the symptoms to the bacterial imbalance). So, in this case it would be TMS on the basis that it's an asymptomatic abnormality (the imbalance is being wrongly blamed).

But, let's say for argument sake that the imbalance does cause symptoms (I'm siding with Dr Schubiner and the other experts given their experience as a side note - but just to take this further to cover other cases) - if the imbalance is caused by stress and emotions, then I still wouldn't necessarily say the symptoms are structurally caused, even if the imbalance itself is causing the symptoms. Hives for example can be TMS (as they are caused by stress), and they are clear physically on the body (as bumps and lesions). TMS does cause physiological changes, which can cause symptoms (but the root cause is TMS). Now, if someone wants to draw the line on the basis of the necessary treatment, then that is fair enough. Whilst it might be caused by stress and emotions, it may still need a medical treatment (such as medication). I'm not denying that (and I understand if that is the case why someone would label it as a structural issue), but then again, whilst the treatment might be necessary in the short term, in a way it is symptomatic treatment and you aren't treating the root cause. If stress and emotions cause hives for example, they will likely come back if these causes aren't addressed, even if they are managed or temporarily removed by medical means.

So, those are two cases where I wouldn't necessarily say the symptoms are structurally caused (structurally represented yes, but not caused).

Compare it to a broken leg for example - the leg break wasn't caused by stress/emotions, nor is the pain (at least in the short term) from it. In a case such as this, I would say categorically that the (acute) pain is structurally caused.

It vanishes sometimes, also during the day. And I can calm it down with an ointment with lidocaine. I am so afraid that I have developed what is called atypical odontalgia!

In terms of this, why would it just vanish at random times? That raises suspicion of TMS. The most important point of this post is probably around the second sentence here. You're afraid you've developed atypical odontalgia - but what does that mean? Atypical (like idiopathic) just means unusual in the sense that they don't know why you have pain (which is usually TMS, as they don't know about TMS!). Odont - means tooth and algia - means pain. So the "diagnosis" just means unexplained tooth pain but in latin/greek. You already knew that as you're the one in pain! You say you are afraid of having developed it, you already have it because it's just a symptom description. The labels are often given to validate your pain (but you know your pain is real and everyone here knows your pain is real too), but at what cost? It creates unnecessary fear and a completely pointless label - it isn't a diagnosis at all because it says nothing of the cause and nothing that you don't already know, it's just a baseline description of your symptoms. Imagine if you went to a doctor and laid everything out and they said "ok, come back next week and we will discuss your results". You get back next week and they say "Ok, I have analysed all the tests and I have found the problem, are you ready brace yourself, you have.... unexplained tooth pain!" You would probably demand your money back and think "tell me something I don't know", but that's exactly what happens with this "diagnosis" only it's in latin/greek.

The more symptoms you have (especially if any of them are shown to be TMS or to have clear neuroplastic elements) the chances of TMS skyrocket (the reason for this is what are the chances of you having multiple different structural problems that are completely unrelated, it's possible and I'm not saying they shouldn't be investigated, but TMS makes more sense to cover them all - you've already shown the propensity for mindbody symptoms), so whilst I can't guarantee it I would be leaning towards all of this being neuroplastic - especially if atypical odontalgia is the only explanation you receive + if you tick a lot of boxes in the FIT criteria (you've already ticked a big one given the pain can vanish sometimes without explanation)

 

[Time2be]

@Adam Coloretti (coach), first of all thank you for this very detailed and thought provoking answer. What I fully get, I think, is the dichotomous way of thinking structural and TMS is wrong. Your example of hives is a good one to this point. And the fact that pain vanishes for no reasons (or reasons we do not know) is suspicious and indicates TMS. I know the test of Dr. Schubiner and I test positive, so to speak.
However, there is one thing I learned and that is that medical science is evolving. In the case of the microbiome you are right, we do not know how the normal microbiome of the bowel, the vagina, the bladder or the mouth should look like, the combination and amount of bacteria etc. seems to be highly individual. My case is more simple, I simply produce too many lactobacilli in the vagina and this has the effect that there is testable inflammation in the vagina (cytolytic vaginosis). This can lead to bacteria overgrowth which is also seen on test. So, when I say dysbiosis I actually mean that my microbiome is part of the TMS story of mine. Because, there are periods I am fine and do not have these symptoms and overgrowths.
With the tooth it is a bit different. A loose, mobile tooth cause pain, the question is now more if the pain will stay, which then would be TMS. I know that atypical odontolgia is nothing but a label (just look at the etymology) saying that there is pain in the teeth which does not come from a disease of the teeth, but from the nerve system producing this pain. I am quite sure that this is often a case of TMS, neuroplasticity.
For me the question is now: what is maintaining the pain? I am prone to this effect of neuroplasticity, but seem also to be able to reverse it, because I have periods without symptoms or pain. On my TMS journey I always tried to find the root course, and I found many repressed emotions, especially anger and resentment. Knowing those has not changed my anxiety and done very little to how I react to something like this tooth issue. A little bit maybe. So, I feel a stuck here.

 

[Adam Coloretti (coach)]

@Adam Coloretti (coach), first of all thank you for this very detailed and thought provoking answer.

No worries!

However, there is one thing I learned and that is that medical science is evolving

That is true.

My case is more simple, I simply produce too many lactobacilli in the vagina and this has the effect that there is testable inflammation in the vagina (cytolytic vaginosis). This can lead to bacteria overgrowth which is also seen on test. So, when I say dysbiosis I actually mean that my microbiome is part of the TMS story of mine. Because, there are periods I am fine and do not have these symptoms and overgrowths.

I'm in no way questioning the tests - and you would know a lot more about this than me given your experience with it and your subsequent research (I have only done a little bit just now). Your last sentence has me curious though. Do you have proof that the symptoms turning off match the lack of overgrowth (i.e. in symptom free periods, have you had testing showing a lack of overgrowth)? That's telling if you do, and I suppose if those symptom free periods are longer time periods (like multiple days and weeks) then that would make more sense to me, as opposed to if the periods are hours to a day I'd be skeptical that the overgrowth is changing quickly enough to match symptom fluctuation (if that were the case, then it would open up the possibility of you having the overgrowth at times without symptoms, which would cast doubt on the overgrowth being the cause of symptoms).

A loose, mobile tooth cause pain, the question is now more if the pain will stay, which then would be TMS.

I think that's a sound way of looking at it.

On my TMS journey I always tried to find the root course, and I found many repressed emotions, especially anger and resentment. Knowing those has not changed my anxiety and done very little to how I react to something like this tooth issue. A little bit maybe. So, I feel a stuck here.

I would focus more on self-compassion in the present - how do you speak to yourself? Do you set proper boundaries? Do you put too much pressure on yourself so everything needs to be perfect? Do you take care of your own needs as well as taking care of everyone else's? Journalling and finding repressed emotions is important for their release, but another key reason for this practice is it's supposed to generate self-compassion for what you went through and teach you to accept your emotions and inner-experience fully. That may be what is lacking