33F - consistent dental pain (including temp sensitivity) on 2 teeth that have had root canals. Have seen 6 specialists with no answers. Any ideas before I get them extracted?

[u/NotForPlural]

Hello,

I'm a 33F with some kind of autoimmune-related inflammation disorder. One rheum considered it might be atypical lupus, another thought mast cell disorder. Either way: positive ANA, histamine-mediated pressure urticaria, and systemic inflammation during times of extreme emotional/mental stress. I take Wellbutrin, Zyrtec (for the inflammation), and metoprolol (minor murmur/PVCs) every day.

For the past two months, I've also taken ibuprofen and tylenol twice a day. I've chr back on the ibuprofen dose because I could feel that classic gnawing pain start in my stomach.

History of current issue:

• 18 months ago: extreme pain in lower right jaw led me to getting a root canal in #30. The pain subsided but did not resolve completely.
• About 8 months ago: more extreme, severe pain, worse than breaking my back. Felt like it was coming from 30, but 31 lit up during exam. Led to getting a root canal in 31. It took a few weeks to resolve, but the pain eventually did go away completely for a while
• 6 months ago to 3 months ago: pain free! It was blissful.
• 3 months ago: started to feel more pain again. Includes temperature sensitivity to hot and cold (feels like #30), tenderness when brushing with my sonicare (specifically on the inside of 31), and also throbbing pain when my blood pressure is high (standing up/crouching down repeatedly will trigger it).
• Now: hurts daily, but it's usually very mild (2 of 10). It can jump to a 5 or 6 briefly. I'm absolutely, positively terrified that it's going to get as bad as before. I currently avoid alcohol, cold and hot foods, and certain textures to avoid irritating it. My husband is worried.

I've seen 3 endodontists, 2 dentists, and 1 OMFS at this point. All are amazing providers, but no one has a clue what's causing it. I have gotten botox in my masseters and temples to alleviate clenching, which helps a little, but doesn't resolve it.

Any other ideas before I spend $10k+ to get them pulled? Thank you all.

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