more jaw pain and teeth sensitivity questions?

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mamanan
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Date Joined Jun 2008
Total Posts : 846
   Posted 7/27/2008 11:15 PM (GMT -6)   
I'm really sorry if I keep bringing up this question, but this pain is so strange, I need answers.
 
I accept that a lot of people with fibro get TMJ, and I'm open to the fact I may have it.  I've also had more sensitive teeth too since my facial pain began in May.  I've gone to the dentist and ruled out major problems, and have started brushing with Sensodyne toothpaste.
 
My facial pain had been feeling better, when this morning I couldn't drink my coffee without discomfort.  Then tonight I had ice cream.  It hurt for the first few bites, every tooth on the right side, then it went away.  A few minutes after I finished my bowl, I felt severe pain starting from the teeth into the jaws.   The bottom went around to the underside of the jaw.  The top teeth referred into the top jaw, the apple of the cheek up into the temple and behind the eye.  This was all dull burning, aching pain.  I also experienced sharper stabbing pain into the fleshy part of the right cheek and into the chin.  I would classify this as an 8-9.  I felt better after my mouth returned to normal temp, after a few minutes.  The pain was so severe, I couldn't talk.  By the time it got into the cheek and hte jaws, it had also left the teeth.
 
What is this?  Is it TMJ?  Anyone else feel this?  My dentist ruled out nerve damage.  It's gone from the jaw to the teeth, now from the teeth to the jaw.  What can I do?
in the land of Limbo, taking OTC meds only.
Don't know what's wrong, can't fix it, doctors are so sloooow!!!


GamJill
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Date Joined Jun 2008
Total Posts : 1279
   Posted 7/28/2008 9:13 AM (GMT -6)   
Oh Mamanan-
Since getting fibro I now get pain in my teeth and I know it is not an infection, I especially notice the pain when I eat things that have alot of sugar in them. I was chewing on some animal crackers the other day, and my god the pain just about put me thru the roof. I have TMJ and the pain can travel back and forth, between jaw and teeth. And yes I have had TMJ pain so bad, it's knocked me to my knees.

Nothing surprises me with fibro either, the pain will travel to different areas of my body (including jaw and teeth) and then it will subside. It's frustrating! And when your getting that real bad pain there is nothing you can do except ride it out or take pain meds.

Start keeping a journal. Is the pain everyday? Only when you eat or drink hot or cold? Are you clenching your teeth during the day and not realizing it? The journal may help you get some answers. I truly feel for you! GamJill
 
 
Fibromyalgia, Depression, Anxiety, TMJ, Arthritis/neck
 
Zoloft, Tylenol 4000 mg., Zanaflex


Marlee2
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Date Joined Aug 2007
Total Posts : 6067
   Posted 7/28/2008 9:16 AM (GMT -6)   
Mamanan that sounds so painful. I don't have TMJ but sometimes my teeth become sensitive for no reason. I don't get it, how can your teeth be sensitive one day and not the next, but mine are. This is the craziest DD.
 
I hope you get answers soon and get some relief.
 
luv and hugs
Marlee
Forum Moderator Fibromyalgia
 
Fibro,Sjogrens, Anxiety, Gastroparesis, IBS, Gastritis, Allergies, High Blood Pressure, Low Blood Sodium and Osteoarthritis
 
Amitriptyline, Celexa, Xanax, Synthroid, Zyrtec, Micardis, Spironalactone, Tylenol, Reglan, Lidoderm Patches and Tramadol
 
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kelly71
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Date Joined Jun 2008
Total Posts : 726
   Posted 7/28/2008 11:11 AM (GMT -6)   
mamanan,
 
Don't worry about asking more questions.  I think all of us understand.  BTW-I promise I won't go into my LONG story about teeth this time. tongue
 
Anyway, maybe you are having new problems with hot & cold things (coffee & ice cream).  Or, since you said you had some decay, perhaps the sugar in the ice cream is making your teeth hurt.  I don't have TMJ, but I certainly understand dental pain.  I think I have a high tolerance for pain, but as soon as that pain used to hit my mouth, I was curled up in the fetal position. sad   Sometimes I would take at least 800mg of ibuprofen (BTW-I'm not suggesting you take any meds without consulting your dentist or doctor) just to get some relief.
 
Alrighty, I do hope you feel better (and get some answers) soon. :-)

FINALLY dxd on 06/13/08
Vicodin, Neurontin, Ibuprofen for pain-which doesn't help, BTW
Zoloft & methadone (NOT for pain) for sanity-which doesn't help, BTW
Klonopin for anxiety (Guess what?  Doesn't help!)
 
"I'll take the Chivas instead"
-Kelly Clarkson


Sherrine
Forum Moderator


Date Joined Apr 2005
Total Posts : 15138
   Posted 7/28/2008 11:46 AM (GMT -6)   
Hi, Mamanan!  I have had tooth sensitivity on and off for years.  I did have a "spell" where it went on for months.  I avoided extremely cold and extremely hot foods and drink.  They would send me through the roof!  So, you are not alone.
 
Here is a link about TMJD and fibromyalgia.  It does sound a lot like you.  If you could work on relaxing more, doing the gentle stretches for the shoulder and neck, that may help some.  Massage around your neck and jaw...gently.  Also this link suggests heat or ice.  I think I'd opt for a warm damp washcloth to put on the jaw to help the muscles relax. 
 
 
Lastly, I would suggest taking extra calcium to keep your teeth healthy.  With fibro, we can be lacking in vitamins.  Also, 99% of calcium is stored in your bones and teeth.  It helps keep both strong.  I know I was deficient.  I noticed several years ago that my teeth looked a little transparent...they were losing the solid whiteness.  I just thought it was because I was getting older and my dentist never said anything about it.  A little over a year ago I was diagnosed with osteoporosis!  I had been taking calcium for 20 years but I wasn't absorbing it.  I switched to Citracal with D (600 mg twice a day) and I take Evista for the osteoporosis and guess what?  My teeth are white again!  My body was taking calcium from my teeth and probably weakening them and perhaps making them sensitive.  I don't know if there is a correlation or not, but I haven't had a problem with sensitive teeth since.
 
Here is a good link, by the National Institute of Health, about the importance of calcium.
 
 
Sherrine
Forum Moderator/ Fibromyalgia
***********************
Fibromyalgia, Crohn's Disease, Ostomy, Diabetes, Autoimmune Inner Ear Disease, Osteoporosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
God does not give us a spirit of fear, but of power and of love and of a sound mind.    2 Timothy 1:7


Tootiebug58
Regular Member


Date Joined Feb 2008
Total Posts : 378
   Posted 7/28/2008 12:14 PM (GMT -6)   
Mamanan
Did you ask you dentist about a bite splint? Sometimes fibro patients grind their teeth at night and dont even know it. The teeth become very very sensitive to hot and cold. My oldest son wears a bite split because of grinding at night and has worn away some of the enamel, thus causing the hot/cold sensitivity. I have severe TMJ
and wear a splint every night. It helps with the jaw and ear pain. I would ask your dentist if there is any sign of grinding on your teeth.

Hugs
Tootie
-------------------------------------------
anxiety/panic attacks...osteoporosis....Fibro
 xanax


mamanan
Veteran Member


Date Joined Jun 2008
Total Posts : 846
   Posted 7/28/2008 6:12 PM (GMT -6)   
GamJill, you don't know how good you made me feel that I've found someone with the same symptoms I have! I have doubted TMJ before b/c it never mentions anything about tooth pain, adn it is at times so deep, it feels like the bone is being affected. I can't wait to see a rheumy who might have more knowledge of it, or get a referral to someone who does. My doctor says I don't have TMJ b/c it doesn't click, and I have no problems opening and closing my mouth. Even my dentist didn't examine the jaw, but is gettign me a guard to see if it will help (as long as ins. covers it). As soon as dh sees me flinch or leave my coffee, he says it's my teeth. I can't make him understand that my teeth are fine, adn the pain is so much more than just regular sensitive teeth. I've never had tooth pain go up as high as the temples and the eyes.

Sherrine, I will ask my doctor about the calcium too. He wants to check all my vitamin levels before he puts me on supplements. Normally I woudl just take a multi vitamin, but I want to be sure to take enough. I also have a feeling there will be lots of differnet ones to take, I want to make sure it's all safe.

Thanks for all your support! (((HUGS)))
in the land of Limbo, taking OTC meds only.
Don't know what's wrong, can't fix it, doctors are so sloooow!!!


GamJill
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Date Joined Jun 2008
Total Posts : 1279
   Posted 7/28/2008 9:47 PM (GMT -6)   
Mamanan-
I have had pain that goes as high as my temple and the eye. My right side is usually where it hits.
I'm real curious, once you get a mouthpiece if that will give you some relief. I hope so!
In Devin Starlanyl's Fibromyalgia book this question "Do you have unexplained toothaches" is asked and this is the reply. "If you have unexplained toothaches that cannot be explained, they may be caused by several trigger points, mostly the digastric, masseter and temporalis. Each trigger point has its own particular toothache pattern. A trigger point induced toothache is usually intermittent." It also says that it will have you running to the dentist with no apparent cause.
Hope your doing a little better tonight. GamJill
 
 
Fibromyalgia, Depression, Anxiety, TMJ, Arthritis/neck
 
Zoloft, Tylenol 4000 mg., Zanaflex


Gamma
Regular Member


Date Joined Feb 2008
Total Posts : 233
   Posted 7/29/2008 10:23 AM (GMT -6)   
Sounds to me like trigeminal neuralgia.  Try looking up the symptoms and see if they fit what you are feeling.

Gentle hugs,
 
Gamma
 
Fibro, Osteoporosis, OA, RA, DDD, IBS, Vertigo, Tinnitus, Carpel Tunnel, Epilepsy, TMJ,  Hypothyroidism, Familial Tremors, Spasms, Neuropathy, Trigeminal neuralgia, heel spurs
 
 


mamanan
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Date Joined Jun 2008
Total Posts : 846
   Posted 7/29/2008 7:48 PM (GMT -6)   
GamJill, I've tried looking up these trigger points, but all I can find are the same words that you have written. Do you have any more info on this? I'd like to know where to activate these trigger points and see if they bring up tooth pain. -as a side note, hot is doing it too now. I had soup for lunch yesterday, and I was in tears. I felt fine, then all of a sudden (after several spoonfuls) pain went from the teeth, jaw, etc, etc... I was very careful eating after that. But now I've noticed, once the pain settles down, adn my mouth gets used to the temp, I'm fine. So I'm learning to take a few bites, let the pain come and go, then resume eating. It isn't as bad then.- Anyway, what was I saying? Oh yes, I found some really interesting lists of FMS signs, even more then the list in fibro 101. Some that I can remember, sensation of falling when falling asleep, tearing red eyes, ridges in nails.. things that I would never have associated or thought important.

Gamma, at first I researched TN too, but it doesn't fit. My facial pain is constant, if varying. I do have sharp pains that go in the fleshy part of the cheek and the chin, but the cheekbone goes from a very mild pinch to feeling liek the bone is being drilled into. Most of what I've read, TN is a 10 pain and only lasts for a short burst. I see you have it, is yours like that? Atypical neuralgia seems to fit much better, but it isn't (supposed to be) bilateral. Mine went from the left, to both sides, and is now concentrating on the right side with much decreased feelign mirrored on the left. It's all very confusing. I was making myself crazy with the research and trying to figure out what I have. I'm finally learning to accept that I can't do anythign about it, and let the doctors do their thing. I'm still tryign to stay informed though ;)
in the land of Limbo, taking OTC meds only.
Don't know what's wrong, can't fix it, doctors are so sloooow!!!


lucysgd
Veteran Member


Date Joined Jun 2008
Total Posts : 660
   Posted 7/29/2008 11:09 PM (GMT -6)   

Mamanan - You've gotten some great advice from everyone.  I have fibro and have experienced the sensitivity you mentioned.  It comes and goes.  I also find high acid foods can cause problems, as well as sugary foods and hot/cold.  The deep tooth/jaw pain, however does seem to be caused (at times) by trigger point/myofascial problems.  I have a good neuromuscular massage therapist who manages to work it out.  The illustrations in Devin Starlanyls (sp?) book (taken from Travel and Simons) show you exactly where the trigger points are and the referred pain areas they affect.  I can sometimes pinpoint my problem being related to what I have been doing - knitting, ironing, anything involving arms and a head forward position - which puts my bite out of whack and then the whole cycle starts. 

Keeping a journal is a good idea - helps  you make connections to what you've been doing, eating, stressing about (clenching jaw) when the symptoms flare up w/ a vengeance.  Moist heat has been helpful to me also.  Good luck - and I highly recommend the Fibro/Chronic Myofascial Pain book by Devin Starlanyl.  It's a wealth of information.

Lucy

 


Gamma
Regular Member


Date Joined Feb 2008
Total Posts : 233
   Posted 7/30/2008 1:04 PM (GMT -6)   

Mamanan,

When I have an attack of TN it is not quick, the last episode lasted for almost 4 weeks.  Sometimes the pain was past a 10 and sometimes it would come all the way down to a 8.  It is sure miserable when it attacks.


Gentle hugs,
 
Gamma
 
Fibro, Osteoporosis, OA, RA, DDD, IBS, Vertigo, Tinnitus, Carpel Tunnel, Epilepsy, TMJ,  Hypothyroidism, Familial Tremors, Spasms, Neuropathy, Trigeminal neuralgia, heel spurs
 
 


D388i3
New Member


Date Joined Sep 2008
Total Posts : 2
   Posted 9/16/2008 2:10 PM (GMT -6)   

Hi Everyone,

I was reading everyone's post and felt I am having the same issues as Mamanan. I was wondering if anyone has had any results or luck with a diagnosis? I have been experiencing this pain for a few days now and have seen the dentist and doctor and been sent home with no help. The dentist took xrays and banged on the teeth. He said he saw where the gums were red, but could not tell how they got like that. The doctor looked at it and said that she could see the cheek swollen a little, but that was the end of that. I cannot live like this too long! The pain is very bad- at times- and I fear this will only get worse.

I hope someone has gotten some answers by now....please help...


mamanan
Veteran Member


Date Joined Jun 2008
Total Posts : 846
   Posted 9/17/2008 11:47 AM (GMT -6)   
Hello D388i3, and welcome to the forums! I'm sorry I didn't see your post sooner. I hope you are feeling a bit better; tooth pain can be so debilitating! This episode that I refered to when I wrote the post lasted about 2 weeks, if I remember rightly. 2 other episodes where my pain had gone into the teeth lasted about a week, but this was the worst by far. Luckily I haven't had it that bad since. I still have 1 tooth that is more sensitive, but the others are fine now. I still have pain in both cheekbones now, but only very slight. I credit that to the amitriptyline the doctor put me on. I still very much doubt TMJ, but I am convinced part of it is muscular. There are times when the pain gets too bothersome, I work at relaxing my facial muscles, or rearrangign them at the least. Then I feel all the muscles on the side of my face pulling up towards the temples, it feels like a face lift, and the pain gets redistributed. Some of it I think is neurological, those zaps and pinches I mean, but I'm no doctor, so who knows.

You mentioned that your cheek was swollen, mine does not. Have you tried Tylenol or Advil? I didn't help with the facial pain at all, but it did help with the tooth pain, so at least it was more bearable. Heat helped also. Please don't dwell on it getting worse. If it is very bad now, I'd say it can only get better! Mine did fluctuate a lot, these last 3 weeks I've hardly noticed it. I hope you get answers and some relief soon. If you have any more question, please feel free to post, we are all here to help.
in the land of Limbo, taking OTC meds (which don't work).  Started at 5mg of amitriptyline.
Waiting for referral to rheumy to get a dx. waiting, waiting, waiting....


poco
Regular Member


Date Joined Jul 2008
Total Posts : 53
   Posted 9/17/2008 4:40 PM (GMT -6)   

It really seems like you have got alot of good info and advice. I really appreciate it because I get pain in my teeth and gums alot. And when I have dental work it rocks my world!!! And it seems to last forever!!! I also have osteoprosis but I don't know if that has anything to do with it. I hope you find some relief soon!

Poco


 Fibromyalgia, Osteoprosis, Allergies, Severe Depression, PTSD, Anxiety/Panic attacks, Stress, Mood Disorders , IBS, Bone spurs, Hypothyroidism
 
I have taken off my meds cause there are so many of them but if you want to know just ask!
 
God delivered me from my severe depression!!!


tyno3
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Date Joined May 2008
Total Posts : 1081
   Posted 9/17/2008 6:10 PM (GMT -6)   
i just want to add my two cents into the mix. Starting about four months ago, I noticed my mouth would ache, teeth would ache but it wasn't always the same teeth. It would be up or down, left or right. I can remember some really unbearable episodes. So, first I went for the quick fix, I found these tooth sensitivity reduction kits, thet are cotton swabs with some kind of gel that you paint on your teeth just before bedtime, don't rinse off and overnight the gel works to put a coating on your teeth to reduce sensitivity yeah   Then I started carrying orajel with me everywhere. Finally, I went to a dentist. She xrayed and found two small cavities (not even near where I was perceiving the pain), and one cracked wisdom tooth which she extracted. I have had only one mild episode since. Also, I started with the Orajel floride and anti-bacterial rinse twice a day after brushing and this seems also to have helped. We Fibro folk tend to perceive even the slightest injury or change in temperature, such as sitting down on a cold chair much more acutely than average folk, at least I do. It's like my body is trying to say : "lookey here lady, healing is a big deal for me so you're gonna hear from me, loud and clear (via pain signals) whenever you put us at risk."

D388i3
New Member


Date Joined Sep 2008
Total Posts : 2
   Posted 9/20/2008 8:43 AM (GMT -6)   
Hello again everyone.
First, thank you so much for the replies and great advice. I wanted to fill you in on the latest....
I went back to my doc and they referred me to an EENT doc because they felt it was a perotid gland stone. I went to the EENT doc and she tried to flush the stone out with no luck. She sent me for a CT scan and the scan showed no stones. The scan showed some sort of nodule on the thyroid gland. So now I am scheduled to see an endocrinologist in a month. The mouth is still sore but not as bad. I am on different antibiotics and hoping it will help clear up whatever is going on.

Well, thanks for listening! I welcome any inputs.

lucysgd
Veteran Member


Date Joined Jun 2008
Total Posts : 660
   Posted 9/20/2008 10:15 AM (GMT -6)   
Hi D388i3 - Glad you are getting some help. I think the swelling adds clues. I want to mention 2 things....first - my daughter experienced the parotid gland stone thing as an adolescent. At least that was the dentist's diagnosis. It's been so long ago - I don't remember what they did - but it did go away and she's never had it return.

Second....you might want to check the lupus/arthritis boards here. Parotid gland swelling & discomfort could be a symptom of Sjogren's Disease. The arthritis foundation would also be a good website for info on these autoimmune problems.

My rheumie strongly suspected Sjogren's with my symptoms of fatigue, dry mouth and eyes, and mild swelling in the parotid area on one side. I even had a lip biopsy since the blood tests came back negative for Sjogren's but positive for ANA. The biopsy is done by an ENT - they take a couple salivary glands from the inside of your lip. Sounds painful, but wasn't bad at all. It was negative for me - though the rheumie isn't quite convinced...said false positives are known to occur.

It's good you're seeing an endocrinologist - do you have a rheumatologist? I'd be interested in knowing what you find out. I have the sensitive teeth issue, but have also been recently having some ear pain (bad, stabbing, nerve-like) over the last few mos. It lasts for a couple days and recedes. Even the outside of the ear is sore. I will ask my rheumie when I see her.

Good luck...and WELCOME....and keep us posted!
Lucy
diagnoses:  mono 1972; postviral CFS 1997; fibro 1998; CEBV 2005; UCTD (dx limbo) 2007
meds:  occasional low dose xanax for sleep, artificial tears w/ ointment at night, ibuprophin (none of which manages the problems very well!)
 
We cannot avoid the birds of sadness flying over our heads, but we need not let them make nests in our hair. 
       ~~ Chinese saying as quoted by Helen Nearing


Sue2z
Regular Member


Date Joined Jul 2008
Total Posts : 368
   Posted 9/21/2008 2:01 AM (GMT -6)   
I know its sounds odd but my husband basically made me take sinus type med a spray for allergy and he made me keep it up and the pain has lessoned heaps,  I have TMJ and  sore teeth and side of face and behind the ear.  So long as I use the spray and watch what I eat it is soo much better.  sue2z

Fibromyalgia, ulcerative colonitus, arthritus, bi-polar
norspan patch, valium, prothiedon, lyrica


poobie1234
New Member


Date Joined Sep 2008
Total Posts : 1
   Posted 9/26/2008 3:42 PM (GMT -6)   
I think you have trigeminal neuralgia. I believe I have it too. I have severe pain in my teeth when I eat and other times during the day. it feels like I am chewing on glass and triggers pain through my jaw. I also haev severe burning pain in my jaw and it hurts to talk or anything else. Does anyone know what this could be?

miss blue18
New Member


Date Joined Jul 2010
Total Posts : 1
   Posted 7/8/2010 9:42 PM (GMT -6)   
my daughter is a pre teen and one of her molar teeth hurt. she says that it is a loose tooth but it has been like that for a month. she also says that it hurts her jaw. anyone know if this is just a stage or of i need to tahe her to a dentist. please if you know send me a message.

4321
New Member


Date Joined Dec 2010
Total Posts : 2
   Posted 12/6/2010 2:16 PM (GMT -6)   
 
DIY triggerpoint may help.  Look at the referred pain areas and zero in on the muscles that need care.
 
 
A good book to buy is:  http://www.triggerpointbook.com/
 
LE

jacaal
New Member


Date Joined Feb 2013
Total Posts : 5
   Posted 2/22/2013 12:49 AM (GMT -6)   
I am new to all of this. New to chat forums ...new to fibromyalgia...new to taking meds and new to finally being able to put a reason to my pain. I am SO RELIEVED to know that I'm not alone. My tooth/jaw/face pain has been going on for 2 years now. Its very random and until now I just thought it was bad teeth. I'm (right this moment) in so much pain I'm alternating between screaming and crying. Yesterday it was a dull ache. The day before that it was a completely other part of my body...my hips. I just don't know what else to do. I haven't missed any doses of meds. I have taken my effexor, meloxicam,hydrocodone,mirapex, (and even in desperation) extra tylenol and ibuprofen (I know this is not a good idea and I normally would try harder to protect my stomach). I have applied heat to my neck front and back and cold to my jaw. I have been massaging my neck and face. All these are great ideas but nothing is helping. AAAAAHHHHHHH!

nameless1
Regular Member


Date Joined Dec 2012
Total Posts : 95
   Posted 2/22/2013 2:32 AM (GMT -6)   
I have also had these issues for years. I was diagnosed with TMJ 20 years ago, but was unable to wear the teeth guard while sleeping as it gagged me. My pain is mostly on my left side.

I goes from the back of my eye, to my ear, jaw and down my neck. It has been bad today. It seems like I have several different kind of head aches which seem to evade diagnosis. Sometimes it is left sided only, others my whole head, other times just behind the eyes.

The only real trigger I have found is when the barometric pressure drops. Living in New England we have a lot of storms, so it happens a lot.

I also have light sensitivity, which was confirmed with an eye exam. They told me I am lacking pigment in my retina, or something like that.

I have a head ache every day, at its mildest it is just sinus pressure and at its worst a full blown migraine.

I do not need any heavy pain killers luckily as it is manageable, even if being in pain all the time is frustrating and exhausting.

I would also like others feedback on this topic.
As I am have been lovingly told by many of you on this site I am not in fact nameless. My name is Jennifer. Thank you all for your support.

Major depressive disorder, chronic muscle fascia pain, chronic head aches, recovering alcoholic/drug addict-clean and sober for 22 years

Luvzminis
Veteran Member


Date Joined Apr 2008
Total Posts : 1832
   Posted 2/22/2013 11:10 AM (GMT -6)   
I had much sensitivity in my mouth on the right side last year and had my dentist take a look at it. It turned out to be fine--no teeth problems--and gradually disappeared. Since having my appendix out in 2011, I have developed all kinds of odd pains--always on my right side. I mentioned this to my dentist and he said he, too, has noticed that if one side of the body has had trauma, most pain comes from that side later, for some reason. Nerve paths, maybe?

My doctor thinks it's nonsense. However, I developed supraspinatus tendinitis in my right shoulder and a very sore hip on my right side since surgery.

I should also mention my right side, for some reason, has always been my 'wimpier' side. And just last night, before the snowstorm moved in, I had major throbbing pain in my right arm, hand and fingers, all the way to the shoulder. It's totally gone now, but interesting it was, once again, pain in my right side.

I do blame the storm for the pain--this seems to happen frequently. Just talked to a lady yesterday whose arthritis was acting up big time, just before the storm.

I wonder if weather might play a bigger role in our pain than we sometimes think?
"Let us always meet each other with a smile, for the smile is the beginning of love."
Mother Teresa
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