Is he a house cat or does he go outside and wander. If so keep him indoors for a while.

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he literally barely wants to go outside, if i leave the door open for an hour he might actually go out there but generally not

i think he is in a lot of pain, all the time

i left a cat with my mother that had mild gingevitis and at some point she took her to the vet and turned out extracting a tooth and cleaning the gums under it made her into such a happy kitty that my mother had to kick her out because she was such a monster for the lap, and my ma is a compulsive fibre artist and her fur was literally interfering with her spinning work (she was a medium hair black cat)