Anyone with tooth sensitivity from TN? If so, what meds relieve it?

Hi, I have classic type 1 TN in my lower mandibular nerve. I am suffering from (quite extreme) tooth sensitivity that just won't go away.

Although 200mg of Tegretol cleared up the electric shocks within ten days, my current dose of 800mg is doing nothing to clear up this very annoying problem. It means I can't eat or drink on the right-hand side of my mouth and I have to be careful about the temperature of everything that goes into my mouth. My 'sensitive' teeth don't like sweet much either!

Do any of you suffer from a similar symptom, and if so, what meds, in what dosage, do you find effective?

Mild tooth sensitivity is very common and is quite normal to suffer from time to time, if you are suffering severe tooth sensitivity then this would indicate a more serious dental condition such as a broken or cracked/chipped tooth or tooth decay which is disturbing the tooth pulp causing the sensitivity, or even a recent or new filling will cause tooth sensitivity.

Mild tooth sensitivity is caused by the gradual exposure of the softer part of your tooth that lies under the tooth enamel, called dentine. Dentine has tiny tubes that lead to the nerve and are filled with fluid (the tooths nerve is protected by pulp tisuue). Eating, drinking hot, cold or sweet foods and drinks can cause a change in fluid movement. This fluid movement causes the nerve endings to react in response, triggering a short, sharp pain (normal tooth sensitivity the pain should quickly subside).

Recent or new fillings will always give discomfort/sensitivity for the first few days, especially if the filling is close to the tooths nerve. Sometimes a dentist may have to drill to far into the tooth if the decay is deep, this then may damage the tooths pulp to much for it to recover. The tooths nerve will then be open for infection (abscess) and slowly the tooth will die, thats if the pulp cannot recover to protect the tooths nerve. If this happens you will need a root canal to save the tooth, but the tooth will still be dead as their is no nerve, the tooths nerve is taken out during the root canal procedure.

There is a condition called Pulpitis, there are two types ''Irreversible and Reversible'' Reversible pulpitis is generally characterized by sharp sensitivity to cold, sometimes to sweets and sometimes to biting. Usually heat doesn't bother the tooth as much. Irreversible pulpitis is a severe inflammation of the dental pulp where the pulp tissue cannot recover and the tooths nerve is effected causing it to die.

Basically is you are suffering from mild tooth sensitivity and you have not had a new filling or any other recent dental work, then you may want to use a toothpaste specially developed for sensitive teeth that helps protect the dentin and those tiny microscopic tubes that lead to the center of the tooths nerve.

If the pain is severe, you may want to see your dentist to check your teeth for cavities, decay. Any tooth with an old filling may have under lying problems such as leakage/decay under the filling, the tooth may have a microscopic hairline crack due to an old filling (micro-cracks do not always show up on x-rays).

I hope you can get the correct treatment and feel better soon.

Many thanks for that mine of information, Dallas. I'm a bit ahead of you though and am already well 'genned up on tooth sensitivity. One of the upsides (maybe!) of being a dental phobic is you obsessively know everything there is to know about teeth. I never go into a dentist's unprepared!

I'm already on sensitive toothpaste, but this was a healthy tooth, both on the X-rays, and in that I had only had ordinary sensitivity until just before this started happening. The sensitivity had got worse, but I think that may have just been a pre-cursor to the electric shocks of the neuralgia moving in on me.

The fact that Tegretol worked for me, and that it is still slowly eroding the problems I'm having each time the dose goes up a little, means that it's almost definitely TN and not teeth. My confusion is merely about the degree of sensitivity.

I'm familiar with tooth problems, what I'm not familiar with is TN. I was hoping people who had TN could help me discriminate between the two things.

By the by, I noticed from an old thread in 2013 that you were refusing to take Tegretol or anti-depressants to control your TN. Have you since found a medication you like?

This pain is terrible. It is TN pain. I take 800mg gabapentin and trileptal along with Norco as needed. I still have pain. By the way, I have been to the dentist numerous times. He takes x-rays. There is never anything wrong with my teeth. It sounds like you may have some type 2 pain developing.

Mine is the same. My left side TN always stems for the same tooth. It was unnecessarily root canaled over a year ago. My dentist has looked at it many times, taken x-rays and done cold tests. It is dead as far as he is concerned and I should have NO feeling in that tooth.

Well even when my medication is working well that tooth still hurts. If I touch it, put any pressure on it or floss around it the pain is terrible.

My dentist did file it down a little bit so that it doesn't touch my other teeth when I bite. I also have trouble eating on that side.

Hi Sunshine, yes, endless visits to the dentist seems to be part and parcel of this condition. I'm still not sure though how many people with TN have wincing type pain that reacts to hot and cold, or classic throbbing, burning type toothache. Which do you get? I see you use a painkiller (Norco). That would be no good for classic sensitivity, so I just wondered. And yes, I have wondered if I have a touch of type 2 in the mix as well.

sunshine said:

This pain is terrible. It is TN pain. I take 800mg gabapentin and trileptal along with Norco as needed. I still have pain. By the way, I have been to the dentist numerous times. He takes x-rays. There is never anything wrong with my teeth. It sounds like you may have some type 2 pain developing.

Hi Jane, yes, this common tale is the main reason why I don't want to do a root canal if I can avoid it. 1)it doesn't seem to help anyone who has it done and 2) I'm frightened it will actually make the situation worse. Reading how many people get TN after dentistry makes me think that the dentistry may not actually have caused it in all of those cases, but going so close to the trigeminal nerve tips an existing condition over the edge and so it becomes full-blown TN.

It would be interesting research for someone to do to see if there is anyone with TN who hasn't had a root canal. They certainly seem to be the most commonly recurring procedure in sufferers.

I've never asked you, is your tooth/teeth classically sensitive, i.e. wincing sharp pain when subjected to hot/cold/sweet or is it more of a generalised toothache (burning, throbbing, keeps you awake at night with a hot water bottle type)?

justjane37 said:

Mine is the same. My left side TN always stems for the same tooth. It was unnecessarily root canaled over a year ago. My dentist has looked at it many times, taken x-rays and done cold tests. It is dead as far as he is concerned and I should have NO feeling in that tooth.

Well even when my medication is working well that tooth still hurts. If I touch it, put any pressure on it or floss around it the pain is terrible.

My dentist did file it down a little bit so that it doesn't touch my other teeth when I bite. I also have trouble eating on that side.

I didn't realize you live in the UK, its great to see another UK member on here.

How do you find the NHS treatment regrading TN ?

Hi Dallas, yep, I'm stuck here in (currently cold) old UK, in Edinburgh. I don't know that I can really comment yet on how good TN treatment is on the NHS as I am really new to this. Unlike a lot of people, I was diagnosed very quickly (I think it was within a fornight-ish). True, my dentist didn't know enough to not go through with a root canal when there was nothing showing on the X-ray, but when I told her what the doc thought it was she did know the disease. I have a neurologist's appointment for the 8th of July, so maybe then I'll see just how good it is. I intend to ask for an MRI, so we'll see how they respond to that. Certainly my doctor actually knows very little about it, just the basics; that's not been helpful, at all. But otherwise those are my only complaints. I've been very lucky compared to a lot of people.

Dallas said:

I didn't realize you live in the UK, its great to see another UK member on here.

How do you find the NHS treatment regrading TN ?

Oh, and I did have to ask for a neurologist's appointment, which I do think is bad form. It's not really something you should be walking about with without a neurologist's appointment because it could be a tumour or MS, but hey, it's not the first time that's happened. I walked about for many, MANY years with gastric troubles, downing ulcer medication, when I actually had gallstones. A simple ultrasound would have found that out, but no doctor ever suggested it.

Woman with the electric teeth said:

Hi Dallas, yep, I'm stuck here in (currently cold) old UK, in Edinburgh. I don't know that I can really comment yet on how good TN treatment is on the NHS as I am really new to this. Unlike a lot of people, I was diagnosed very quickly (I think it was within a fornight-ish). True, my dentist didn't know enough to not go through with a root canal when there was nothing showing on the X-ray, but when I told her what the doc thought it was she did know the disease. I have a neurologist's appointment for the 8th of July, so maybe then I'll see just how good it is. I intend to ask for an MRI, so we'll see how they respond to that. Certainly my doctor actually knows very little about it, just the basics; that's not been helpful, at all. But otherwise those are my only complaints. I've been very lucky compared to a lot of people.

Dallas said:

I didn't realize you live in the UK, its great to see another UK member on here.

How do you find the NHS treatment regrading TN ?

Lol, the neurologist's I saw down here in Christchurch in Dorset was absolutely useless. He got me to do a dozen small exercises and said, its stress you are suffering from, he also said dont have anymore teeth out and keep taking the medication.

Maxi-facial clinic more-or-less said the same thing, told me my MRI came back normal, told me stress can cause TN and that its a chronic condition and I would have to keep taking the medication. They said they would not want to operate at this stage, they also said dental procedures can cause Trigeminal Neuralgia.

I find the UK NHS very un-skilled, doesn't seem to be very much knowledge regarding TN here in the UK.

There definitely isn't much knowledge, for sure. I have no idea where your neurologist got the idea that stress caused TN. Are you sure he didn't say stress made it worse? That's definitely true - I've learned that from experience already. As soon as I get upset I get more frequent pain, which hurts more acutely. But causes it? I don't think so.

However, they are both right about not having any more dental work done; that can only make matters worse, and is pointless to boot. And also it is a chronic condition which means you do have to keep taking the medication. It's a bitter pill to swallow (ha! a pun), but if you think about it, it's in your interest to be Zen and go with the flow. After all, you can't change it, and stress makes it worse, so why inflict extra pain on yourself?

The MRIs coming up blank, as it were, is a real problem. I know they are very reluctant to operate unless they can see something, but you can hardly blame them. Brain surgery is no joke, and do you really want a bunch of surgeons poking around in there in the off-chance they find something? I mean where would they begin looking? The brain is a big place.

I think they definitely do a lot wrong; not least of which is there is no - ZERO - connection between dentistry and doctoring, which means conditions like these often go misdiagnosed by both parties. And rare conditions definitely don't get the budgets, either for doctoring or for research, but they can't be blamed for the fact that the disease is incurable and for not wanting to poke inside your brain without something to go on.

It sounds bizarre, but you'll need to hope a tumour or something shows up some day and that way they can do something more concrete for you!

Hi Jamie, yeah, I've already taken this message to heart. I went back to the dentist yesterday, told her the tooth sensitivity was suspect and probably part of the disease, and we closed the tooth back up in the most minimally damaging way we could. So I'm saved the horror of one, probably needless, root canal. Unfortunately I lost some of my tooth in the process, but that's crying over spilt milk. Things could have been a lot worse. You see many, many people on these forums who go as far as having three or four teeth extracted, looking for relief, so I got off very lightly!

Jamie said:

Im kinda like you justjane37,

My tooth was filled with amalgam. Still pain. Crowned. Still pain. Root canaled. Still pain. Finally extracted after begging and pleading. STILL pain.

The pain is still being referred to the extracted, empty tooth as if the tooth were still there. Phantom tooth pain now or Atypical Odontalgia. A healthy tooth with TN pain was all it ever was. Nobody said a dang thing. This was all within a 5yr span. The extraction was the last thing done in 04. The filling was in '99. The pain was going on the entire time. I'm not getting a bridge bc it's in the back and can't be seen when I smile. And I'm never ever never evertrrr getting an implant!

Moral of the story, if the dentist tells you and shows you that nothing is wrong with the tooth, leave it alone. All the needless and unnecessary dental work just causes more pain and complications.

justjane37 said:

Mine is the same. My left side TN always stems for the same tooth. It was unnecessarily root canaled over a year ago. My dentist has looked at it many times, taken x-rays and done cold tests. It is dead as far as he is concerned and I should have NO feeling in that tooth.

Well even when my medication is working well that tooth still hurts. If I touch it, put any pressure on it or floss around it the pain is terrible.

My dentist did file it down a little bit so that it doesn't touch my other teeth when I bite. I also have trouble eating on that side.

Hi, I am one of those people who have had several unnecessary extractions, and yes I would plead with the dentist to take the tooth out (would have to sign a consent form).

With each extraction has brought pain relief, having less rear teeth has certainly reduced the TN pain. It may sound silly, but as the tooth or teeth are not there, they dont hurt as much.

I can still feel the TN pain where the tooth/teeth were (phantom pain/ache as it were), but its alot less which is a god send. It has been a massive struggle through (psychologically), its still hard to come to terms with losing so many teeth unnecessarily.

So in all fairness, its really hard to say what really works for the individual. In my case the TN won, it won the battle over my teeth and now wants to keep going. BUT! I have weakened its strength by removing some of its pain conductors (my teeth), I have taken some control back. They may call it the suicide disease, so it may take my teeth, but it will not take my life.

Regards

Dallas


Woman with the electric teeth said:

Hi Jamie, yeah, I've already taken this message to heart. I went back to the dentist yesterday, told her the tooth sensitivity was suspect and probably part of the disease, and we closed the tooth back up in the most minimally damaging way we could. So I'm saved the horror of one, probably needless, root canal. Unfortunately I lost some of my tooth in the process, but that's crying over spilt milk. Things could have been a lot worse. You see many, many people on these forums who go as far as having three or four teeth extracted, looking for relief, so I got off very lightly!

Jamie said:

Im kinda like you justjane37,

My tooth was filled with amalgam. Still pain. Crowned. Still pain. Root canaled. Still pain. Finally extracted after begging and pleading. STILL pain.

The pain is still being referred to the extracted, empty tooth as if the tooth were still there. Phantom tooth pain now or Atypical Odontalgia. A healthy tooth with TN pain was all it ever was. Nobody said a dang thing. This was all within a 5yr span. The extraction was the last thing done in 04. The filling was in '99. The pain was going on the entire time. I'm not getting a bridge bc it's in the back and can't be seen when I smile. And I'm never ever never evertrrr getting an implant!

Moral of the story, if the dentist tells you and shows you that nothing is wrong with the tooth, leave it alone. All the needless and unnecessary dental work just causes more pain and complications.

justjane37 said:

Mine is the same. My left side TN always stems for the same tooth. It was unnecessarily root canaled over a year ago. My dentist has looked at it many times, taken x-rays and done cold tests. It is dead as far as he is concerned and I should have NO feeling in that tooth.

Well even when my medication is working well that tooth still hurts. If I touch it, put any pressure on it or floss around it the pain is terrible.

My dentist did file it down a little bit so that it doesn't touch my other teeth when I bite. I also have trouble eating on that side.

I agree Jamie. I am terrified of the dentist now. I first had TN in a tooth when I was 29. I took Amitriptyline and went into remission until last year when I was 37. When I had all of the dental work I knew in the back of my mind that it could be TN. As soon as the root canal didn't make the pain go away I asked my doctor for Amitriptyline.

The dentist knew I had previously had TN and he still talked me into doing a root canal. I desperately wanted it to work so I went along with him. When the root canal didn't work the first thing he said was that it could be related to TMJ. I had been down that road the first time and knew it wasn't that.

I consider myself lucky though. Listening to how long it takes for people to receive a diagnosis and all of the dental work people have had unnecessarily.

Jamie said:

Im kinda like you justjane37,

My tooth was filled with amalgam. Still pain. Crowned. Still pain. Root canaled. Still pain. Finally extracted after begging and pleading. STILL pain.

The pain is still being referred to the extracted, empty tooth as if the tooth were still there. Phantom tooth pain now or Atypical Odontalgia. A healthy tooth with TN pain was all it ever was. Nobody said a dang thing. This was all within a 5yr span. The extraction was the last thing done in 04. The filling was in '99. The pain was going on the entire time. I'm not getting a bridge bc it's in the back and can't be seen when I smile. And I'm never ever never evertrrr getting an implant!

Moral of the story, if the dentist tells you and shows you that nothing is wrong with the tooth, leave it alone. All the needless and unnecessary dental work just causes more pain and complications.

justjane37 said:

Mine is the same. My left side TN always stems for the same tooth. It was unnecessarily root canaled over a year ago. My dentist has looked at it many times, taken x-rays and done cold tests. It is dead as far as he is concerned and I should have NO feeling in that tooth.

Well even when my medication is working well that tooth still hurts. If I touch it, put any pressure on it or floss around it the pain is terrible.

My dentist did file it down a little bit so that it doesn't touch my other teeth when I bite. I also have trouble eating on that side.

I have to say I think I have been lucky with the NHS. My GP had trained in neurology so immediately knew what the problem was. My neurosurgeon Mr Patel, Bristol, is very understanding. I unfortunately have been unlucky with the outcome of the procedures I have had done but at least I have had the opportunity to have them.

Dallas said:

Lol, the neurologist's I saw down here in Christchurch in Dorset was absolutely useless. He got me to do a dozen small exercises and said, its stress you are suffering from, he also said dont have anymore teeth out and keep taking the medication.

Maxi-facial clinic more-or-less said the same thing, told me my MRI came back normal, told me stress can cause TN and that its a chronic condition and I would have to keep taking the medication. They said they would not want to operate at this stage, they also said dental procedures can cause Trigeminal Neuralgia.

I find the UK NHS very un-skilled, doesn't seem to be very much knowledge regarding TN here in the UK.

Been in remission over a year but still occasionally have sensitive tooth days...that is actually the main symptom I had before my full-blown tn attack. It is definately the tn because one day it is my upper incisor another day a lower molar --all on the left side... some days I can't even bite down, but then I wake up the next day and it seems to be fine. I know I always will be dealing with this, but hope the tegretol will calm things down if they flair up bad again. I have a lot of dental work that needs to be addressed, but I have heard that for a number of people it brings you out of remission...at this point I will live with the chipped teeth and missing fillings...terrified to get it stirred up! Hope your nerve calms down soon!!

Darn it, my post disappeared. Look, there's a chance it comes from a bad bite and you need some simple tooth grinding. I have had TN 2 for decades, but came down with toothache plus sharp head pains on the same side. I almost went to the ER. Dentist didn't know I had TN2 (it's the first time I visited him), yet he diagnosed me with TN1, ground my teeth to correct the bite, and sent me home convinced he was a jerk. The pains, tooth and head, vanished that evening. I remain a TN2er, unfortunately, and now appreciative of what you Typicals have to live with.

Hi Tacocat, I'm on 800mg of Tegretol now but I still have bad tooth sensitivity in one area of my mouth. My big fear is that the tooth actually is so sensitive it needs fixing by root canal and I'm giving myself grief, but then I remember how it was before the TN electric shocks started, and it wasn't like this, so I find the whole thing suspect. Unfortunately mine doesn't move about, although I do get mini-strikes in a front (filled) tooth so that's a little comforting, in a bizarre way. I wish I could get something more definitive to go on, but it just taunts me.

I don't feel very keen on upping my dose at the moment since my jump from 600 to 800 has not gone nearly as smoothly as previous jumps; I have bad side effects that are refusing to let up, although it's been a fortnight at the new dose now. I'm seeing a neurologist tomorrow, so perhaps she'll be able to suggest something - although I've already learned that medical professionals are not too great with this condition! If only I could lose, or even damp down, the sensitivity I could live with this, but it's a major pain.

tacocat said:

Been in remission over a year but still occasionally have sensitive tooth days...that is actually the main symptom I had before my full-blown tn attack. It is definately the tn because one day it is my upper incisor another day a lower molar --all on the left side... some days I can't even bite down, but then I wake up the next day and it seems to be fine. I know I always will be dealing with this, but hope the tegretol will calm things down if they flair up bad again. I have a lot of dental work that needs to be addressed, but I have heard that for a number of people it brings you out of remission...at this point I will live with the chipped teeth and missing fillings...terrified to get it stirred up! Hope your nerve calms down soon!!

Hi Howard, believe it or not I've suspected a bite connection from the very beginning, but no-one else thinks it's valid. When I very first went to the dentist I took my nightguard with me (this was before we learned it was TN) and showed her the fact that there is a big hole ground away in it right over my 'sensitive' zone. I know grinding can cause gum recession and tooth sensitivity, but she just said 'That's interesting' and paid it no more heed. I also told my doctor, but he's not interested either.

I actually know my bite is off because some years ago my incisors stopped meeting on that same side. I told my dentist at the time and I think he put it down to my teeth moving about due to gaps in molars (practically no molars on the right side- again the same side). To me it all seems kind of cumulative and suspicious, but no-one else seems to think so, so I ran out of people to ask. If they think it's not important I assume it's not important.

What is the tooth grinding thing they did for you? It sounds a bit lethal! I have dental phobia, which complicates the issue, as I'm not good with dental procedures!

thehoward said:

Darn it, my post disappeared. Look, there's a chance it comes from a bad bite and you need some simple tooth grinding. I have had TN 2 for decades, but came down with toothache plus sharp head pains on the same side. I almost went to the ER. Dentist didn't know I had TN2 (it's the first time I visited him), yet he diagnosed me with TN1, ground my teeth to correct the bite, and sent me home convinced he was a jerk. The pains, tooth and head, vanished that evening. I remain a TN2er, unfortunately, and now appreciative of what you Typicals have to live with.