ATN after re-root canal, overfill? implant?

General General TN & GPN (Old Site)
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It started with a sore face. X-rays showed 4 cysts, abscesses in my upper jaw this past March. My dentist sent me to endodontist specialist. the best around here... 1 apico, and 2 re-root canals.and 1 extraction. Immediately after one re-root canal, i had unbearable face pain, shooting and constant. i really thought I would not make it through for a week or two-- narcotics did nothing but make me sicker. clove oil helped some for brief periods, and finally steroids worked to quiet the nerve, my face was still sore for months though and i was on antibiotics for over 1 month with no relief. Things seemed to finally resolve with a magic mouth wash my dentist prescribed - a mix of antibiotics and steroids. Most of the summer I felt good. But now my face hurts again, above me teeth, my cheek and under the eye... I went back this week and the X-ray showed 2 abscesses are still there :( and of course -- one is at the root of the re-root canal that caused all the ATN. the last x-ray shows what maybe an "over-filled root" on that tooth.?
Q: Might an over-fill cause the ATN?

My dentist is sending me back to the endontist specialist where I had the work done originally. I see him in two days.
I also went to another endodonist last week, on my own for a second opinion, and he said about the over-fill: these things happen ... and he'd send me back to the same endodonist as he is the best.

My dentist said he will talk to my endodonist about what would be best at this point, try again and re-do or extract...

I told him that either way i am scared.

I am afraid that re-doing this root canal, for the 3rd time, could aggravate the TN nerve again and I have heard that having it pulled could cause permanent TN pain!

mc%20root%20canals%20xray.jpgAt least he seems concerned as well, he said:

"If the endodontist feels it cannot be fixed again, and we have to pull it, you will come back to me and I have been doing research specifically because of your case. I have learned there is new method where they pack the extracted tooth with a steroid, and have success at keeping the nerve pain at bay."
I am glad for that

Q: has anyone had experience with this packing with steroids to avoid ATN pain? was it effective?

He also said he'd want to do implants and that scared me...

Q: has anyone had ATN from implants? could an implant cause nerve pain?

I called a homeopath am trying plantain and yarrow for the infection now, as they hesitate to give me more antibiotics as this infection seems to be resistant to....

I am not sure which direction to go, to keep getting a root canal when the infection returns? or have them pulled and risk permanent damage to the nerve?

Thanks for any advice. mc

134-mcrootcanalsxray.jpg (570 KB)
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Oh I should've said: My dentist did confirm I had TN (1&2) but I was never referred to a neurologist as the steroids calmed it down.

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Dental procedures such as root canals, implants and extractions can definitely cause nerve damage. Sometimes the damage will heal itself over time but, unfortunately for some, the damage remains. There are a couple of members on here with good knowledge regarding this and they will probably jump in.

My advice to you is do your homework before you let another dentist or specialist touch your teeth.

The diagnosis of TN/ATN can also be tricky if there is a possibly that your neuropathy is from damage rather then compression on the nerve.

TN is the compression of the trigeminal nerve by a vein or artery. Sometimes people that have TN will mistake it for a toothache and have procedures down trying to get rid of the pain. That happened to me. I had pain for months and ended up having an unnecessary root canal. Some of us have gone so far as having several teeth pulled only to be left in the same or worse pain.

But if your nerve pain is from damage to the nerve from dental procedures then it is not TN and must be treated accordingly.

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Question for just jane, what do you mean that TN can’t be caused by damaging the nerve. My husbands TN started imideately post root canal. MRI showed nothing compressing the nerve,. So if that’s how it starts, it’s not considered a form of TN?
New here and trying to learn.

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mcv, could they have missed a root when doing the root canal ... both times?

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I'm no where near an expert at looking at xrays but the tooth on the right does have an overfill. It appears to be a small bead outside of both roots which isn't always a problem. The tooth on the left doesn't seem to be filled to the end and/or the large filling looks awfully odd....it seems the edges on both sides are almost uniformly jagged. Is there a file or something left in that tooth?

What material did they use? Ask if anything with formaldehyde was used. Don't just ask what they used. you have to specifically ask if formaldehyde was use.

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This is something that is being discussed on the forum a lot right now. It can be confusing. Trigeminal Neuralgia is caused by a compression. From what I have learnt nerve injury or neurological pain with an unknown cause is called many other things--ATN, AFP, AO, etc. It's an important distinction because the procedures used to treat each can be different.

Look at this post:

http://www.livingwithtn.org/forum/topics/dont-treat-dental-injuries-with-classic-tn-procedures

Edna said:

Question for just jane, what do you mean that TN can't be caused by damaging the nerve. My husbands TN started imideately post root canal. MRI showed nothing compressing the nerve,. So if that's how it starts, it's not considered a form of TN?
New here and trying to learn.
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THANK YOU ALL FOR YOUR COMMENTS! I see my endodontist tomorrow, I will see what he suggests. I will ask him questions. Since my nerves are close to these roots, as my past experience indicates, I just want to know how we can best avoid activating the pain, maybe an oral surgeon or neurologist would be advised...

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And some information on the website that Cleo posted ... Although this may have come from an attorney website, there is no doubt in my mind that there are qualified doctors behind this information and probably a whole lot of medical malpractice cases...

Microvascular decompression is performed under general anesthesia and is the most invasive of these surgical procedures, but it does not result in permanent nerve damage. The aim of microvascular decompression surgery is to alleviate neurovascular compression upon the trigeminal nerve root and therefore is a surgery which is used to treat trigeminal neuralgia which was not caused by dental trauma.


http://www.mccullochlaw.net/root_canals/root_canal_malpractice.html

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MCV , I definitely would get another Dentists opinion about the teeth needing work done. AND then go to a specialist to get that work done. Like especially if you need the tooth PULLED, go to an Oral Surgeon. I didn't even feel it. Mine was on the top. Also I think it's best to be put under for lower teeth work, as it can trigger more TN pain if you get shots in the back of your jaw near the TN nerve. That happened to me. I personally chose to have a bridge put in where I had a tooth pulled. I didn't Like the idea of sticking a post in there. I had residual pain on the floor of my sinus cavity and pain in my upper gum area even after that tooth was pulled. So that was off limits for me, cuz I was sure that would instigate more pain and who knows how long it would have lasted...maybe indefinitely..You never know with TN.

I wish the best of luck with ALL of this. Let us know how it all works out for you. Min

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while it isn't 100%, canals that are not fully filled (like many shown on that website) can be a warning sign that Sargenti Paste (RC2B, RC2W, etc...) was used. It has been the thinking by many of the dentists who use it in secrecy that you don't need to completely fill the tooth since the gasses from the formaldehyde will kill any bacteria that is in the tooth. Problem is ... their thinking is wrong. Bacteria can reinfect the void in the tooth. This is one of the reasons that injuries from Sargenti Paste can show up months to years later and the patient never makes a connection. It is highly unlikely that the dentist who retreats the tooth is going to volunteer that what they are dealing with is sargenti paste if thy know or suspect. They don't want to get involved....

Cleo said: