Botox Injections - TN2

Has anyone tried Botox Injections for TN2 pain? My pain started about 18 months ago when a dentist tried to replace one of my lower right molars with a dental implant. Not sure what went wrong with the procedure but i’ve had the “boring / burning” pain in my jaw ever since. The intensity of the pain varies from day to day, and is usually worse at certain times of day or during/after certain activities.

My Story - When the pain wouldn’t go away my dentist recommended me to the local university oral surgery department. They initially concluded it must be an infection of some type. I spent several months on every type of antibiotic known to man. The implant was removed and they tried cleaning the area out surgically, scraping out more bone from the tooth socket, called a “debribement”. When that didn’t work they tried it again 6 weeks later. Then they removed another back molar tooth thinking it might have been damaged during the initial surgery ( none of which was supported by multiple x-rays, CT Scans and MRI’s). But, honestly, I was in so much pain i was ready to try anything. None of it worked. I kept asking them if there was any possibility it might be a nerve injury since my symptoms mirrored what i’d read on-line. They told me i’d be better off not doing research on-line since there is so much incorrect information, but they did prescribe neurontin, which seemed to help relieve some of the pain. My last visit to the University (14 visits in total) they shook their heads and told me there was nothing more they could do for me, and wished me good luck finding a solution.
After some research I went to see a neurosurgeon specializing in TN1. He prescribed carbamazepine and combined with a lack of positive response to that medication and since my symptoms involved constant pain instead of short episodes of shock like pain he concluded I must have something other than TN1’ which was the only thing he specializes in. Based on all my research to that point and the fact the pain hadn’t subsided in nearly 12 months i was finally convinced it must be a nerve injury from the implant procedure. Not ready to give up on life I located an oral surgeon who specializes in repairing injured nerves. It was expensive and involved a hospital stay, but If I was going to do it I needed to try it quickly. The successful outcomes from his procedure were mostly with injuries less than 1-year old and on patients under 50 years old. I was 49 years old and the injury was almost a year old. He was kind enough to shuffle his schedule around and got me in for surgery within 4 weeks (June 6, 2013). That procedure involved removing a portion of jaw bone between where the mental nerve exits the jaw bone near the bottom lip and back to where the molar was extracted. The nerve was pulled out of the canal, the injured area was sectioned out and the two ends were sewn back together and a cuff placed around the repaired area. The next 3 weeks were a living hell. Several nights the pain was so intense I almost wished I could go to sleep and not wake up. My local MD (who i’d been keeping updated) decided I needed something to kill the pain and prescribed Tramadol along with the neurontin I was already taking. Now it’s been nearly 4 months since the repair surgery and most days I truly think it helped some, other days the pain is really strong and it feels like we accomplished nothing. Add to that the fact I’m now on daily Cymbalta along with the neurontin & tramadol I can’t tell if the improvement is due to the surgery, or the meds. The oral surgeon that did the repair told me at my 90 day follow-up to get off the meds completely and if the pain is still bad enough we should try Botox Injection. Has anyone ever heard of this and if so was it successful? Sorry for such a long story. I hope everyone is doing well today. Jeff

Oh my gosh Jeff. Sorry you've had to go through all that. I don't know about Botox for TN. Only my opinion but I can't see it working for TN (although I'd love to have it for vanity reasons). Sounds like you need a really great Neurologist to figure all this out for you. Don't stop until you find one. It's too bad the dentists have put you through so much and possibly caused and/or made worse your symptoms. Wishing you pain free days ahead.

Jeff, I don't have any answers for you. Your pain is the same as mine and I have been through the ringer with dentists, oral surgeons and endodontists. I've had jaw surgery as well and am still in pain everyday lately. I've been told by two top neurologists at the Mayo Clinic and another at a University Hospital I don't have trigeminal neuralgia based off my many ct and MRI scans and their exams but my oral surgeon at the Mayo thinks I do. I'm not sure what to do next either as both groups of doctors tell me I should talk to the other one,

Thanks for the responses. Maybe I’ll give the botox injection a try and see what happens. I’ll probably try and wait another couple months to see if any spontaneous recovery from the last surgery before adding another variable. Surgeon told me the botox is low risk since it only lasts 4 to 6 months. If it messes with my facial muscles or makes the pain worse he says it’ll resolve when the botox wears off. If it reduces or eliminates the pain I’ll need to go back 2or 3 times year to have it done again. It’s pretty expensive and he said insurance might not cover it. I’ll let everyone know if I decide to go ahead with it and how it goes. Thanks again for the responses. Hope everyone has a great weekend. Jeff

Hi, My case is simililar to yours. I see your post is from 2013. How are you doing now. Appreciate your reply.

Hi Jturn49, I’m considering botox for my tn2 and wondered if you ever tried it? I hope you are doing well.