Hi, I was wondering if anyone knew if Tegretol or Gabapentin can actually make the pain of toothache go away, as in if you have bona fide toothache the drugs will disguise it by deadening it, just as they do for TN. I read somewhere, right at the start of my TN, that it was one of the ways of diagnosing TN - if carbamazepine took the pain away it couldn't be toothache because it didn't work on ordinary tooth pain.
Anyone know if this is true or do you know of anywhere this is discussed? I'd be grateful for any links to sites where you might have seen it, or any other insights you might have.
I've always wondered the same thing since teeth have nerves and Tegretol and Gabapentin calm nerves??? ...But I thought I read somewhere that the medications DIDN'T mask tooth pain..I'm sure someone will come along with more information.
Toothache doesn't have to end with nerve overstimulation. Toothache that ends with nerve overstimulation isn't like average toothache. It's not clear what anticonvulsant masks because all this (along with nerve overstimulation) happens within the same time. Clear enough is what anticonvulsant stops. I think this differential mythology is not worth spreading.
I've read the same thing somewhere, right at the start of my illness, and I can't remember where I saw the damn thing. I feel it was a neurologist talking, but I can't be sure. It seems logical that they would kill nerve pain. After all, the trigeminal nerve is the toothache nerve and anticonvulsants work on the trigeminal nerve. Aren't they, in fact, killing 'overstimulation' on the nerve? So it makes sense that if you have a cracked tooth, for example, and it's firing off, then anti-convulsants would deal with it in just the same way, by deadening the pain.
My doctor is useless on this - his retort is that his knowledge "stops at the mouth" and he knows nothing about teeth problems, because, of course, we all know teeth are not part of the body!
I am desperate for information on this. I was wondering if a pharmacist might know. Anyone know a knowledgeable pharmacist???
stephanie said:
I’ve always wondered the same thing since teeth have nerves and Tegretol and Gabapentin calm nerves??? …But I thought I read somewhere that the medications DIDN’T mask tooth pain…I’m sure someone will come along with more information.
Not sure what you mean, Lisa. When you say toothache doesn't have to end with nerve overstimulation do you mean it might have decay or something, separate from nerve stimulation? Not sure that's true since the way the body conveys pain is through nerves, regardless of the cause, and that nerve would be the trigeminal nerve.
And what do you mean by a "differential mythology"?
Lisa said:
Toothache doesn't have to end with nerve overstimulation. Toothache that ends with nerve overstimulation isn't like average toothache. It's not clear what anticonvulsant masks because all this (along with nerve overstimulation) happens within the same time. Clear enough is what anticonvulsant stops. I think this differential mythology is not worth spreading.
Overstimulated applies to TN. Not every toothache ends with typical TN symptoms, which are a lot worse than average toothache. In toothache we have standard stimulation. TN stimulation-like is something extra.
Woman with the electric teeth said:
Not sure what you mean, Lisa. When you say toothache doesn't have to end with nerve overstimulation do you mean it might have decay or something, separate from nerve stimulation? Not sure that's true since the way the body conveys pain is through nerves, regardless of the cause, and that nerve would be the trigeminal nerve.
And what do you mean by a "differential mythology"?
Lisa said:
Toothache doesn't have to end with nerve overstimulation. Toothache that ends with nerve overstimulation isn't like average toothache. It's not clear what anticonvulsant masks because all this (along with nerve overstimulation) happens within the same time. Clear enough is what anticonvulsant stops. I think this differential mythology is not worth spreading.
That makes sense. According to my doc though, if a tooth has an irritated nerve then theoretically Carbamazepine could calm that too, but it wouldn't work on decay or an abscess, for example. That sounds plausible to me.
Lisa said:
Overstimulated applies to TN. Not every toothache ends with typical TN symptoms, which are a lot worse than average toothache. In toothache we have standard stimulation. TN stimulation-like is something extra.
Woman with the electric teeth said:
Not sure what you mean, Lisa. When you say toothache doesn’t have to end with nerve overstimulation do you mean it might have decay or something, separate from nerve stimulation? Not sure that’s true since the way the body conveys pain is through nerves, regardless of the cause, and that nerve would be the trigeminal nerve.
And what do you mean by a “differential mythology”?
Lisa said:
Toothache doesn’t have to end with nerve overstimulation. Toothache that ends with nerve overstimulation isn’t like average toothache. It’s not clear what anticonvulsant masks because all this (along with nerve overstimulation) happens within the same time. Clear enough is what anticonvulsant stops. I think this differential mythology is not worth spreading.
I can only share my experiences but when I had a cracked tooth after a r/c I was in a great deal of pain. My endo took care of me right away on that one. Last year I had a nasty abcess on my good side and it hurt some sporadically but I barely noticed except for the swelling, lol. Had that tooth extracted and it was bad, very bad.
Hi Shadow, so when you had your cracked tooth were you on anti-convulsants at the time? If so, what kind of pain could you feel? Same as TN - with hot and cold sensitivity and so forth, or was it different?
It was about 3 yrs ago when I first went on a/c (very low dose). I wish I could remember better details but I think it was a sharp pain. I am TN2 so my pain was always constant, deep, boring. The tooth had been r/c a few months before and I was waiting for the new year for the crown for new insurance coverage. I didn't make it. I really wish Cleo would see this thread and comment as she is much more knowledgeable.
Ah, I'm TN1 so electric shocks are the norm for me, at least without meds. But I have constant residual pain in my teeth/tooth. My doctor put the worry into me by announcing, in the middle of a conversation about dosing me with B12, "We're not even sure you have TN; it could be a dental pain". Now he says. But I have always had a sensitivity to sweet, which seems to be unusual. I'm trying to see if anyone else has that as a trigger on this forum. It's also recently started hurting when I bite down on it, but I think that's not unusual with TN.
But my real concern is whether it's possible for the anti-convulsants to mask the electric shock pains and leave this residual pain if I had a broken tooth. The trouble is, it's a healthy tooth, without restorations, so I am VERY reluctant to do anything to it. If only dentists had an efficient way of testing them for cracks, but they don't.
I have experience with this and the answer is "Yes" (at least in my case) that the anti-convulsant medicines can mask tooth pain that is nerve-based (i.e. root canal needed). After my successful MVD surgery a little over a year ago, I stayed on my meds for several weeks and then slowly weened off of them. About a week after weaning off my meds, one tooth began to hurt badly. I was so scared that my surgery had not been successful and that what I was feeling was my TN pain. The pain though was different. It was more isolated to just one tooth and it was also more constant, versus the shocks from my TN pain. It was also not nearly as intense (it was pretty bad but nothing compares to TN) and unlike my TN, it kept me up all night. I was hopeful that it really was "just" a tooth thing as it was on my TN side. TN had always tricked me thinking it was a tooth when it was not. I went to my dentist and he did X-rays and sure enough, it was 100% evident that I needed a root canal in that tooth. I was overjoyed. The dentist had never seen someone excited to have a root canal LOL. I had the root canal taken care of over a scary few days and have not had a flash or pain or anything that even registers on any scale since my root canal and that was done in January. The dentist told me that the high-dose of Tegretol XR I was on (2400 mg/day) likely masked any nerve tooth pain that was developing. I talked to Dr. Casey (my neurosurgeon) about this at a conference I was at in April and he agreed that this was likely.
Mybell, thank you, thank you, thank you! I cannot thank you enough, so I will thank you again - thank you. There seems to be a stunning amount of ignorance about this. Doctors don't know, dentists don't know. I was actually considering going down to my local pharmacy and asking a pharmacist!
I confess I am really surprised it masked the pain in a tooth that needed root canalling though. Can you tell me exactly what was wrong with the tooth - was it decayed through to the pulp or what? And when you say the pain was more constant do you mean a constant ache or was it sensitive to hot and cold?
mybell said:
I have experience with this and the answer is "Yes" (at least in my case) that the anti-convulsant medicines can mask tooth pain that is nerve-based (i.e. root canal needed). After my successful MVD surgery a little over a year ago, I stayed on my meds for several weeks and then slowly weened off of them. About a week after weaning off my meds, one tooth began to hurt badly. I was so scared that my surgery had not been successful and that what I was feeling was my TN pain. The pain though was different. It was more isolated to just one tooth and it was also more constant, versus the shocks from my TN pain. It was also not nearly as intense (it was pretty bad but nothing compares to TN) and unlike my TN, it kept me up all night. I was hopeful that it really was "just" a tooth thing as it was on my TN side. TN had always tricked me thinking it was a tooth when it was not. I went to my dentist and he did X-rays and sure enough, it was 100% evident that I needed a root canal in that tooth. I was overjoyed. The dentist had never seen someone excited to have a root canal LOL. I had the root canal taken care of over a scary few days and have not had a flash or pain or anything that even registers on any scale since my root canal and that was done in January. The dentist told me that the high-dose of Tegretol XR I was on (2400 mg/day) likely masked any nerve tooth pain that was developing. I talked to Dr. Casey (my neurosurgeon) about this at a conference I was at in April and he agreed that this was likely.
It was a crown that had cracked and decay had gotten deeply into the tooth all the way to the root/pulp. It was a very small crack - not noticeable to me or at my prior 6-month cleaning. The pain was pretty bad but not even closet the TN1 pain I had experienced. It was sensitive to hot/cold and also would "ache" all night long. My TN had always taken a break when I went to sleep but not this. Also, when I took ibuprofen, it actually felt a little better and that NEVER happened with TN. Finally, it was very isolated to just that one tooth. It was probably a combination of nerve pain and inflammation pain that I was feeling in that tooth, and with the anti-convulsants plus the ibuprofen, vicodin etc. I was taking for the couple of weeks after surgery, it was surely masked as it was progressing. I hope this info helps you.
Yes, really helpful, thank you. How amazing that the decay had been able to get all the way to the pulp and you hadn't felt it. You were on much higher doses of anti-convulsants than me though. Very best wishes for your MVD - hope that gives you many years of joyous pain relief!
mybell said:
It was a crown that had cracked and decay had gotten deeply into the tooth all the way to the root/pulp. It was a very small crack - not noticeable to me or at my prior 6-month cleaning. The pain was pretty bad but not even closet the TN1 pain I had experienced. It was sensitive to hot/cold and also would “ache” all night long. My TN had always taken a break when I went to sleep but not this. Also, when I took ibuprofen, it actually felt a little better and that NEVER happened with TN. Finally, it was very isolated to just that one tooth. It was probably a combination of nerve pain and inflammation pain that I was feeling in that tooth, and with the anti-convulsants plus the ibuprofen, vicodin etc. I was taking for the couple of weeks after surgery, it was surely masked as it was progressing. I hope this info helps you.
Thank you, so much! I'm at 13 plus months post surgery and not a lick of pain and on zero meds. I like to say that I "kicked my TN to the curb" :). I'm so grateful to my surgeon, Dr. Ken Casey, and to all on this support group that helped to point the way for me. I don't think I would have come to the decision as quickly as I had to have an MVD without this group. I felt very lost and hopeless when I was first diagnosed until I found this group - it saved me. I will now spend the years of my life "paying forward" to help those in some way who are afflicted with this horrible, terrifying and life-changing disease. God bless all.
Zero meds - what heaven! I wish I was in the States and could get Dr Casey, or indeed any neurologist who knew the condition, but I shall just have to struggle by with the good old NHS.
What a sweetheart you are for paying forward - let's hope it brings you good karma in the shape of an MVD that lasts for twenty years, at least!
mybell said:
Thank you, so much! I’m at 13 plus months post surgery and not a lick of pain and on zero meds. I like to say that I “kicked my TN to the curb” :). I’m so grateful to my surgeon, Dr. Ken Casey, and to all on this support group that helped to point the way for me. I don’t think I would have come to the decision as quickly as I had to have an MVD without this group. I felt very lost and hopeless when I was first diagnosed until I found this group - it saved me. I will now spend the years of my life “paying forward” to help those in some way who are afflicted with this horrible, terrifying and life-changing disease. God bless all.
Wow, that is Caraazy info MyBell. Thank you for sharing this. I am currently going to have a tooth worked on and was wondering about this myself. I was pretty sure that it was a filling coming loose or something. I have a tooth with a big one in it and it is very old. I knew from ten years ago that my dentist said it may need to be capped at some point. Well every time I have been biting down on it it has been hurting. So I finally got into a new dentist now,( because I am being knocked out for this.) and he has determined that it is CRACKED....
Well, I am kind of not sure at this point. Second guessing---But this new dentist has worked with TN patients before, and seems to be knowledgable. So, I am going to go ahead and have the work done. But I am with ya Woman with Electric Teeth. It sure is very hard to distinguish whether or not there Really IS a problem.
Especially when we are talking about a significant amount of money to fix the problem!! My thinking was that if my meds took care of the pain.....then I really DON'T have a tooth issue. But now, after reading what MyBell has posted.....it would seem it is possible to have issues and NOT know it...
Oh how lovely it is to have TN............I wish you luck with your tooth problem. I hope it gets better for you. :)
Hi Min, yeah, I've recently had some biting pain, which I've never had before. That was one of the other things that was worrying me. BUT, and it is a big but, it's not unusual for TN to cause biting pain either. I know on a discussion I had on the forum, right at the start of my illness, some of the others were describing TN tooth pain for me (I was worried even then about 'is this teeth or TN?'!) and I remember a couple of them saying it hurt to bite down on their teeth. And lots of people have TN pain on chewing - so really, how can we ever be sure of anything? Unless we can see a bloody big hole in a tooth, it's all guesswork! I hate this f*!$£** disease.
Min said:
Wow, that is Caraazy info MyBell. Thank you for sharing this. I am currently going to have a tooth worked on and was wondering about this myself. I was pretty sure that it was a filling coming loose or something. I have a tooth with a big one in it and it is very old. I knew from ten years ago that my dentist said it may need to be capped at some point. Well every time I have been biting down on it it has been hurting. So I finally got into a new dentist now,( because I am being knocked out for this.) and he has determined that it is CRACKED…
Well, I am kind of not sure at this point. Second guessing—But this new dentist has worked with TN patients before, and seems to be knowledgable. So, I am going to go ahead and have the work done. But I am with ya Woman with Electric Teeth. It sure is very hard to distinguish whether or not there Really IS a problem.
Especially when we are talking about a significant amount of money to fix the problem!! My thinking was that if my meds took care of the pain…then I really DON’T have a tooth issue. But now, after reading what MyBell has posted…it would seem it is possible to have issues and NOT know it…
Oh how lovely it is to have TN…I wish you luck with your tooth problem. I hope it gets better for you.
