Considering another root canal

I’m going to the dentist Tuesday, and am seriously considering another root canal (which would be done by an excellent endodontist). Like most of you, I am totally fried from being in pain all the time, and ready to find some kind of relief.

For a brief history of my dental work–pain started with an abscess, had an extraction (root was cracked on #14) and the pain got worse, started to move around. Had a root canal on tooth next to extraction (#13) but it didn’t really help with the pain. The endodontist did say that the tooth was “on it’s way out” based on the condition of the pulp.

Over the last year, the pain has settled more and more in #12 and is no longer moving around at all. #12 is a very old crown. On bad days it feels like someone is already trying to pull it out. The pain seems to be getting more intense, and I also have some numbness on the side of my tongue.

In February, the dentist took more x-rays and said all is fine, to my great disappointment. I’m sure I’ll have more tomorrow. But I really feel like going ahead even if he says it is normal.

So my question is–am I crazy? Anything I should consider beforehand?

Hi, you are not crazy, many of us have had root canals which end up having extractions due to pain not going away. Make sure there is a reason for RC. Is pain keeping you awake at night? Does it sleep when you sleep, then it could be neuropathic pain. Have you seen a facial pain dr or just dentist and endo

I think we all feel like we are crazy with this odd pain that we have. I have TN type 2 and my pain does refer directly to where you are talking about except mine is on the right side of my face and head. My pain management doctor referred me to another doctor to do a steroid/lidocaine injection directly to the TN GANGLION. To my utter amazement, IT MADE MY PAIN GO AWAY!!! Unfortunately it only lasted 2 days but perhaps it will lead to to more permanent pain relief. All this to say, no, you aren’t crazy, I’m not crazy and I pray that we each will find a permanent cure.

I get pain just before the complete facial pain starts hurting and I know it’s not my teeth although I only have 18 teeth left of the 32 I’m supposed to have I’ve had root canal’s in almost every one of them just recently had an x-ray of my teeth they looked good but two weeks later I use a pic around my teeth to clean and I found a hole under one of the crowns told my dentist about it he said hopefully it’s early enough and it was he was able to take the crown off and now we’re going to replace the crown without having to do a root canal because that tooth has not had a root canal so you need to check your teeth quite regularly because of the dry mouth you get from some of the medications that you’re on to stop the facial pain if you’re on any medication. It sounds like you are just having tooth pain not the complete face painting that a lot of us do have when the wind hits my face it hurts it sometimes almost feels like it’s burning and if I move my finger down my face feels like it’s on fire good luck in fixing your tooth, whatever it is

Have you been screened for bone infection in your jaw?

Unless you definately need it ,I would try Tegretol first if you haven’t taken that or other meds.I have terrible pain in teeth both sides & tongue numbness on right side only.I have TN2.If meds take the pain away, then it’s not your teeth.I really couldn’t believe my teeth were perfectly fine but they were.

Hi Ziggy, No, you are not crazy.This stuff will make you try anything that might work. I have a good friend that has had 5 of them and they didn’t work for him, nor a lady that I am friends with. It seems a lot of the doctors that deal with this stuff suggest a dental procedure, in some cases just to try to get rid of not being able to solve that problem for you. I think that they all are trying to help but as for me a Root Canal does very little except make one more problem for us. Well you have to do what you think is good for you so I hope you find the relief that we all are seeking. Best to you,
Wheels for legs said that. In case you wonder about the nick name it’s because I had a machine dropped on me and was crushed from the waist down and use a power chair now to get around (for legs) lol.

Thank you all so much for the input. My heart goes out to all that are hurting–I wish we all could get some better answers!

In answer to Ajb–for the last year or so, the pain did go away when I went to bed, it was my only respite. But over the last 3 weeks or so, it is still bothering me at night, and I find myself taking a 1/2 Valium more and more to settle it enough to sleep.

The doctors I have seen include the dentist, periodontist, endodontist, the head of an oral medicine clinic, another dentist at another oral medicine clinic, and a GP. I’ve had a detailed MRI that was evaluated by neurology and oral medicine doctor. And of course tons of dental X-rays of all kinds.

Tried gapaentin and amitryptiline which just made things worse, as well as topical carbamanzepine and doxepin. Only things which help are topical lidocaine, capsaicin and Valium, as well as oxycodone. I’m very reluctant to take stronger oral medicines.

My dentist and endodontist are certainly not encouraging me to do this and would not unless they saw something indicative of problems with the tooth. But I know it is very difficult to evaluate the tooth under a crown (they didn’t see that #14 was fractured!), so my feeling is I would rather err on the side of overkill at this point. Hoping it can’t make things worse!

azurelle–not sure what is involved in screening for bone infection. Wouldn’t this show up on a dental X-ray? I’ve had three courses of amoxicillin.

I actually don’t know what’s involved with screening for bone infection, either. The only thing I know is that several years ago my dad had an abscess/root cannel/crown situation that ended with somewhat extreme facial pain (admittedly hard to tell with him because he’s a known dental-work weeny). But it did end up that there was some sort of infection in his jaw bone. Once the infection was treated properly and cleared up all went back to normal. Reading the ongoing issues it crossed my mind that maybe there was an underlying infection or something along those lines that had been missed.

---- ziggy ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ wrote:

First, I am so sorry for your pain and hope you find relief soon. My pain is quite similar to yours and it began more than 20 years ago following dental surgery. I’ve had 2 root canals on the same tooth and had it re-crowned a number of times over the years. My neurologist said “I implore you, don’t do anything to your teeth.” She sent me to UCLA for a special Morita scan of the tooth (which she says is the gold standard for finding cracks that dentists might not be able to see on other x-rays). The tooth was not cracked, but there are days when the pain is so terrible that I fantasize about extracting it anyway, just in case. My neuro also said that if I go from dentist to dentist, sooner or later I’ll find an unethical one who will perform the work and I may well end up in more pain than I am now. I tend to believe her, because the second root canal left me worse off than the first and the dentist could not keep me numb enough (which my neuro says also speaks to the pain being neuropathic). I could feel the work on the root no matter how many shots they gave me. Not fun. Over the years, my pain has progressed to other teeth, all in that same upper left quadrant. It also envelops the entire left side of my head. My neuro says it has progressed to the diagnosis of Complex Regional Pain Syndrome, for which she recommended Ketamine Coma treatments. Sounds weird, but they actually helped and I was able to chip away at my oxycodone meds (I was up to 60mg a day and I weigh 115 pounds, so apparently that was a bit high). I got my oxy down to 30mg (half!) and had a couple of really good weeks, though the pain was most certainly there, it was far less. Anyway, it’s slowly creeping up again. 45mg the past few days, so I’m going to get a cavity taken care of in the painful quadrant, then I’m going to have another ketamine coma a few weeks after that and try to progress again. I only tell you this because the origin of your pain sounds so similar to mine, which goes away when I sleep and starts up in 5 to 30 minutes after I wake up in the morning. I wish you all the best. Please keep us posted.

If your neuro has diagnosed you as TN sufferer. It is not going to take your pain away. TN is different type of pain compared to tooth ache. Tooth ache can b tolerated but TN pain can’t. That is why it is known as suicide disease.
If you have not seen your neurophysician. Pl see him first.

Can’t help but agree with those that suggest caution. Must be absolutely certain that a root canal is necessary. I have a good friend , and fellow Support Group Leader, in suburban Detroit, that had a root canal some years ago. The endontist damaged his trigeminal nerve and he is now on disability retirement from GM and is on daily morphine. Also, I just read that hospitals are using IV Lidocaine for chronic pain and have had a 56% positive response with Trigeminal Neuralgia. There is also the possibility, as mentioned, of NICO ( neuralgia inducing cavitational osteonecrosis) or pockets of jawbone becoming infected dying with nerve damage and a “bone cavity” remaining. There is a surgery to fix that but the treatment of NICO remains controversial. Hope you make the right decision.

So here’s an update on where I’m at, I’ve been too tired to even log on after work.

Met with the dentist, new X-rays and exam, absolutely nothing on the X-ray. But, there is some pain on palpating what I assume is the root area of #12 (lumpy area on gums above tooth). We also discussed all the other treatments and Drs. I’ve seen regarding this. He sent me back to the endodontist.

The endodontist did pulp vitality testing, normal. New X-rays that also looked normal. Then did a CBCT scan of the area. He is sending this off to a Dr. Miles who is supposedly THE expert on reading these scans. This scan looks for bone and sinus issues including NICO.

So at this point we are just waiting to hear back from Dr. Miles. Thanks for all the input, this is a difficult decision.

Best of luck.

When you say your endodontist says a tooth is on the way out makes me nervous. They typically don’t do anything until they actually need to. Have you ever had an MRI done?

Thanks for your concern, Glamarella. I have absolute confidence in my endodontist, fortunately. I know that he is very competent and trying to do the best by me.

I had a very extensive MRI done–I was in the tube for almost an hour! This was evaluated by two different neurology departments, and also the oral medicine doctor, so I’m pretty confident that anything abnormal would have been found. Hey, at least I know I don’t have any brain tumors!

But this week has been pretty bad, I’m tempted to get back into the oxycodone.

I’m sorry :frowning: I’m glad you got that MRI. If the root canal makes you feel better Then have it done.

Well, I’m going to be the one to play devil’s advocate here, Ziggy, and say yes, you are crazy. Unless there is concrete proof that there is something wrong with the tooth then I think you know in your heart of hearts that it’s TN. If you didn’t have a TN diagnosis or an existing problem then yes, doubt the tooth, but as you do have a known TN problem then you must know that TN is the most likely culprit. Given that a) a root canal won’t help and b) that a root canal runs the danger of damaging the nerve (like you need that!) then yes, it is crazy to consider a pointless root canal. Why damage a healthy tooth? You don’t need that grief.

I know big time what a terrible temptation it is to want to blame a tooth, to find a much simpler and less fatalistic solution, but the fact is all of us here have TN and when we have tooth problems that have no apparent cause then we are actually having TN problems. Don’t punish your poor teeth for that. Keep them as long as you can.

Still waiting to get the CBCT scan report back, very impatient here…in constant pain.

But, I have a pimple on my gums! A gingival abscess! I am ridiculously happy to see it–it is a sign of infection (the first concrete sign other than pain), and that should mean something that can be FIXED! calling the endodontist on Monday.