I haven't been on in a while- I have a question please. (osteomylitis)

Hi everyone!

I saw my neurologist. He said I don't have trimgeminal neuralgia- .... thinks it is tooth related and something else. I have not had an MRI to determine if this could be osteomylitis and you read online and read so much-- that it is a bit-- scary. I saw my endodontist y'day and he says the tooth that is beside my root canal-- the one that hurts so bad-- looks fine- but it can still be bad- and says give it a month and come back. If the pain is still this bad- he will root canal it... but I don't know if I have this osteomylitis-- I had the root canal in January- and a CT at the ER in Feb.-- but I just don't know where to go from here. Before I have another root canal in my head-- and this one has never exactly settled down- I want to know if this is something else... Would an MRI show osteomylitis? Yesterday at my family doc's office they took blood from both arms and it is supposed to show hidden infections-- I don't know what this is called-- it is to check for infectious disease...but they must take blood from BOTH arms.. and quite a bit. --- My family doc wouldn't order an MRI- she said if this were osteo- by now I would be dead or in a coma... I have a lot of facial pressure- the tooth hurts-- a lot-- and I don't want to take pain pills- when I know it will just be masking what is going on..... I don't know if I believe this neuro about TN either.. I just am not sure what to do-- and if anyone could possibly help -- I would appreciate it. I know this is a TN site- but I am still searching-- and don't know if I need an MRI or if this blood work would show it. Having some neurological symptoms-- ... I am not sure what to do. xx beekeeper

Hi beekeeper,

as far as I know, the only way to make sure if you have osteo or not is to take bone and tissue sample from the area surrounding the tooth and have it examined in a laboratory. I was told that not always osteo shows on MRI or CT scan. Blood work certainly is an indicator of infection, but there could be infection elsewhere in you body than your jaws and the results could thus be misleading. On the other hand, if your blood shows no signs of infection then it would be unlikely you have osteo. I thought I could possibly have osteo so I had the biopsy done but then my neuro told me that had it been this case I would also have pain during night hours which I don't have - I only hurt during the day. That's possibly another indicator. I hope this helps at least a little bit. Take care and good luck finding the right tests and treatment!

If they think you have an infection in the bone I am surprised they would wait. A infection could easily show up on a simple x ray. The TN nerve is the one that goes to the teeth and that is why TN is often manifests as dental pain. I went to the dentist 7 times thinking all the teeth on the upper left side of my mouth were rotten to be told they were fine.

Thank you for the information. Insurance doesn't cover oral surgeons around here... I just don't want to have yet another root canal only to have more pain... from a doc who told me that TN only has pain in ONE of the nerves-- w/ ATN-- can't it be allllll of the nerves??? I don't get this part. I thought ATN could be all the nerves on one side of the face..... I don't want to contradict him June 3--- but this is what I've read. He has me on Gabapentin- low dose-- (high dose causes mania)-- and Lyrica..... Neither help. The pain is constant in this tooth and in my face... So I don't know-- It all BEGAN w/ ear pain and vertigo etc... I wonder sometimes if that tooth was dead -- and the pain presented in the ear- long before it did in the tooth? Pain -- severe--- began in November- (ear pain - etc)- but bad enough in the teeth for a root canal in January. I am at a total loss... This Neuro looks like he is maybe 10-- LOL.... but when he said that TN could only be ONE of the nerves-- I was very confused by this.

Are anti-convulsant meds helping you? If so, I would go to another neuro and get another opinion.

No- they aren't helping..... but I can't get on a high enough dose b/c of the bipolar so it would help -- ..... It is a difficult situation..... I've only seen him once- so see what he says a second time...

I am sorry to hear you are going through this! I had 2 perfectly fine molars pulled on the pain side of my face,was given antibiotics for phantom ear infections,and was told it was probably just stress. It took me 8 years until I was finally treated for TN.
Because it is relatively uncommon some Nuerologists will not even consider TN other than as a symptom of MS. Insist that you are taken seriously,get a second opinion,or a third if you have to. In the mean time stay of caffeine and citric acids as they can act as triggers for an attack.
Bless you and hang in there! : )

I posit I will end up with 2 root canals and pain that still makes me want to bang my head against the wall. sigh.

Don’t bang your head against the wall…try a heating pad or washcloth soaked in hot water instead…that is bathwater hot…not tea kettle hot.

Christina citric drinks DO make my pain worse… these are frontal – well “pointed tooth” and also - first molar… I have had more x-rays of these two teeth Cleo- than you could even imagine-- panorex— I bet my head glows in the dark… The problem w/ drugs like neurontin is-- they kick my mania into OVER DRIVE… I just am sitting here crying… have a heating pad on my ear and left side of my face… neuro said that TN didn’t cause pain on the whole side of the face— just one part of the nerve-- not all of them-- and whole side of my face and ear hurt… I am so tired today… :’(


I'm new here too but you sound like me..I had a wisdom tooth extracted and started having severe jaw pain/pressure and ear aches..Then my front left side tooth started having sharp shooting /dull pain..I had it extracted also. then the pain went to the other teeth...I went to 4 different dentist who all did xrays and said the tooth was fine...The last dentist said it was probably a nerve problem. So I went back to the oral surgeon and told him about my pain.He did another cone beam scan and said there was nothing wrong with my jaw or teeth..I was referred to a neurologist who did some tests and blood work and told me it wasn't a nerve problem.I started crying and said well you say it isn't a nerve problem and the dentist all say it isn't a tooth problem what do I do about the horrible pain I'm in all day???So the neurologist looked up Atypical Odontalgia(I brought him an article about it) so he goes and looks it up and comes back and prescribes me Amitriptyline...It has helped with the sharp pain in my tooth and ost of the jaw pain although I still get some pain...It is sad how some of us get tossed around from dentist to doctor to neurologist with no concrete answers....So for now I take amitriptyline and hope I don't have anything more serious like a deep bone infection....I hope you find some medicine that helps your pain!

Hi Lillyh~ I can’t figure out how to respond directly to you— LOL… That sounds like me-- but mine started in the ear first- I have Amitriptyline here… but- I am bipolar-- . I don’t know how much you take-- but if I take very much at all I end up hypomanic-- and that really is a bad thing… I am trying Neurontin right now-- it causes mania too … but going to get it as high as I can before my appt w/ the neuro so he won’t say “You can’t take doses high enough to help you!”-- sigh. Well, sure, I’ll take all the Elavil and Neurontin he wants me to take if he wants to pay off the manic spending on my Mastercard…LOL… Bipolar jokes aside-- I haven’t seen the oral surgeon yet- waiting for them to recommend that-- I haven’t had an MRI yet-- just a CAT scan and balance test. I am waiting for results of blood cultures-- in case this is due to an infection that has hit my blood stream… I don’t have dental insurance and that oral surgery stuff is pricey…I don’t know what I am going to do. I know that it TRULY feels like that root canal that was done-- is BAD. The neuro I saw didn’t know about atypical trigeminal neuralgia… he said it could only hit one nerve— and if someone could correct me-- I DONT think that is correct. I have not heard of Odontalgia… I will look this up!!! The roof of my mouth is sort off and on from where they put that needle for the root canal. The bone under my left eye (root canal on left side) is always sore. This entire situation is tearing my family apart… I just stay in my room w/ the door shut rotating ice and heat on my head— … I mean this is nuts… I’ve never heard of anything that affects people LIKE THIS!!! Yeah, I can see this happening to me bouncing around from neuro to GP to neuro to endo---- until I have no teeth-- or a mouth full of root canals and no answers… This neuro looks like he is 10 years old- and I took him an article and he didn’t like it-- I could tell… I am going to mention this ATN though… I think he is WRONG here…I don’t know… I just don’t know. I hope this Elavil keeps helping you!!! It sure dries your mouth and eyes out, yes? xx beekeeper