Need advice friends, and fast!

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Hi Ali, I'm so sorry to hear that some of your teeth are abscessed. That's really awful news. It sounds so stressful to have to determine the best course of action with so many issues to consider. I'm not a dentist, but I can tell you a bit about my own experience. I have both ATN and teeth that have been abscessed and have needed dental work or extraction. I lost my upper back molars on both the left and right side within weeks of each other due to a fracture on the left where the tooth was broken completely in half and abscess/fracture on the right. The tooth on the left was extracted under duress and was hell on earth. That said, once the tooth was out and the extraction site started to heal, my pain decreased dramatically. While the ATN pain remained, it became clear that the infected tooth was contributing significantly to my pain in general. I never had any pain in the molar on the right side despite the evidence of abscess and that extraction was a piece of cake as was the healing process. I never questioned why that particular tooth didn't hurt but think I was just really lucky. Perhaps it just hadn't started to hurt YET.

For what it's worth, as someone who has been down this road themselves, I absolutely agree that if the teeth are showing strong evidence of abscess, they need to be removed if root canals are not an option. Untreated abscessed teeth can lead to far more serious conditions, including death in very extreme circumstances. My dentist described the need for the extractions as unfortunate, but unavoidable and necessary for my long-term health.

In terms of healing, I found gently swishing with warm salt water to be very soothing. Using ice packs to control the swelling also helped me. I'm sure your dentist will give you an instruction sheet to follow. On a side note, I have noticed that my ATN usually escalates for a few weeks after dental work but once that calms down, I am much better off than I was before the work was done, so there's a chance you might experience something like that as well.

I will be sending you tons of good thoughts and wishes that you will have a speedy recovery and feel much better once this is over.

Take care,

Chris

22

Chris, thanks so very much for your very thoughtful, insightful, and informative reply. I love to hear stories that others have gone through because it gives me an idea as to what I might expect in the same situations. And yes they must be take out, we just cannot afford the root canal process and even if we could I think its going to be easier just to have them taken out. I will be calling them tomorrow to see if perhaps the Dentist might give me some extra meds but I am not holding my breath either. I will let you know how it goes, and thanks so much for your kindness! Much love!!

23

I had 10 lowers pulled all inflamed and loaded up on meds, didnt leave the house. applied compresses. I will do the same after my NY trip. It wasnt fun but 72 hours is the turning point. I am no braver than you. I have to also read articles on dental issue. I will be the last patient, so the air wont be so strong, Im bringing a blanket. Medibeads makes a cheap face pack, Its really good, I surround myself in one of those extra long pillows and use a heated mattress pad. Keep ice packs in the fridge. Your picture is beautiful… hugs. Im using gas not needles.

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Wish I could give words of wisdom but all I can give are words of support; we all wish you well. Be strong like Samuri!

Best Regards,

RH

25

Hi Ali,

I had a tooth ache. Xrays were taken. A root canal was performed. The tooth ache remained. A different dentist looked at the pre-0p xray and said he did not understand why the root canal was performed. I looked perfectly healthy to him. No abcess or lack on enamel.

A look at the post-op xray showed the operation was okay except a little bit of the nerve may have been left over. Over a few years the pain subsided to where it bothers me only when I chew on something cold on that side.

Last year I had a cap put on a cracked tooth behind the one that had the root canal. Again, I had tooth pain after the surgery.

David

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Don, Sounding all too familiar to me… Min

27

can you get a second opinion, before you start pulling perm teeth. he could be wrong. i had work done on an eye tooth several years ago. it wasnt the tooth. it was a nerve in my cheek.

28

Thanks guys, I really do love you all!! I am already on Xanax 0.5mg three times a day and I have plenty extra so that will not be a problem. And Elaine, I called their office the other day to ask if they would use the gas, but since they are with the Dept. of Public Health they do not use the gas. Have talked this over with my hubby and kids and have actually thought of doing it natural. So what do you all think? I mean, do you think I could have two teeth pulled with no gas or shots? After everything I have read here I am terrified of having it done using the shots. And gosh, if I could afford a second opinoin I would have one but we are broke. Okay guys, now I am really freaking out about this, I don't know what to do! But Elaine my eye tooth definitely needs to come out because when I run my tongue across the back of it it feels like it's mostly been chipped away or something, like it is no longer there, does that make any sense??

And stupid me! I waited till today (Friday) to call and ask them to medicate me prior to the procedure and I totally forgot that they are not even open on Fridays, so no extra meds for Ali. My appt. is Monday afternoon. I cannot tell you how much I appreciate all the support I have been given. You ALL are the best! And Elaine thanks for the compliment dear, your a sweetie!!

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Ali, I strongly suggest some type of numbing. There is a possibility the tooth could break when trying to extract it.

My wish for you is that you could go to my oral surgeon, he is the best!! I didn't even feel the shot he gave me at all!!

Especially with it being the eye tooth. I had braces when I was in my twenties. I had extractions and then had to wear head gear to move the eye teeth back into their new position. OMG!! The right one ALWAYS hurt like no other, and some other choice words I cannot speak of on here... Now I know why, of course, as this was early signs of the ATN, who knew. I sure didn't. But gosh just hearing you think about that with the way MINE is killing me right now makes me shudder. I might do it, on another tooth. But not that one. Wishing you the best Ali, I will be thinking of you on Monday. Min

30

Guys, I normally wouldn't lift an entire article from another site for use here. But I think several of us could use some seriously authoritative advice and what follows below seems to be just that. This is from the US Trigeminal Neuralgia Association, and it's worth heeding.

Ali, in my opinion, you need to postpone your appointment for dental extraction by a couple of weeks, until you can get your med levels up high enough to reduce or stop breakthrough pain. The article may give you some sense of why.

Regards, Red

Dental Issues related to Neuropathic Facial Pain and Trigeminal Neuralgia

Patients suffering from face pain, including TN (Trigeminal Neuralgia) are often concerned that dental procedures will aggravate their pain. TN patients who are pain free are at little or no risk, yet they still fear work within their mouth. Dental work is hardest on those with constant neuropathic facial pain.

TNA Tips for Keeping Dental work as painless as possible:

Go to the dentist when you're not hurting. Make sure your dentist knows you have TN so he or she will be flexible to schedule your appointments (maybe even on short notice) during periods when your pain goes into remission. This will also help the dental staff to understand in case you have to cancel in the event that your pain flares up right before an appointment.

Be well medicated. If you don't have remissions or must have dental work done during an active pain cycle, consult your doctor so you're on an optimal dose of medicine. To prevent a breakthrough, your dentist may want to increase the dose of any TN medications you are taking for a day or so before and after the procedure. Also try to schedule your appointment during the time of day when you're least likely to get pain or when your medication is at peak effectiveness (usually about one hour after taking a dose). Several hours before the procedure, take a pain-killing medication such as codeine. Take it again after the procedure. The goal is to have at least five hours after the procedure during which you're pain free.

Topical anesthetics. Most dental patients need numbing compounds mainly for tooth repairs, crown work, extractions and the like. However, even teeth-cleaning and exams may bring on pain for facial pain patients. Topical sprays or gels can be used to temporarily numb the gums.

Touch the sensitive area last. If there's a trigger zone that usually sets off the pain, ask the dentist or hygienist to examine and clean everything else first.

Switch local anesthetics. If you need treatment, discuss with your dentist the type of anesthetic to be used. Ask your dentist to use Mepivacaine 3% or Carbocaine 3%, neither of which contains preservatives or a vasoconstrictor. You may want to ask in advance, because the average dentist doesn't keep this particular drug in stock.

Epinephrine is a vasoconstrictor; it's sometimes added to local anesthetics to prolong their numbing effect. Epinephrine can trigger nerve pain, especially in cases of trauma-induced TN. In these cases, ask your dentist not to inject a vasoconstrictor with local anesthetics in the area of nerve damage.

Consider the injection point. Ask the dentist if possible to inject the local anesthetic at a site as far as possible from known, active TN trigger points.

A knockout. If all else fails and you absolutely need dental work, discuss the possibility of a general anesthetic (either IV or inhaled) to put you to sleep while the work is being done. This type of anesthesia can reduce emotional trauma.

========================================

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Thanks Red, although I had already read this several times, I am now going to print it and take it with me. We do not have a working printer and since it is Sat. we will have to wait till Mon morning to print before the appt. but at least I am going armed with some information. Just saw my GP and she raised my Amytriptline from 10mg to 25mg and will be raising the tegretol on Monday. Other than this I am outta luck as she tells me to consult my Pain Doc, and he simply refuses to give me any extra for ANY reason because the man is convinced that I caused my overdose last October by taking extra meds, which I did NOT. So Red, please forgive me for gently disagreeing with you here but I just do not see how postponing the appointment for weeks is going to help me any. If he is able to do the knockout via IV meds I will certainly request it. Thanks for all your efforts on my behalf Red, I surely do appreciate it!

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Thanks Min, really didn’t mean to leave you dear! I very much appreciate your thoughts, concern, and support! It really means a lot to me dear!! Much love to you!

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Thanks, after some thought and discussing this with my family I realized how stupid that must have sounded, but I will not be doing this natural, no way I could handle that kind of pain. I will request an IV knockout if they have that available, and if not, then I have no choice but to have the shots. So I have decided to leave this in the hands of God. He has always taken care of me and I have no doubt He will take care of me this time as well. Thanks so much to all my friends here who responded with caring supportive and informative replies, cause this is what it’s all about!! Will post an update on here when I get home Monday afternoon, much love to you ALL!!

34

I thought you meant the Dentist feels the TN shock whilst Ali is passed out on the iv. HAHAHA

Had to re-read that,...Didn't get much sleep last night. LOL

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Hi Min, just thought I would let you all know that I called the Dentist's office earlier and they do not offer IV sedation either, but I explained my situation to him and he feels confident that he can give me these shots without causing any further nerve damage, really liked your idea about giving him a signal should I feel TN pain and will definitely do so. Min, so sorry you didn't sleep well last night dear, maybe you should have a long nap today!

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How are you doing Ali?? Min