Any ideas how to distinguish between nerve damage pain and tooth damage pain? I have been through many doctors as par for the course. I was sent by an oral pathologist to an endodontist to rule out a fractured root on my very back molar. ( My pain started immediately after the lidocaine wore off after an extraction of my second to last upper molar) The oral pathologist did not think that my pain was consistent with nerve damage. The endodontist did x-rays and tests. He said everything looked fine, HOWEVER, there are times when they cannot see or know everything. And pulling the back tooth may or may not be the problem.
I wasnât willing to get the tooth pulled but after over a year of pain I have decided to. As I lay here I feel pain in my back tooth. There is no tooth on the bottom for this tooth in question to hit or maybe this would be more obvious as to the pain. I feel pain in my jaw and face. When I first had the tooth in front of this one pulled, the pain was in the extraction site and burned along my jaw up to my nose. That has gone away over time.
This tooth hurts when I push on it. I had a root canal in this tooth about 4 months after the initial extraction. And before any of my issues I needed the root canal.
I have had some pain that makes me think it is the tooth. I was molding my teeth for a retainer ( another story) and as the material hardened I had terrible pain in the tooth and surrounding tissue. It didnât stop until I popped the stuff out of my mouth.
And another time I was showing my son where his hair was sticking up in the back of his head. And he wasnât getting the spot on his head so I starting patting my own head to show him. Every time I patted the back of my head, that tooth had a spike of pain.
I am on nucynta, effexor, and Lyrica and I still have way too much pain to live a normal life. I just make it through work and donât feel up to much at home.
I am getting the tooth pulled Monday. My new dentist said it is possible that the dentist that pulled my tooth damaged the back tooth because they use other teeth for leverage when the pull a tooth. I am having it pulled by an oral surgeon.
Any thoughts? I want to make the right choice.
Thanks!!!
That is a tough one, it is hard to make the right call sometimes. I just recently was dead set on getting a root canal, but my endodontist did a lot of diagnostic work and talked me out of it. I ended up getting a new crown, which I think was a good call. Pain is still there but better, different.
The things that distinguish nerve pain versus ârealâ nociceptive pain include:
Nerve pain does weird things, moves around, morphs in quality and quantity. Nociceptive pain seems much more consistent in location and quality.
Nerve pain often will abate at night, or when you lie down and are relaxed, conversely it also kicks up when you are stressed.
Nerve pain does not respond much to OTC pain meds, may respond a little to opiods, but does often respond to anti-eleptics and anti-depressant meds.
I hate to give an opinion either way, have you consulted anyone who is familiar with ATN (atypical trigeminal neuralgia, or traumatic neuropathic pain)?
Thank you both for your input. I have been to so many doctors. As you know there are no easy answers. I was diagnosed with atypical neuralgia. But 3000 mg of gabapentin did nothing for me. Lyrica may be helping? I am not sure.
Says prayer for me please and thank you!
I have had my ATN for 3 years now. My first medication recommendation for ATN peeps is Nortriptyline, or Amitriptyline, which ever one your body tolerates better. For me this gave the best pain relief with the most livable side effects.
My story: I had numbness and tingling with touch from a nasty wisdom tooth extraction when I was 18, but it didnât hurt or effect my life much so I ignored it. At 24 I woke up with pain in the left lower 2 branches of my face nerves, and by that afternoon it was unbearable and it hasnât stopped since, though the meds bring it to a lower level. I found out weeks later, in my search for an answer that I had a very badly infected back molar on the left side. I had a root canal, but the pain continued, including phantom pain in my âdeadâ tooth. I believe my damage was set up by the wisdom extraction, and set off, by the infection.
I have not had the tooth pulled because unlike yours it has no reaction to touch, and is the ONLY tooth on the left side of my mouth that doesnât scream with temperature change. I feel like it would be a waste of money in my case. But as your tooth is reactive I would probably pull it in your shoes. As long as you have enough others to eat, it sounds like the small chance it could help is worth it, but I wonât be terribly surprised if some or all of your pain is still there after the tooth is gone.
Hi, big difference is tooth pain usually will wake you up at night, respond to otc drugs, nerve pain usually sleeps when you do, can worsen as day goes on. I have neuropathic tooth pain. Had 2 root canals, then ended up extracting them. Wish I never did. Atypical will and can move to the next tooth after extraction. We think itâs out teeth, but many times itâs a nerve issue. Hard choices. If it sleeps when you do, donât pull. I have a group on fb called Atypical ODONTALGIA and Atf pain. Join if you would like to.
Sorry, nerve pain can surely wake you up !
I have TN due to MS ( = nerve damage - ATN ? ) . It started slowly , so first I also believed there was something wrong with my teeth , which the dentist ruled out .
Last year I had a very bad period . The first weeks the heavy pain attacks didnât come at night but later on they were only " calmer " at night, but they still woke me up several times each night . So âŚ
I was very lucky when my neurologist put me on Tegetrol . The TN was " under controle " after a couple of hours !!!
I hope you find a solution ⌠nerve pain is absolutely NO FUN !!!
My nerve pain wakes me up too, for 4 months I went without a diagnosis and EVERY night I drugged my self silly, slept for 3-5 hours and woke to my own screaming because the pain was so bad. On bad break through days it also wakes me up, but with less screaming now, thank goodness.
Granted, now that I have medications for treatment I do seem to get a âresetâ every night where the pain lowers while i sleep then builds throughout the day, and repeat.
But I would not say sleeping pain is a definitive test one way or the other.
Good advice in all those replies. I have ATN following routine dental work. Ended up taking out the âoffendingâ tooth. No change. Whilst I do regret losing the tooth, at the time it seemed the ONLY thing to do. Well now I know it was not the solution but it eliminated one possibility. I think youâll find the same thing. Medications: tried many, no relief from continual low grade pain & nausea. Opiods can help but they have to be carefully managed and will not work on an ongoing basis. You must use low doses and be prepared to withdraw from the drug so it can regain its effectiveness. If not, you will develop dose tolerance and rebound pain (usually in the mornings) which is as bad as the ATN pain. Good luck.
Thank you to everyone who responded. I had the tooth pulled two weeks ago. Sometimes it seems like it worked and I go for hours with relativelyow pain and then bam, the pain returns. I am still holding on to a little hope.
One thing I really noticed is that my buccinator muscle inside my mouth is SUPER painful!! Any ideas out there???
Well, depending on how long or tough the extraction was the muscle could be strained a bit. And of course the nerves feed the muscle so it could be low level nerve pain. I know I donât sound helpful, apparently it could be from an alien probe, too ( just kidding!) But that is what makes this so hard! It can be impossible to pinpoint problems.
One thing I found by accident with dental work is the use if a wedge. My new dentist has a softish wedge he puts in my mouth to prop it open, it takes all effort from me to open or close my mouth. I have been stunned by the difference it makes. I used to have about a month of ATN flare after even routine cleanings. With this wedge thing, and the fact this dentist respects facial plain and moves at the speed of light for me, I have had cleanings with no flares after.
You mention patting the back of your head causes pain, whilst tooth inflammation would possibly still cause pain in doing so, have you thought it might be possibly caused by your neck. I know and have read of folk for whom this is the case, indeed both trigeminal pain and eye/ supra orbital pain. For those struggling look, in your case, google images of trigeminal nerve and for the latter occipital neuralgia.
As a first course of action (if you think a possibility);
Change your posture, donât use a laptop without a separate screen/ keyboard adjusted to the correct height. Limit tablet use, always bad posture when prolonged.
Change your posture at home, e.g. if you sit on the left of the TV in your favorite chair, kick other half out of theirs and sit there.
Seeing as other half is no longer comfortable, get them to give you a neck rub, particularly the top of your neck and shoulders. Tell them you might be nicer for it
Reduce stress, easier said, though the above might have helped. Try abdominal breathing, regularly- can be very effective. Consider toxic relations, work and family, past and present.
Posted before, but optimize vitamin D levels ( the conductor of the orchestra), and stay hydrated.
