New here - Invisalign and possible ATN

Welcome New Member Introductions
1

Hi everyone! I'm so glad to have found this site. It has given me wonderful information so far.

My pain began about 3 months ago. It started with a very minor toothache, and then exploded into horrible tooth, jaw and mouth pain, with a bit of cheek, eye and ear pain. After seeing 9 doctors/dentists and being diagnosed with bite problems, my orthodontist has suggested that I need to see a neurologist. I had suspected ATN or something like it from the beginning, so I was actually relieved to hear him make that suggestion.

I will be seeing a neurologist in a week. (I'm seeing Dr. Patience Reading in Austin, if anyone has any experience with her that they'd like to share.) Then, just under a month from now, my Invisalign will arrive. I'll be in braces for approximately a year.

Has anyone out there had orthodontic treatment while suffering with nerve pain disorders? I'd love to hear your experience with it. Since most of my pain is dental, I'm very nervous about the additional pain that Invisalign may bring. I think it's important to go through with it, since I have both a structural and a nerve problem. But I'm terrified of the pain level, and really want to find a way to manage it.

I'd also like to hear about your experiences with medication. Were you able to resume normal activity once medicated? Right now, I have tremendous pain when speaking and have been on a liquid diet for 3 months. I had been hoping to go back to normal. But now, I just want to be able to carry on a conversation without regret. How much function were you able to regain with medications? I'm already fairly certain that my pain is atypical, and won't benefit from surgery.

As a side note, I am (was?) an actress, and am booked for an industrial (web video) in a few weeks. I'll be reading off a teleprompter for around 4 hours. This is usually a really easy gig. But now I'm concerned that I won't be able to get through it. I have alerted my agents to my problem, and won't be taking any auditions for the foreseeable future. But this is an ongoing job that I really couldn't turn down. I anticipate that I will have started medication shortly before the industrial shoots. How quickly can I expect to see pain relief? And will I be too spaced out to perform as needed?

I meant to make this short, but it looks like I've gone on and on. I just want to say thank you for sharing your stories and providing this wonderful resource!

2

Hi,

There many medications that can be effective to treat TN/ATN. It is largely trial and error until you find the right med or the right combination of meds that will work for you.

I have been pain free for months at a time in thanks to my medication. It isn't always as easy as that though. I have had several severe flare ups over the past two years lasting from days to weeks that have caused me intense pain regardless of the medication I was taking. And some people do have a really hard time finding relief from their pain.

Having said that I do work full time and am a single mom so I really am able to function well despite having ATN. There have been some times that I don't know how I managed to make it through but I did.

You are very brave to consider getting braces while having this pain. I can barely make it through a simple cleaning with my dentist. I will caution you that many TNers have exacerbated pain after dental work. I do not remember meeting anyone that was getting brace's so I have no idea what the implications of that could be.

Have you tried any medications for TN yet? And what does your dentist know of TN? Or what have they said regarding your concern with the braces? I honestly wouldn't go through with it unless all of my doctors were on board with addressing the situation and providing continued observation and care with the possible pain that could happen.

3

Hi Jane,

Thanks for responding.

This is a really daunting condition. And I'm terrified to be at the beginning of this journey. Though, I'm glad to hear that you've had pain free periods since your diagnosis. I had been hoping to just get better and move past this. But more and more, it looks like it's going to be a long-term issue. So it helps to know that I can at least hope for pain free times.

I can't imagine having children and dealing with this. I worked with kids for a couple years, and would never be able to do it with this pain. So you must be a great deal stronger than I am!

I don't have a diagnosis yet, so I'm not really being treated. I am taking massive amounts of ibuprofen and acetaminophen on my dentist's recommendation. It doesn't really do anything, though. The one thing that has been helping is voltaren gel. That helps my jaw pain.

I'm very concerned about the braces. But my oral surgeon and orthodontist are both convinced that I need to fix my bite to alleviate that portion of the pain. I'm going to put them in touch with my neurologist once I see her next week. I'm hopeful that they'll act as a team.

I don't think my dentist knows anything about TN. But my orthodontist seems to have some idea about facial nerve pain. So I'm hopeful that he'll listen and respond to my concerns. My Invisalign is already paid for and ordered. So it's going to happen, whether I want it to or not! I hope to get some medication for the pain prior to starting braces. And then maybe just staying on the meds until I've finished with the orthodontics, since the side effects I'm reading about seem really horrible.

4

Hi again Karen,

I remember how frightening it was when I started to experience symptoms. Mine started off in one tooth and in the matter of months encompassed the two whole bottom branches of the trigeminal nerve. It has continued to spread since then. Two years later I am bilateral with two bottom branches on the right and all branches on the left.

I am glad you are seeing a neuro and am curious about what he/she will have to say about the invisalign.

There are a lot of different drugs that are used to treat this. Unfortunately they all have side effects and they all take time to start working. BUT! We are all different and many of us have huge success with medication. Yes there are some very bad experiences with side effects but don't dwell on that while trying to find relief. Some people don't have many side effects.

My life saver has been Amitriptyline or Nortriptyline. They are tricyclic anti-depressants and can be very effective in treating atypical type of pain. The side effects from these are fairly minimal for me and what they are is more then a fair trade off to be out of pain.

Pain killers and anti-inflammatories do nothing for this! Let that show how little your dentist knows about it. I also use Voltaren for the burning and deep aching around my jaw, cheek and temple.

TN is progressive but there are also many different things that can cause facial pain. Until you are able to have an MRI and start to rule some things out don't assume that this is a life long condition. TN can also have remissions. I first had ATN when I was 29 for a year. It went away for seven years! It did unfortunately come back two years ago and has been with me since.

Does the orthodontist suggest that having the invisalign might help your symptoms in the long run? Each of our experiences, pain, locations and triggers are so different that it is impossible to know what all of this will hold for you. Have you looked into the various medications used? Or are you waiting for your neuro apt?

5

It's good to hear that remissions are possible. And I hope you have another long remission soon!

And I know that I don't have a diagnosis yet, so I can't assume that this is forever for me. But it certainly feels like it's going that way.

My orthodontist does think that fixing my bite will help eliminate at least some of the pain. Most of my pain is in my front teeth, bilateral. But I do have a lot of pain in my jaw and some in my molars. And he seems to think he can help with that piece. So it makes sense to do it, if the neurologist agrees. And if I have pain management!!

And yes, I've looked into the medications. They are a little scary to me. But it's good to hear that you have minimal side effects.

I've never known pain like this before. My heart goes out to everyone suffering from this prolonged pain.

6

Hi,

I have just finished my Invisalign treatment and was actually wondering whether it could possibly have triggered my trigeminal neuralgia and now I read on the forum that you are considering starting the treatment whilst already suffering from TN...

Did you go ahead with it or not?

I notice that your post dates from June last year, so how did you go?

I would be very curious to know.

As for me, I am still going through a huge flare up.

It is horrible indeed.

I am currently taking lyrica and topamax and it is not doing much for me...

Take care my fellow TN sufferers.

7

Peirce my pain was triggered by removing a permant wire retainer that was bonded to my bottom teeth. It’s been14 of non stop without one pain free day. Can you please tell me a little about your Invisalign and your pain? I’ve considered in the back of my mind ( no dr has told me) getting Invisalign may help me . But that’s just me thinking of any crazy thing I can to get better because nothing works. Thanx in advance for any help / your story