New Member Advice possible TN?

Welcome New Member Introductions
1

I have not been diagnosed with anything yet- Im gathering information and trying to figure out my next step? Im considering neurologist? I’ve had 8 dental appts including 2 endodontist appointments since August for right side gum pain between incisor and canine tooth 7 & 6. I’ve had close to at least 10 oral xrays including a full mouth 3d Dental CT scan. Tapping, cold testing, X-rays & they can’t find anything. I’ve been on clindamycin for gum inflammation (my request, dentist didn’t want to prescribe) Im still scared its abscessed tooth despite endodontist telling me no? Gums were peeling where tooth and gum meet due to a mild reaction to toothpaste (dentist said?) so the inflammation is making things more painful? One dentist said I needed a root canal on tooth #5 but the endodontist did not agree with these findings? Some Other teeth are bothering me too #30 bottom tooth. Sometimes my front tooth hurts?

I had a very painful appointment a month ago that i now believe was trigeminal neuralgia.The Pain was following a filling on #4 and crown on my molar #2 (right side) An hour into the appointment i started to Notice i wasn’t as numb? I began having terrible excruciating nerve pain, it was electric stabbing, deep, pulsating pain from teeth up jaw to temple then head? I couldn’t pinpoint which tooth was sending the pain? I was then Injected with 3 more shots of anesthesia but it didnt touch the pain? It took 2 hours after going home for things to calm down.

Currently: I keep having intermittent jabs of pains in my gums in between tooth 6 & 7 (there is a gap in between these teeth). and then a shooting pain that runs through my gums beside my nose, up through my scalp. (Right side). I also get ice pick scalp pain sometimes too? I can press on my gums and teeth and there is no pain? Another crazy thing is My cheek turned bright red a few days ago and it was warm to the touch? It calmed down and didn’t hurt? I’ve noticed being in the cold outdoor air or in air conditioner makes the pain flare up?

Im at a loss - no clue what to do? :slight_smile: 2 dentists, 1 endodontist, Numerous X-rays, a total of 8 appointments and no answers? I’m out of money and still owe dentist 1300 for my crown and filling. This is exhausting
Thanks — feeling concerned.

2

Sounds like you need to get to a neurologist at this point, you’ve ruled out all the dental stuff.

3

Yes, unfortunately the pain does sound like it is neurogenic (nerve generated) at this point. The good news is if you can get the nerve to relax and calm down, and recuperate from all the dental work, there is a good chance you can get out of this in a matter of weeks or months.

A neurologist is not a bad place to start. They will probably want to put you on a systemic drug such as amitryptiline. I would also look and see if there is an Oral Medicine clinic near you as they deal with both dental and nerve aspects. Better yet look for a Neurology or Oral medicine clinic at a university near you.

Here are some things that have worked well for me, that a doctor is unlikely to tell you:

Since your dental pain is very localized, you might have very good results with a topical anaesthetic such as the OTC benzocaine products for dental pain, or a OTC 4% lidocaine gel (my preference). I put the gel on a rubber pick and put it between the teeth, as well as on the gums if necessary. You might also find a topical capsaicin to be helpful, once you get used to it.

If the pain is wider spread, I use an OTC lidocaine patch, cutting a 1" by 1" patch that I put beside my nose. This has worked well for many who have pain further up the nerve branch–cut the patch to fit your situation.

You will probably want to wear a scarf or other covering when you are out in cold air.

I would recommend not using any toothpaste, whiteners, or other products that might irritate the gums, but I do find a non-alcohol fluoride mouthwash (ACT) to be helpful for sensitive roots.

If you can avoid any dental work for a while, that is best unless it is absolutely necessary.

In a pinch, I have found gum to be very helpful (peppermint or cinnamon), but it makes the situation worse for some.

I highly recommend getting some kind of mouth guard, especially to wear at night. It is likely that you are grinding your teeth at night and this is not helpful. If you can’t afford one made by your dentist, you can get cheap OTC ones that will work, or you can pay a reasonable amount (about $150) to get one made online. This is often enough to calm my nerve down, and has been a life saver for me (though annoying).

Last but not least–eat well, avoid excess sugar and alcohol. Take a B vitamin complex. Keep a journal and avoid anything that stirs up the nerve!

4

Might want to investigate the possibility of sympathetic facial pain which can be part of SUNCT syndrome, is a rare type of primary headache that belongs to the group of headaches called trigeminal autonomic cephalalgia (TACs), bearing in mind your red cheek.

Not intended to diagnose, far from it, but the more info you can gain the better prepared in order to ask questions in further appointments which can be daunting especially when in pain. Potentially more bang for your buck.