A question has been bothering me when I read some profiles on here. Some people relate the onset of their TN 1 pain to a root canal treatment. Then they have the MVD and the pain is gone or at least much better. Does anyone know how is that possible that the MVD solves the problem when it is done at a place distant from the one where the pain originated? I'd think that people whose pain started after a root canal (where there is a clear proof, e.g. an x-ray, that the root canal is needed) would suffer from atypical TN or neuropathy and only a surgery done at the place where it all started could help it but it seems that this is not always the case. Can anyone explain this? Many thanks,
I can only tell you about my own experience with root canals. I started having generalized "tooth" pain about 10 years ago while on vacation out west. I kept taking Advil but had no relief. This usually helped with past toothaches. I thought maybe it was the altitude, but it persisted so I found an endodontist in Salt Lake City who performed 2 root canals on me. While he was numbing me, I felt the first sharp twinge of what I would later recognize as TN pain. When I almost jumped out of the chair, he said, "That's good. It means I got close to the nerve." The pain did subside for awhile. When it returned, I went to another endodontist back home who completed another root canal. He also found that the root canals I had done in Salt Lake City had been overfilled and were close to the nerve. My pain continued after all of these root canals so I was referred to an oral surgeon to have a tooth extracted. No luck. Still had pain. Had another tooth extracted. Still had pain and it was getting worse.
It would take me 4 years from that first tooth pain until I got a diagnosis of TN. The day my neurologist started me on Tegretol and Neurotin my pain subsided immediately. The drugs worked for about 6 years until they stopped abrubtly. I had an emergency MVD and my surgeon found a very large artery cutting a large groove in the nerve. I was so afraid to have an MVD and put it off because I thought my TN was caused by a dental injury and the doctor wouldn't find the cause. It turns out, it really was an artery wrapped around a nerve.
My suggestion to anyone who has unexplained dental pain (nothing shows up on xrays or visual exam) is to make an appointment with a neurologist before having any major dental work done. If it is TN, drugs like Tegretol and Neurotin will provide almost immediate relief. I lost two teeth to extractions and will lose 3 more due to an improperly fitted bridge which destroyed the teeth underneath. I now have to come up with about $15,000 to have those teeth replaced by implants.
I have ATN pain and have been to 2 oral surgeons who said I have bone loss under my implant, an endodontist 3 times who says I don't need a root canal, and a periodontist who doesn't agree with the oral surgeons and said bone loss does not cause pain. He said I have an upper cracked tooth and the bottom tooth that has been burning terribly for months needed a root canal. Went to a nuero and had an MRI and MRA which were both normal and he said there is no way to test for nueralgia. He started me on gabapentin and I have had some improvement and some side effects. From what I have heard you have to increase the gabapentin to a higher dose the I am taking to really get relief(I am on 300mg per day) I don't know if I will be able to increase the dose too much because the side effects wil probably increase too. How does anyone know if they have an artery wrapped round a nerve if the MRI and MRA are negative? brownkat said:
I can only tell you abou my own experience with root canals. I started having generalized "tooth" pain about 10 years ago while on vacation out west. I kept taking Advil but had no relief. This usually helped with past toothaches. I thought maybeeit was the altitude, but it persisted so I found an endodontist in Salt Lake City who performed 2 root canals on me. While he was numbing me, I felt the first sharp twinge of what I would later recognize as TN pain. When I almost jumped out of the chair, he said, "That's good. It means I got close to the nerve." The pain did subside for awhile. When it returned, I went to another endodontist back home who completed another root canal. He also found that the root canals I had done in Salt Lake City had been overfilled and were close to the nerve. My pain continued after all of these root canals so I was referred to an oral surgeon to have a tooth extracted. No luck. Still had pain. Had another tooth extracted. Still had pain and it was getting worse.
It would take me 4 years from that first tooth pain until I got a diagnosis of TN. The day my neurologist started me on Tegretol and Neurotin my pain subsided immediately. The drugs worked for about 6 years until they stopped abrubtly. I had an emergency MVD and my surgeon found a very large artery cutting a large groove in the nerve. I was so afraid to have an MVD and put it off because I thought my TN was caused by a dental injury and the doctor wouldn't find the cause. It turns out, it really was an artery wrapped around a nerve.
My suggestion to anyone who has unexplained dental pain (nothing shows up on xrays or visual exam) is to make an appointment with a neurologist before having any major dental work done. If it is TN, drugs like Tegretol and Neurotin will provide almost immediate relief. I lost two teeth to extractions and will lose 3 more due to an improperly fitted bridge which destroyed the teeth underneath. I now have to come up with about $15,000 to have those teeth replaced by implants.
The artery and nerve usually don't show up on an MRI so they really don't know until they go in according to my surgeon. The MRI is usually done to rule out MS plaque deposits because MVD is not effective in patients whose TN is caused by MS.
The endodontist said the crack was so little that I didn't need a root canal. I do not get shooting pians, I get burning which is the worst on my bottom tooth and it sometimes causes pain in the one above that is supposedly cracked. I also get bad burnig in my upper and lower front teeth, gums and palatte and sometimes have the feeling that they are very swollen but they are not. I am going to a nuero/facial clinic in about 10 days and they are going to take a look at everything and hopefully come up with a diagnosis. I pray they can help me. The fact that I am having side effects on only 300mg daily of gabapentin worries me because it is giving me some relief but i don't know if I can deal with more side effects when it is increased. I get nauseous very easily from meds and I am allergic to codeine I am hoping that the side effects go away the longer I am on it. I don't have a nuero to guide me because the one I wentto was terrible. My family doctor is prescribing the gabapentin and i don't know how expeienced he is with it. I guess I will have to see what the clinic tells me and maybe they can deal with the meds.Damaged by Sargenti said:
Gizmo, you need to get the cracked tooth fixed and any other dental problems. I have had sharp shooting pains from two cracked teeth. If you are anywhere close, go to your state dental school and get the other issues resolved. You can ask that the more experienced staff evaluate your X-rays and ce there when work is done. It is cheaper and you get more eyes on the problem.
Mine actually started with little twinges, making me think it was a tooth for MONTHS. Dentist found nothing. Finally he saw what he thought was a tiny little crack in a tooth. He prepped me for a crown and put a temp on it. I had a novacaine shot with this. That night is when the disabling electrical shocks came. Knocked me to my knees! A few days later he sent me to an endodontist for a root canal and it didn't get better. I went back to the endo and he said my pains sound more neurologic to him. So a few days later I went to my doc and was diagnosed. My theory is that you initially think its a tooth. You go for dental work and when they give you the shots in your mouth, it just sets the TN off into full-blown attack mode.
The endo didn't do a root canal because he said I didn't need one. He did give me a nerve block to see if the pain went away from it. It was better whi\e I was numb but then came back. The last time I had a novacaine shot was when the dentist drilled for cavity and put on a crown. A few months later is when the pain started. It wasn't bad pain in the beginning and I thought it was because I was constantly getting food stuck there and flossing too much or too hard. The burning started months later and contiiued to get worse. I then had another crown put in next to it and the pain seemed to get even worse. Right now I am getting relief from 300mg per day of gabapentin. I changed from 300mg at night to 200mg at night and 100mg in the morning. I am having a problem with nausea which seems to start immediately after I eat breakfast. Today is the first day I am at work after starting the morning dose and I'm not feeling too good. I hope as the day goes by it gets better. i haven't tried elavil since I just started taking meds 2 weeks ago. I will see what the facial pain clinic says when I see them next Tuesday..I don't even know if I have TN. Thanks for the advice.
Damaged by Sargenti said:
Gizmo, from re-reading a previous post, it sounds like the endo may have hit your nerve with the novacane injection. It will cause that sharp pain and make you come out of the chair and then permanent burning because the nerve is damaged. Most people don't know about it unless the luck runs out on them. Have you tried elavil (amytriptiline) for the burning? It helped me the most but can take awhile to get used to the drowsy side effects. Good luck with ur appt.
Kind of makes you scared to have any dental work done, but what do you do if you do have a cracked tooth, it still has to be fixed?
Donna Cook Turnage said:
Mine actually started with little twinges, making me think it was a tooth for MONTHS. Dentist found nothing. Finally he saw what he thought was a tiny little crack in a tooth. He prepped me for a crown and put a temp on it. I had a novacaine shot with this. That night is when the disabling electrical shocks came. Knocked me to my knees! A few days later he sent me to an endodontist for a root canal and it didn't get better. I went back to the endo and he said my pains sound more neurologic to him. So a few days later I went to my doc and was diagnosed. My theory is that you initially think its a tooth. You go for dental work and when they give you the shots in your mouth, it just sets the TN off into full-blown attack mode.
I know! I have a little cavity on my good side right now AND I am overdue for a checkup and cleaning. I AM SO NERVOUS! But it has to be done, so I am just going to have to suck it up and go. My neurosurgeon said that if I go and then I have problems, that it shouldn't be permanent, meaning that it won't make my meds stop working....it will just set it off for a while. Guess I will be making that appointment in the next few days................
gizmo said:
Kind of makes you scared to have any dental work done, but what do you do if you do have a cracked tooth, it still has to be fixed?
Donna Cook Turnage said:
Mine actually started with little twinges, making me think it was a tooth for MONTHS. Dentist found nothing. Finally he saw what he thought was a tiny little crack in a tooth. He prepped me for a crown and put a temp on it. I had a novacaine shot with this. That night is when the disabling electrical shocks came. Knocked me to my knees! A few days later he sent me to an endodontist for a root canal and it didn't get better. I went back to the endo and he said my pains sound more neurologic to him. So a few days later I went to my doc and was diagnosed. My theory is that you initially think its a tooth. You go for dental work and when they give you the shots in your mouth, it just sets the TN off into full-blown attack mode.
I know! I have a little cavity on my good side right now AND I am overdue for a checkup and cleaning. I AM SO NERVOUS! But it has to be done, so I am just going to have to suck it up and go. My neurosurgeon said that if I go and then I have problems, that it shouldn't be permanent, meaning that it won't make my meds stop working....it will just set it off for a while. Guess I will be making that appointment in the next few days................
gizmo said:
Kind of makes you scared to have any dental work done, but what do you do if you do have a cracked tooth, it still has to be fixed?
Donna Cook Turnage said:
Mine actually started with little twinges, making me think it was a tooth for MONTHS. Dentist found nothing. Finally he saw what he thought was a tiny little crack in a tooth. He prepped me for a crown and put a temp on it. I had a novacaine shot with this. That night is when the disabling electrical shocks came. Knocked me to my knees! A few days later he sent me to an endodontist for a root canal and it didn't get better. I went back to the endo and he said my pains sound more neurologic to him. So a few days later I went to my doc and was diagnosed. My theory is that you initially think its a tooth. You go for dental work and when they give you the shots in your mouth, it just sets the TN off into full-blown attack mode.
I can just say that I had a root canal. During which the dds hit the mandibular nerve. I jumped out of the chair in response and felt guilty. Then he sent me to a endodontist and he did it again. again, I screamed and jumped out of the chair. They both denied that this was the cause of my TN and the endodontist told me never to come back after the way I "behaved".
I wish now that I had sued. Little did I know that my injury would mean living with pain for life.
Hi, I have a traumatic nerve injury that presents like TN2 but is not that. I have been referred to the neurosurgeon up in Great Neck, NY because another neurosurgeon referred me. I still don't quite understand how he would do surgery on me when the damage to the nerve occurred from a dental instrument hitting it. I have not yet tried Tegrotel but maybe I should.
Damaged by Sargenti said:
The previous statement that if neurontin and tegretol work, it is TN, is not accurate. I have root canal damage and they work for me. Technically anyone with damage to the trigeminal nerve branch has "TN". The question is what causes it and what will fix it. There are doctors out there (incl one in great neck NY) who is willing to do MVD surgery even if you have the X-ray like my profile picture. People with this pain are desperate for a cure - I am too. Common sense about what happened before it started and therefore caused the problem should prevail. TN is a term that can mean more than one thing and they all do not equate to MVD solutions. The TN association has (or had) a write up on their site that said that trying to fix a dental problem with "traditional" TN treatments, is the wrong thing to do.
I learned that had my endodondist been honest when I called hours after my root canal because I was strangely still numb and given me a high dose of steroids immediately that I would not be having this constant pain. It has been over 5 years now. The main problem is that if the endodondist had done what was right -- prescribed the drugs -- then he would have admitted to having made an injection error and opened him up to a suit. It saddens me, though, that all of this could have been avoided.
My friend just had to have a root canal on her back molar and her endodondist actually gave her steroids before, during, and after as a precaution. It turned out that the reason the endodondist did so was that someone had actually made a mistake on him and he had constant facial pain for over a year. It went away for him. Lucky.
uwfotogal said:
I can just say that I had a root canal. During which the dds hit the mandibular nerve. I jumped out of the chair in response and felt guilty. Then he sent me to a endodontist and he did it again. again, I screamed and jumped out of the chair. They both denied that this was the cause of my TN and the endodontist told me never to come back after the way I "behaved".
I wish now that I had sued. Little did I know that my injury would mean living with pain for life.
This is the first time I read about steroids given as a precaution before a root canal. I don't think it's a common practice and that not giving steroids to the patient would be considered a professional mistake. Then again, this may vary country from country.
janetm said:
I learned that had my endodondist been honest when I called hours after my root canal because I was strangely still numb and given me a high dose of steroids immediately that I would not be having this constant pain. It has been over 5 years now. The main problem is that if the endodondist had done what was right -- prescribed the drugs -- then he would have admitted to having made an injection error and opened him up to a suit. It saddens me, though, that all of this could have been avoided.
My friend just had to have a root canal on her back molar and her endodondist actually gave her steroids before, during, and after as a precaution. It turned out that the reason the endodondist did so was that someone had actually made a mistake on him and he had constant facial pain for over a year. It went away for him. Lucky.
uwfotogal said:
I can just say that I had a root canal. During which the dds hit the mandibular nerve. I jumped out of the chair in response and felt guilty. Then he sent me to a endodontist and he did it again. again, I screamed and jumped out of the chair. They both denied that this was the cause of my TN and the endodontist told me never to come back after the way I "behaved".
I wish now that I had sued. Little did I know that my injury would mean living with pain for life.
I think that my friend was given the steroids as a precaution because her oral surgeon experienced constant facial pain for a year from his own root canal experience. The professional mistake in my case was that he hit my nerve during the mandibular block and once I called later that day and said there was a problem, he did not prescribe the steroids that could have saved me from constant pain.
Oldriska said:
This is the first time I read about steroids given as a precaution before a root canal. I don't think it's a common practice and that not giving steroids to the patient would be considered a professional mistake. Then again, this may vary country from country.
janetm said:
I learned that had my endodondist been honest when I called hours after my root canal because I was strangely still numb and given me a high dose of steroids immediately that I would not be having this constant pain. It has been over 5 years now. The main problem is that if the endodondist had done what was right -- prescribed the drugs -- then he would have admitted to having made an injection error and opened him up to a suit. It saddens me, though, that all of this could have been avoided.
My friend just had to have a root canal on her back molar and her endodondist actually gave her steroids before, during, and after as a precaution. It turned out that the reason the endodondist did so was that someone had actually made a mistake on him and he had constant facial pain for over a year. It went away for him. Lucky.
uwfotogal said:
I can just say that I had a root canal. During which the dds hit the mandibular nerve. I jumped out of the chair in response and felt guilty. Then he sent me to a endodontist and he did it again. again, I screamed and jumped out of the chair. They both denied that this was the cause of my TN and the endodontist told me never to come back after the way I "behaved".
I wish now that I had sued. Little did I know that my injury would mean living with pain for life.
I see. I imagine you must be angry with that endodontist. I did file a complaint with the Dental Association for medical negligence of my then dentist and oral surgeon. I had the first hearing last Thursday and I felt like Don Quixote fighting windmills. They have a lot to lose, so they even altered evidence, such as my medical records. I felt so helpless because it was my word against theirs and doctors stick together. I hope I'll be able to prove at least some of their lies.
janetm said:
I think that my friend was given the steroids as a precaution because her oral surgeon experienced constant facial pain for a year from his own root canal experience. The professional mistake in my case was that he hit my nerve during the mandibular block and once I called later that day and said there was a problem, he did not prescribe the steroids that could have saved me from constant pain.
Oldriska said:
This is the first time I read about steroids given as a precaution before a root canal. I don't think it's a common practice and that not giving steroids to the patient would be considered a professional mistake. Then again, this may vary country from country.
janetm said:
I learned that had my endodondist been honest when I called hours after my root canal because I was strangely still numb and given me a high dose of steroids immediately that I would not be having this constant pain. It has been over 5 years now. The main problem is that if the endodondist had done what was right -- prescribed the drugs -- then he would have admitted to having made an injection error and opened him up to a suit. It saddens me, though, that all of this could have been avoided.
My friend just had to have a root canal on her back molar and her endodondist actually gave her steroids before, during, and after as a precaution. It turned out that the reason the endodondist did so was that someone had actually made a mistake on him and he had constant facial pain for over a year. It went away for him. Lucky.
uwfotogal said:
I can just say that I had a root canal. During which the dds hit the mandibular nerve. I jumped out of the chair in response and felt guilty. Then he sent me to a endodontist and he did it again. again, I screamed and jumped out of the chair. They both denied that this was the cause of my TN and the endodontist told me never to come back after the way I "behaved".
I wish now that I had sued. Little did I know that my injury would mean living with pain for life.