Lately for the last few months I have experienced
Excruciating ,continuous pain in one of my back molars
On the same side as my TN.it never stops! It is
Obviously the third branch of the trigeminal
Nerve ending in my tooth. Anyone else experiencing this?
You could be experiencing a variation on trigeminal pain that is called "atypical odontalgia", David. Whatever you decide to do, I would recommend that you do NOT have the tooth pulled or a root canal done, unless there is conclusive evidence of abscess or a cracked tooth, in high resolution X-ray images.
Regards and best,
Red
David, does it get worse if you bite down on it? then linger after that?
Red (and all)
, i have to say something about warning of removing teeth. i know the medical literature is full of people removing "teeth after teeth" but the pain stayes - and even got worse.
i've also heard from people i know personally that they said "i wished i hadn't removed the tooth".
but i've stated here - that i know personally people that were diagnosed as "neuropathic pain" - and removing a teeth that was "healthy" according to ALL the XRAYS - saved thier life.
also - some people here in Israel i talked to - told me - that they removed the "problematic teeth" they though that caused the problem - and although the burning senstationg etc. STAYED... and didn't pass - they also said that removing the teeth brought them "some" relief (it was not a solution) but some said i reliefed some pressure from their mouth.
but - again - i've heard by doctors mant say the and unnecceret dental procedure can cuase more grief in that area.
i'll admit that in the first year and a hald i had GREAT senesitivity in pain no. 37 (molar) ... and that it became a bit better... the pain is still so severe.. but if was concinced it came from "under the tooth" - i'm not so convinced of that now.
Please note the qualifiers in my posting, Nir: you should not have root canals or extractions UNLESS there is clear radiographic evidence of abscess or cracked tooth. And this goes double for someone who has first experienced chronic pain in the face and jaw, before experiencing pain that seems to be localized to a specific tooth. I think you'll find any number of dentists and neurologists who would advise you similarly.
Regards, Red
Min mine feels bruised if i bite down on it. Red my tingling/throbbing tooth is much better now, does that rule out
atypical odontalgia or can that come and go?
Nir, they probably feel a slight relief after it's pulled because some surface nerves are removed. But those nerves quickly grow back. Or perhaps the psychological burden of wondering if it's a tooth problem or not was such a huge burden, that eliminating that from the equation made things easier to cope with, therefore less stress, and therefore less pain. This is just a guess. All the people I have met tell me not to pull my teeth and say that the fake teeth hurt just as much.
Do not pull any tooth unless something shows on an x-ray or there is puss oozing out of it. A bad tooth will eventually reveal itself.
David, I have 24/7 pain in my upper teeth, and the only thing I've found to even come close to helping that pain is amitriptyline at the 100mg/day dose. If your pain is something that is here to stay, you might want to ask your doctor about this med.
David I was going to say that if you did have similar symptoms as I do,the Bruised feeling as Elstep described.. I also would get on the upper right the roots of my molars feel like hot prongs going into my jaw.. the only med that helped was Effexor xr at 75mg.. Min
I also want to mention that when I eat something cold not only could make the tooth hurt. Now I have bilateral ATN and I notice when I eat somethin cold it may NOT hit the tooth but it WILL make my ear hurt.. so just giving you a heads up at possible affects.
You may already know tho. Peace, Min
When TN was being triggered by my teeth, it was due to gentle touching/brushing. Hot and cold caused no pain, nor did heavy pushing up/down/left/right. I did have one tooth extracted (I was still in TN denial) and oddly it DID help for 6 months (no pain)... before it returned. As someone already said, nerves will grow back. Also, TN triggering will come and go, giving false hope.
Next time I had a tooth act up same way (lower molar) I was wise enough not to go to my dentist. Instead my Lyrica was increased to 600mg per day. After 7 years of this, on and off, it did not stop.. 18 months.. causing me to finally give in and go for my MVD end of January. So far a success. I wish you well. Bob
All of the time. I'm sorry to hear about your pain. Mine is in all of my back top molars on the main ATN side.
David, make sure you have x-ray done before you do anything . Unnecessary treatment not only can cost a hole in your pocket , it may divert the pain to other areas , problem remains unsolved .
Take care.
Atypical Odontalgia "can" come and go, Elstep. That's one of the maddening aspects of the diagnosis. There is no one reliable pattern that can be used in definitive diagnosis.
Regards, Red
elstep said:
Min mine feels bruised if i bite down on it. Red my tingling/throbbing tooth is much better now, does that rule out
atypical odontalgia or can that come and go?
Can abscess be cured with antibiotics? Maybe not need root canal or extraction as dentist recommends? I have no insurance so would have no choice but to do extraction.
Richard A. "Red" Lawhern said:
You could be experiencing a variation on trigeminal pain that is called "atypical odontalgia", David. Whatever you decide to do, I would recommend that you do NOT have the tooth pulled or a root canal done, unless there is conclusive evidence of abscess or a cracked tooth, in high resolution X-ray images.
Regards and best,
Red
if read about Atypical Odontalgia - in thie artical - very intersting - http://facial-neuralgia.org/conditions/ao.htm. i do wonder what's the differnce between that and Atypical Facial Pain.. i guess the diferences sometimes are very gentle.
I'll say again - that here - every specialist told me - not to remove teeth - cause it can hurt more etc.
but again, i swear i heard personal stories of people wanting to kill themselves from pain . all thier XRAYS were TOTALLY fine . but they've had unexplained headaches.. eye aches... and they removed the teeth - (althout the doctors told them it won't help - and IT DID help. they are cure.) a doctor once told me they've had a patient coming to the hospital every week crying from tooth ache.. they told her nothing was wrong with the tooth - and in the end they pulled the tooth out. althout there was nothing wrong in the XRAYS. after doing so - her pain was GONE. i asked him to medically explain this - and the doctor gave me this exlantion " the lady was so convinced it was her tooth - that when remving it - the pain psycollogically stopped".
crystalv - i do agree that in times... pulling the tooth - seemed to me like a good idea - only for "getting it off my system and move oN" . until the tooth is there.. i will always wonder if it is the cause of all my problems.
today - i'm not so sure.
and 100 mg of amitriptyline ! ! ! that' sound so much.. i couldn't handle almosy the 10 mg
Red can Atypical Odontaglia occur after a Classic TN Attack? What causes it? Mine has improved since having a magnetic field treatment done. Sounds improbable I know, maybe it would improved anyway?
Kath,
Some dentists will attempt antibiotics by injection. But efficacy can be compromised by the fully contained nature of abscess. Besides which, I rather doubt that extraction is cheaper than root canal. And as I've suggested, unless you have X-ray imaging results that support a finding of abscess, neither procedure may be warranted and both can comprise a danger of greater pain.
Regards, Red
kath jaco said:
Can abscess be cured with antibiotics? Maybe not need root canal or extraction as dentist recommends? I have no insurance so would have no choice but to do extraction.
Elstep,
I would personally characterize a diagnosis of Atypical Odontalgia as somewhat dodgy -- in other words, AO may turn out to be a diagnostic label that isn't particularly helpful. Pain in a tooth that seems to "shift around" from tooth to tooth may comprise a form of facial neuropathic pain, and will most often be treated in pretty much the same way as ATN pain is. But I don't think the medical/dental community has made up its mind yet on the proper taxonomy or cause-effect relationships of the disorder (if it actually IS a separable disorder). I do know that AD and ATN can both occur in combination or following a Classic Type I TN attack. But I've never seen convincing evidence of a reliable relationship between these disorders, nor am I satisfied that AO is a separate medical entity from ATN.
I hope this isn't too hopelessly confusing. From a perspective of categorizing pain, Atypical Odontalgia is something of a mess.
Regards, Red
elstep said:
Red can Atypical Odontaglia occur after a Classic TN Attack? What causes it? Mine has improved since having a magnetic field treatment done. Sounds improbable I know, maybe it would improved anyway?
Nir,
In a nice way (if one may be nice about such things), I would urge you to wash out the mouth of anyone who speaks the term "Atypical Facial Pain"... with lye soap! There is no such medical entity. PERIOD. And I personally regard implications that any form of facial pain is somehow caused by the patient's mental state, to be outright medical malpractice.
We know that mental attitude or expectations can affect perception of pain severity, and there is evidence from functional MRI that placebo effect is associated with actual changes in neurochemistry or brain activity. But there is NO body of objective evidence that demonstrates a cause-effect relationship between the mental state of the patient, and the original development of physical pain. NONE. NADA! The doctor at the hospital you mentioned was outright speculating, on the basis of no real evidence at all. A lot of so-called psychosomatic medicine is highly subjective (in the minds of financially self-interested psychologists who want to treat -- and be paid for treating -- problems that regular medical doctors don't understand).
These things being said, let's admit that dental imaging isn't perfect. Cracked tooth syndrome can be a difficult problem to confirm without actually opening up a tooth with a drill. And sometimes a small abscess may not show up well on a panoramic X-ray. But these outcomes can often be separated or differentiated from neurological pain, if the dentist will simply do an in-depth patient history and a pin-test on the cheek of the patient (looking for trigger zones).
FYI, I contributed in a minor way to a couple of articles on Facial Neuralgia Org. A lot of their material is very good, and I know that it was extensively researched. However, it is my understanding that the materials there haven't been actively maintained since about 2005.
Regards, Red
Nir Morita said:
if read about Atypical Odontalgia - in thie artical - very intersting - http://facial-neuralgia.org/conditions/ao.htm. i do wonder what's the differnce between that and Atypical Facial Pain.. i guess the diferences sometimes are very gentle.
I'll say again - that here - every specialist told me - not to remove teeth - cause it can hurt more etc.
but again, i swear i heard personal stories of people wanting to kill themselves from pain . all thier XRAYS were TOTALLY fine . but they've had unexplained headaches.. eye aches... and they removed the teeth - (althout the doctors told them it won't help - and IT DID help. they are cure.) a doctor once told me they've had a patient coming to the hospital every week crying from tooth ache.. they told her nothing was wrong with the tooth - and in the end they pulled the tooth out. althout there was nothing wrong in the XRAYS. after doing so - her pain was GONE. i asked him to medically explain this - and the doctor gave me this exlantion " the lady was so convinced it was her tooth - that when remving it - the pain psycollogically stopped".
crystalv - i do agree that in times... pulling the tooth - seemed to me like a good idea - only for "getting it off my system and move oN" . until the tooth is there.. i will always wonder if it is the cause of all my problems.
today - i'm not so sure.
and 100 mg of amitriptyline ! ! ! that' sound so much.. i couldn't handle almosy the 10 mg
Yes- I had 2 attacks, 7 months apart, and each time I had electric in my back molar. I had an attack on the left first, then the next was on the right. The first time I swore it was the molar but the dentist said the tooth was fine. The second time, I had severe stabbing in my head, ear, and molar on the right.