I have since several years Trigeminal Neuralgia, type 1 .
At the moment the trigger is in and around my left front tooth so I can talk tough and can only eat liquid. After an X-ray through the GP of the sinuses (which was nothing to see on) and a change of medication (Carbamazepine for a combination of Gabapentin and Oxycodone) by the neurologist, now I have an appointment with a oral surgeon scheduled to see if there is something wrong with my teeth/tooth.
I want to prepare myself as much as possible prior to the visit to the oral surgeon . My concern is mainly that I want to anticipate to the outcome of his investigation (xray , etc.) and then especially if turns out there is indeed something wrong. (If he can not find anything wrong we know that this is 'only' the TN and further consultation with my neurologist will follow.)
Suppose therefore he thinks there is something wrong with the left front tooth (which incidentally more than 30 years ago was covered with a crown) ? I read here and on the web often bad experiences with Root canal treatment, Apicoectomy, Extractions, anesthetics that do not work, etc. This applies also as regards the sensation of pain during and / or after the treatment. Especially if you have facial pain (in my case typical facial pain) all of these are extra sensitive and frightening issues .
I very much hope that you have some information for me so that I will not consent to the surgeon with something he sees as a good solution to do (eg possibilities mentioned above), but what no good idea for us Trigeminal neuralgia patientsis.
= Where am I supposed to do or not agree ?(Eg extraction is 'better' or less risky than a root canal ? Etc...)
= Who can you go to best for a roottip-/rootcanaltreatment (oral surgeon / endodontoloog / dentist .. ) ?
= If something needs to be done I want it to be done as pain free as possible, so I thought maybe a dentist who uses full sedation/anesthesia (narcoses) could be a solution. Do you have or do you know if there are TN1 patients with experience in treatment under full anesthesia (narcoses) ? (There are some dentists where treatment under full sedation/anesthesia (narcoses) is possible).
= Does an ordinary anesthetic at the dentist work well if you have TN1 ?
Any tip or experience in this matter is very welcome to me and is so very much appriciated!
I didn’t have dental work until three years after I was diagnosed, so by that point I was in really bad pain. Before the surgery, I know I would need full mouth x-rays, nine feelings, two teeth pulled on the back right, and then ended up pulling the two left back teeth (my pain is on the left). They pulled the two teeth on the left side as they said they didn’t want to try and fix them as they said that wasn’t something they did.
Also, last year the fillings didn’t stay, so I had a new dentist go back in and fix the feelings. Next week I will be going in for dental cleaning and a few fillings. I have a really good dental through hospital dentistry at UCLA.
I did have a lot of pain with the extractions which was more than the other dental work, but I know everyone is different. Since my pain gets a lot worse following dental work, I take Percocet.
The first two times I had the dental work done in was under general anesthesia. I ended up have serious complications from the anesthesia, so now I can only have sedation which I have had twice following general. Personally I think sedation makes a huge difference and you are not a wake enough to feel the pain.
I would recommend you decided ahead of time, what you are willing to do if it needs a crown or other dental work. The first time I wasn’t prepared and was in so much pain, that I ended up letting them do work I wasn’t comfortable with. Although, I could only three dentists in California that would treat me due to my TN, so I didn’t have a lot of choices. My advice is, if possible find a really good dentist as for me that has made a huge difference.
I just had a root canal Monday on one of mine. It's hard to pinpoint whether it's TN or dental pain sometimes. I am now having pretty bad stabs today. I don't know if my TN is just aggravated because of the root canal or not, but I am going to take more meds on the way home today. If it doesn't stop soon, I will have to call my neurosurgeon for an increase. The anesthesia (local-novacaine) worked pretty well. However, there was one point that some kind of pain crawled through my whole jaw at the lower part and I had to make him stop for a minute. Other than that, I was fine. I hope you have a good experience. :-)
Oh man, I always get dental pain and TN pain confused. That is why I never do any dental work unless something OBVIOUS shows up on an X-Ray (or those terrible times I have woken up swollen like crazy from abscesses). I have had both root canals and extractions done during TN flare ups. I found the root canal a little more difficult to sit through, but MUCH easier to deal with afterwards than the extractions. The extraction is so quick, but takes so much longer to heal. I also got dry socket twice. I will say this, it is rather uncomfortable, but nothing compared to TN pain.
But that is only my story, everyone is different. I wish you lots of luck!!
Thanks for your comments ! They mean a lot to me and help me well.
I understand that you don't just want to let anything do to your teeth, but only if it is very clear that something is wrong and / or if it can be seen on an x - ray .Good tip ! Also a good tip is the Percocet , I'm using at the time variant ( Oxycodone ) and I would not know what I would do without it because it works better than the Gabapentin that I'm on right now.
I was now at the oral surgeon and guess what: he found nothing!The x - ray was clean, nothing to see on, and he has the crown firmly touched and moved and I got no TN -pain! At all! For months now I have severe TN pain with the crown and gums as a trigger point.And now I felt nothing!
I could have sworn something was very wrong with my crown... I feel betrayed by my own body! It is of course nice that my teeth are fine, but in the meantime I have a lot of pain.The Gabapentin does not work properly (3x300mg per day), and even with the Oxycodone with it the pain comes through.
Soon I will have an appointment with my neurologist, I hope she has other options with medications.
As for my teeth, I have promised myself that IF there appears to be something wrong with my teeth in the future, I get treated under full general anesthesia.