Tooth 'sensitivity' - how real is it?

General General TN & GPN (Old Site)
21

No need to apologise, Jackie - I was just baffled as to why you were recommending something that didn't work for you. Pulp capping is just an attempt to heal a healthy tooth that has (usually inadvertently) been opened up into the pulp cavity. That's what's happened to mine now, and it is further complicating the issue of whether this tooth sensitivity is real or not. It may well be, but I'm still going to try the capping if the dentist thinks it's viable. I am loath to do a root canal when I have TN - it just seems like tempting fate in the worst way!

Jackie W. said:

In sharing my story with you, I was hoping that it might help knowing someone else has experienced similar events.
I'm sorry if I misunderstood the root canal part. You said that the tooth was opened up, and I assumed that to close it would mean to finish it. I've reread your story and see that you are considering pulp capping. I don't know what that is. I apologize.
22

Yes, Southerngal, that's right. This would need a direct pulp cap, so no, the prognosis is not so good. But hey - I'm an optimist. I still think it's a better option than the root canal. The dentist however might nix it entirely as not being viable, so I might just have to suck it up!

Southerngal said:

it's my understanding - through dental books- there's 2 types of pulp caps. Direct and indirect. You didn't have decay, right? It was a perfectly good tooth that was opened. If it's a direct pulp cap the long term chances of survival are very poor. If it's indirect pulp cap a medicated temporary filling is placed to calm and shield the nerve until and endo can do a rc or you have the tooth removed at your discretion. Make sure you understand exactly what your dentist is going to do - direct or indirect. Then look up the direct/indirect - research! Good luck. Hope this helped.

23

Our stories are similar. I actually had ATN when I was 29. It went away and came back last year when I was 37 in a different place. Even knowing that the dentist still convinced me that the pain was coming from the tooth. It sure felt like it. I desperately wanted it to be the tooth because I knew if it was TN again it was not good :( So painful and relentless.

I'm sorry that you are going through this and I hope they are able to do something for you. I agree about tempting fate with this disease. I am very, very reluctant to have any dental work done.
I also hope that you find relief with medication. That is when it was confirmed for me that it was neurological and not dental.


Woman with the electric teeth said:

Many, many thanks for your story, Jane. It was so like mine that it was very reassuring to read. Of course, it may be too late now to save the tooth, since we opened it up, but I'm hoping she might be convinced to try a pulp capping. But now that I know to be more stringent with the condition of a tooth before I allow the dentist to do anything, that's really going to help for any future problems.

This is not really the dentist's fault; she was just trying to help me. Ironically, the level of pain I was in actually went against me. She said when I went that she could see how much pain I was in so "there's obviously something wrong". Even more ironic, when I told her the doctor thought it was TN, she said that she'd thought of that, but thought it was too unlikely! Ah, if only she'd spoken up. Well, I'll just have to make the best of a bad job now.

justjane37 said:

Hi,

Just reading through your post here.

This is how my ATN started a year and a half ago. On one tooth. Progressively felt like the worst tooth ache in the world. I had a filling, a medicated filling, three rounds of antibiotics, many pain pills and finally an unnecessary root canal.

TN feels exactly like a toothache. All this time later and I still am convinced sometimes that there is something wrong with my teeth. My TN goes far beyond my teeth now but that is how it started and that is always the most painful part.

What I have been told about dental work is that I should not have any work done unless there is physical evidence. When the dentist removed the filling he said that the cavity was very close to the nerve and that is why it is so painful and that is why I needed a root canal. Physical evidence would be signs of infection such as a bump of the gum due to an abscess or a dark spot on an xray. If those things are not present than I am safe to assume it is the TN.

My advice to you would be to have a filling put in and not a root canal. Some people wind up in more pain after having dental work so make sure you do your homework before having anything done. Cleo is absolutely the right person to talk to.

24

Hi Jane, yes the Tegretol dealt with the electric shocks within 10 days, and that was just on 200mg. That's partly what has caused my confusion and concern. I am now up at 800mg, but still no relief of the sensitivity. This makes me worry that there is something wrong with the tooth. On the other hand, I've had further little improvements, like I've lost pain on putting in my nightguard, and I've lost the sensation/taste of metal on that side of my mouth, and it no longer hurts to yawn, so the tablets are still working. So my big quandary is this: when or how do I know what is TN and what might be genuine tooth sensitivity? It was sensitive before I got the shocks, but it was 'normal', if more painful than it should have been. I just haven't had this condition long enough to know what can be trusted and what can't.

This is another problem, everybody's dosage is different, and it can take a while to get an effective dosage, or the right mix of tablets. I really am floundering around in the dark here.Can I ask, what sort of dose were you on before you lost tooth sensitivity/pain?

justjane37 said:

Our stories are similar. I actually had ATN when I was 29. It went away and came back last year when I was 37 in a different place. Even knowing that the dentist still convinced me that the pain was coming from the tooth. It sure felt like it. I desperately wanted it to be the tooth because I knew if it was TN again it was not good :( So painful and relentless.

I'm sorry that you are going through this and I hope they are able to do something for you. I agree about tempting fate with this disease. I am very, very reluctant to have any dental work done.
I also hope that you find relief with medication. That is when it was confirmed for me that it was neurological and not dental.


Woman with the electric teeth said:

Many, many thanks for your story, Jane. It was so like mine that it was very reassuring to read. Of course, it may be too late now to save the tooth, since we opened it up, but I'm hoping she might be convinced to try a pulp capping. But now that I know to be more stringent with the condition of a tooth before I allow the dentist to do anything, that's really going to help for any future problems.

This is not really the dentist's fault; she was just trying to help me. Ironically, the level of pain I was in actually went against me. She said when I went that she could see how much pain I was in so "there's obviously something wrong". Even more ironic, when I told her the doctor thought it was TN, she said that she'd thought of that, but thought it was too unlikely! Ah, if only she'd spoken up. Well, I'll just have to make the best of a bad job now.

justjane37 said:

Hi,

Just reading through your post here.

This is how my ATN started a year and a half ago. On one tooth. Progressively felt like the worst tooth ache in the world. I had a filling, a medicated filling, three rounds of antibiotics, many pain pills and finally an unnecessary root canal.

TN feels exactly like a toothache. All this time later and I still am convinced sometimes that there is something wrong with my teeth. My TN goes far beyond my teeth now but that is how it started and that is always the most painful part.

What I have been told about dental work is that I should not have any work done unless there is physical evidence. When the dentist removed the filling he said that the cavity was very close to the nerve and that is why it is so painful and that is why I needed a root canal. Physical evidence would be signs of infection such as a bump of the gum due to an abscess or a dark spot on an xray. If those things are not present than I am safe to assume it is the TN.

My advice to you would be to have a filling put in and not a root canal. Some people wind up in more pain after having dental work so make sure you do your homework before having anything done. Cleo is absolutely the right person to talk to.

25

Hi there, So sorry to hear of your trouble with your teeth, I know exactly how you feel.

Firstly you say you had sensitive teeth on lower right jaw. You also say you went to your dentist and she X-rayed the tooth. So was it a tooth that was recognizable giving you pain ?

Could you pin-point which tooth was giving you the sensitivity, was the tooth sensitive to hot or cold food, liquid etc, this does make a big difference to the diagnosis and treatment. Your dentist should firstly have carried out a cold stimulus test to assess the pulp vitality of each suspected tooth along your lower jaw. She would either of used a electric pulp tester probe or a ethyl chloride substance, The most common used is ethyl chloride which is quickly applied to the suspected tooth, once the cold stimulus is applied you should feel a short sharp cold pain, but as soon as the cold stimulus is taken away, the pain should quickly subside. If the cold/pain sensation lingers, this indicates pulpitis, if no sensation then this indicates a non-vital tooth which is not a good sign. You can suffer Reversible Pulpitis and Irreversible Pulpitis, the two conditions are different from one another, Reversible pulpitis is a simply mild inflammation of the dental pulp. It can be caused by anything that irritates the pulp such as cavities that haven't reached the nerve yet. Erosion of the tooth that reaches the dentin. Drilling done by a dentist when doing a filling or crown preparation on the tooth or a fracture of the enamel layer of the tooth which can expose the dentin. Having your teeth cleaned can be a cause that disrupts the pulp, but the pulp tissue normally settles.

You also mention, your dentist made a best guess that it was a big old filled tooth and we decided to open it up. She announced that it looked fine but it was very close to the 'filling' (do you mean nerve) ?

I hope your dentist did not do all this quick thinking method on your first visit, did your dentist carry out any other tests ?

A dentist should only open up an old filling if true signs are showing discomfort, a tooth may be sensitive to pressure, air, sweet foods or hot/cold temperature. An old filling can leak and have underlying decay, but an x-ray would show this, old fillings can also cause the tooth to crack / suffer micro-cracks, which again a good dentist should be able to correctly diagnose this. If your dentist said your tooth looked fine, you really should not have let her open it up, especially what looked like a perfectly good tooth which gave you no pain or discomfort.

I have pretty much suffered facial pain from the age of 12 years old, I had four large Amalgam fillings at age 11 and 12 which went on to have root canal treatment in later life, Around the age of 25 the root canals were failing and I was suffering neurological pain/facial pain which would indicate early TN symptoms from unnecessary dental treatment. Now aged 41 I have had all 3 root canal teeth extracted along with an old filled tooth, I have also had all 4 wisdom teeth extracted even though they were healthy. 10 years on and I am still in pain, more than I have ever been. I suffer TN type 1 and type 2, I strongly believe certain dental treatments can cause TN.

Another idea I have recently found out about is..... We all know Amalgams fillings consist of mercury along with a combination of silver, tin, and copper. Well! I have recently found out that Mercury is a powerful neurotoxin and at certain levels it can cause neurological issues, autoimmune disease, chronic illnesses and mental health disorders. Everyone is exposed to mercury through air, drinking water etc, but how much does the body absorb. When working with mercury the person can suffer several symptoms, these include anxiety, irritability, memory loss, headaches and fatigue.

If I were you, I would have the tooth extracted, this will prevent any further continued pain from any tooth restoration, just make sure your dentist is familiar with extracting teeth, this also can cause/trigger TN pain if the procedure is done wrong or gets complicated.

26

Hi Dallas, many thanks for answering my post - I appreciate it.

I actually believed it was a different tooth when I first visited the dentist, but when she X-rayed them, there was nothing showing as wrong in any of them. She cold-tested all the teeth down there. I can't remember how now. I think she put something on them then puffed cold air on them. Oddly enough, none of them reacted at all, until afterwards. This was normal for me at the start of this problem. There could be sizeable time delays in reactions. It could take as much as twenty minutes before electric shocks would hit from being outside or eating. I got a whole load of warning signals first, then the shocks would strike. Well, on the day she tested the teeth there was nothing from any of them, except a delay of a few minutes and then the throbbing pain I usually got, but no shocks (they were very random).

She didn't think it was the tooth I thought it was (it didn't even have a filling in that one), but because I was in so much pain she surmised something had to be wrong so we opened up the big old filled tooth next door on her suggestion. I was desperate for help at this point and I had no reason to suspect TN, being as how I had never heard of it, and so we opened it up. She said the filling was very close to the nerve and she reckoned the tooth must have pulpitis. She put a sedative dressing in, along with a temp filling, and set me home. And I've been stuck there in limbo ever since.

In the meantime I discovered TN on the internet, because certain things didn't mesh about this as a tooth problem, and I went to the doctors. He diagnosed it the same as me, without me telling him what I'd discovered, so that made it seem even more likely. I was put on Tegretol 200mg, and after about ten days it kicked in and the shocks went away. I was left with various other pain reactions that have slowly receded, but even now at 800mg I am still stuck with the tooth sensitivity.

What I was trying to establish on here is how common tooth sensitivity is with TN sufferers and how likely it is to be genuine.

I have to say I can't quite understand the logic behind you saying I should have the tooth extracted, especially as it has been so unsuccessful in your case. I favour a conservative approach. Having lost a lot of teeth as a teenager, I can vouch that that causes its own problems. My teeth have all shifted over the years because I have so many gaps in my molars. And I no longer have a proper bite in my teeth, so more extractions is definitely not the route to go. Only demons chewing my tail would make me extract teeth!

I'm going to the dentist on Tuesday to see what options I have. I may have to have a root canal, although how I will make myself sit through one, I do not know. The TN has made my dental phobia a lot worse and my anxiety levels are through the roof, but I am still of the opinion it is always better to save what you can of your teeth. You'll regret the loss of them if you don't.

I can't say I believe in the mercury theory either. It's been kicking around for many years, but there is no substantiated scientific study that backs it up. Also, as most TN is caused by a trapped nerve of one sort or another, I can't see how Mercury would impact on that. Unless it was making arteries loop, or myelin casings wear away, and how would it do that while not affecting any other nerves and arteries?

But thanks for sharing your story - these personal accounts are always really helpful - and for taking the time out to give me such a detailed reply. It was very kind of you.

27

My TN symptoms started similar to yours, certain teeth would ache and would appear sensitive. (my dentist even said once that I have tooth hypersensitivity).

Do you suffer the common 20 minute morning no TN pain symptom, where you wake up in the morning and you have no TN pain. But after 20 mins the TN pain creeps up on you, many on here suffer this symptom.

I always thought my teeth were sensitive because I would brush them in the morning and they would ache with pain, but after joining here and reading about the first 20 minute pain free mornings I quickly realized the pain was TN (not tooth sensitivity). I stopped brushing my teeth in the morning for a while and long and behold, after 20 minutes of getting up in the mornings my TN would kick-in as usual (it was nothing to do with teeth brushing).

You say you lost alot of teeth when you were a teenager and now suffer tooth misalignment and gaps, this would certainly introduce a whole set of new problems regarding dental problems. How long have you suffered tooth sensitivity, do you have other teeth with fillings that are sensitive ?

As for Amalgam fillings, I wouldn't dismiss the mercury vapor theory causing ill health to patients. Mercury at certain levels in our bodies can cause neurological issues, autoimmune disease, mental health disorders and chronic illnesses. There have been many studies that are documented across the internet, Norway, Denmark and Sweden have banned the use of mercury in dental amalgams fillings.

Kind Regards

28

Hi Dallas, no, I must be a freak of nature. I'm the opposite with morning pain. I have none during the night, as is normal (thank God), but as soon as I go through to the kitchen I can feel the 'sensitivity' start and I become more aware of the metallic taste/sensation on the right side of my mouth (that is with me 24/7, and is very reluctant to leave, although it is now a taste rather than the feeling that my teeth have all been electrified, as it was originally).

Breakfast is the one meal of the day where I am guaranteed to have painful reactions to eating - all that cold milk and refrigerated berries! For that reason I actually prefer to eat a cooked breakfast, usually kedgeree because it cools relatively quickly and I can eat it quite comfortably.

As the day wears on, and I take more Tegretol, of course, the pain becomes easier to handle, although it never goes away. But I have no electric shocks now, other than the odd twinge going in and outdoors, so I consider myself VERY lucky indeed. When I was first having the shocks I couldn't eat at all, or do anything very much - including talk, so if this was as good as it got, I'd still consider myself blessed.

However, I'm upping the Tegretol 200g every fortnight, trying to find the magic dose. The side effects are bad for a week then they settle down - then you have to go through it all again! But it's worth it.

I do have other sensitive teeth, but I gave up sugar two months ago, roughly, and find it much improved since then. That's ALL sugar, not just sweets and cakes! I only eat fresh fruit. I'm in my fifties, so some tooth sensitivity is normal as the gums recede. But most people have too much of it, too young, due to bad diet. No, it's not related to fillings, that I've noticed. However, my TN does seem to be. I only have two fillings in the TN side of my mouth and they act like gate posts for the pain. It literally shoots from one to the other, or sometimes one OR the other, or sometimes both, but doesn't appear in the healthy teeth in front or in the root canalled tooth to the rear. I have a theory that my brain is getting cross-wired signals from the filled teeth and is misreading them as something dangerous!

And no, I definitely don't dismiss the mercury theory, as in I keep an eye open for any new research that might give something more concrete and scientific, but so far no luck. Like I say, it's been around a long time, but no-one's been able to prove it yet.

All the best, Chancery

29


DeboraRoad said:

My Tn started with tooth pain. I had a root canal and new fillings put in. Nothing helped. My dentist told me to go to a neurologist and that is how I found out I had TN.. I am still very tooth sensitive. Even the root canal tooth. It is not the tooth, it is the nerve.

30

I have found that most of my teeth that have extensive work done on them are the most painful during a crisis. Like today, I started a new anti seizure drug on Tuesday of this week called Aptiom, at 400 mg. The goal was to go up to 800 after one week. I had a feeling it wasn’t going to last due to a few random zips through my teeth. Sure enough my lower jaw began to ache. I called the neuro and got the ok to jump up to 800mg. I am now comfortable. I do however, go every four months to have my teeth checked. In retrospect, how many unnecessary root canals did I actually have? Too many I think. To go to those dental appointments I go medicated with a driver. Too traumatic. The fear of a relapse due to probing being the biggest.

31

Hi Lou, ah yes, triggers. I find mine is anxiety or upset. The teeth definitely hurt more before an ordeal of some sort. The dose I'm on now means I can put my night guard in pain-free, but if I have to go to the dentists the next day there's a good chance it will hurt. Likewise if I cry or get upset, my teeth will sometimes start spontaneously throbbing!

I've found that now I have the diagnosis of TN my dental phobia has increased ten-fold. I have to go this Tuesday and although I am only going to talk to her, I am going to ask for X-rays and know that she will have to put the gum shield in my mouth. Just the act of anyone putting anything in my mouth has me sweating. I said to my partner that I don't know what I'll do if I do have to have a root canal in this tooth because I don't know how I could sit through one. Unfortunately the NHS in the UK doesn't do intra-venous sedation for patients so I'll need to see if I can get it done in a dental hospital or somewhere where they do offer sedation. The idea of anyone drilling and sticking files down close to my Trigeminal nerve is horrific to me.

I wasn't a good patient before this happened, now I'm a walking disaster!

Lou said:

I have found that most of my teeth that have extensive work done on them are the most painful during a crisis. Like today, I started a new anti seizure drug on Tuesday of this week called Aptiom, at 400 mg. The goal was to go up to 800 after one week. I had a feeling it wasn't going to last due to a few random zips through my teeth. Sure enough my lower jaw began to ache. I called the neuro and got the ok to jump up to 800mg. I am now comfortable. I do however, go every four months to have my teeth checked. In retrospect, how many unnecessary root canals did I actually have? Too many I think. To go to those dental appointments I go medicated with a driver. Too traumatic. The fear of a relapse due to probing being the biggest.