Toothache or Neuro - Please Help

I’m back for the second time. :frowning: The last time I lucked out. It ended up being a toothache and I was fine. I felt incredibly relieved to say the least.

Now the other side hurts. It was a bottom molar. Endo did a few root canals on it and it still hurt so I got a second opinion. The new endo is saying I should see a Neurologist.

It has been 3 weeks since my apico (where they cut off the root of your tooth.). He said it looked fine and that extraction probably wouldn’t help. My teeth are have been crowned since my 20’s. They aren’t good but aren’t horrific. It still hurts a bit when I press on the gum line. I’m not sure what to do. I’m getting it extracted on a few days.

The last Neuro I saw diagnosed me with Atypical face pain. That ended up being an abscess that didn’t show on the X-ray yet. I have the same symptoms. Just a mild/moderate ache. Some pain towards the ear but I know that’s a root canal pain, because I’ve had it before.

Can anyone offer advice? From my knowledge now it doesn’t seem like anything you are describing. The pain did completely vanish after the 2nd and third root canal on the tooth. It stated getting better after the apico but now it’s back to the same. It’s been like this for 8 months. I just want to cry. I am so scared and don’t know what to do.

The endodontist said it could be a neuralgia. Is that true? Nothing sets it off. No shorting shock like pains etc. I am 37 years old. Thank you.

Like You I too Suffered Toothache Pain Early On

I won’t ever pretend to be a Physician, but I before I was ever diagnosed, I did have a short remission from TN after having some silver amalgam filings removed; however when the pain did return I went back to the dentist in search of a new phantom pain…if I were you I’d get a second opinion from a neurologist familiar with trigeminal neuralgia.

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Thank you so much for responding! I have been a mess. The Neuro I was seeing was recommended here. He said I didn’t have any of the symptoms of TN. So I’m so confused. I still don’t have those symptoms and never have. I have read a lot too. But why would the endo tell me to see a Neuro? I do have an appointment but how can you tell if it’s your tooth or not? I’m having mine pulled. I know it’s drastic but I really don’t believe him. I’d appreciate any thoughts you might have. Thanks again.

I have toothache in a couple of lower molars a lot of the time. I’ve had the silver amalgam filling removed, and the pain was worse after that, and has never completely gone away. But I’ve been taking Amitriptyline for a couple of years now and it helps a lot. (I’ve never had the shooting pains neuralgia, but constant aching and boring pains) I’ve been back to the dentist for check-ups and every time I get her to check the teeth- she puts a cold bud on it to check it, but I can’t remember whether the pain’s worse or the same, but whichever way it is, she knows that it’s not a dental problem, along with the x-rays.
Sorry I can’t be more helpful, but I would be wary of having an extraction personally, especially have had the root canal already.

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Hi Niki
The endo probably suggested that because your pain is not something they specialize in and no one ever wants to do something that might make the patient worse and tarnish their own reputation.So it is only logical to refer you around.
Have you had an MRI yet?Is an apico the same as a neurectomy?
I wish you luck.
I am in brutal pain for a year and a half now.
Hoping the last MRI which followed the TN nerve on all it’s pathway shows something.
Please stay on and keep asking questions.There are some brilliant people here-including you

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Thank you so much for your support everyone. I really appreciate it. An apico is where they cut off part of the root of your tooth. I had it done before with success.

Was you pain controlled by jut Tylenol? Mine is. So I’m really thinking it is the tooth. I had a crown prep, 4 root canals (they couldn’t do it all in one session), and then the apico. Honestly I think the tooth is shot but they seem to be so desperate to save teeth these days. I’ll keep you posted. Maybe he’ll see something when they pull it.

Again thanks so much.

Oh - I was scheduled for an MRI on the other side but it was a tooth issue so I never got it done.

No one telling you that pulling a tooth is what so many in this clinical population did and that it was counterproductive? Classic mistake. But, i know the wish only to well to stop the pain.

For ten years I have wondered about an apioectomy for my own tooth pain. Regional and internationally known specialist advised against it.

Hi Niki
Mine is NOT controlled by tylenol.If yours is controlled by tylenol then
you probably have something other than trigeminal neuralgia.Notice how we
all hedge our bets with probablies and maybe’s
I take gabapentin,codeine,tylenol with codeine and medical marijuana and it
is not controlled a lot of the.time.I also have a topical cream with
Please keep on searching.
Sometimes going to an emergency dental clinic ,they will just pull the
If that is what you think it is.I did and lost 2 healthy teeth.But still in
my mind,I say the tooth that is hurting like crazy is the problem.
Please let us know how it goes.
Thanks for the explanation for apico.Never heard of it before.

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Thank you. That’s what I’m thinking too. There has been so mich work done on this tooth that I think it really is a toothache. If it is I’m going to feel terrible for bothering you with all this. For the most part Advil kills the pain. I’m having it pulled in a few minutes and will keep you up to date. Perhaps this will help others, too.

Hi Nikki
We will all be thrilled if that is what it is for you.
I will be for sure.
Having a tooth pulled has been my preferred option.
This time-the pain would jump from the tooth that was pulled to anither
Please let us know how you are doing.
best of luck.

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I think my last reply got lost, hopefully you are felling better today.

My dentist wasn’t familiar with TN, but he refused to act on my issues with pain. On the other-hand, I had two Ear Nose & Throat (ENT) specialists that had no problem operating on what they diagnosed as: “chronic sinusitis,” but after the second nasal endoscopy I finally discovered from a new neurologist I had TN.

So we really need help from* all* our healthcare providers.


Hi Nikki
Just to let you know I am going to my cabin for a few days-no hydro,no
internet and only the occasional cell signal.
I hope your fix worked.

Hope that pulling it did the trick for you, please let us know. I agree, if tylenol works well to kill the pain, it doesn’t seem like ATN. I sometimes fantasize about having a tooth pulled and suddenly having everything just go away.

Thank you so much everyone. I had it pulled out and there was an abscess. He said no wonder why you were in pain. So hopefully that’s all it is. And hopefully it maybe will help someone too. I passed all the endo tests, which makes it even more odd. Thanks again everyone. I’ll update in case anything changes.

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Glad having the tooth pulled relieved your pain. I had the tooth I felt pain in removed years ago, even though they said it wasn’t the tooth. The pain never went away and I finally decided to have an MVD…and all pain was gone for 8 years. When my TN came back, the same exact tooth pain was back too. Feels like a hot poker is being shoved up into the root of the tooth…and is not relieved by tylenol. Very happy for you that your pain is gone and the abscess is cleared up. Stay well!

Yay Nikki YAY
I am so glad you reached out-asked questions and made a decision based on how you know your body.
I am so glad.
I wonder how come the abscess did not show up on imaging?
\Now there are about 10000 people imagining that a tooth pull will take their pain away.
I am so glad it worked for you and I hope that you have empathy for people walking around with no teeth but still in pain.
I wonder how long the doctors would have made you suffer?
Glad you took control and got the help you need.

Glad to hear that you have made the right choice. Yes, it does make you wonder–an abscess that they could not find? Of course it makes you think…maybe there is a tooth problem after all? Wish answers weren’t so difficult!

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That is great! Glad you figured it out and so glad it appears not to be TN. I am also curious about an abcess not showing up on imaging. I definitely have TN (type 1 with shocks/attacks and all the accompanying fun) but had a root canal and crown placed in February (set off a ton of issues with my TN) and am still having aching in that darn tooth although shocks/attacks are under control with Tegretol. There is no root. It’s dead. It shouldn’t hurt. Ugh. Anyway, I’m going to see a facial pain specialist/dentist who treats TN patients to take a look at the crown since my regular dentist and endo are out of ideas. We are just tricky dental patients! Take care.

Thank you everyone. I’m sorry I didn’t update sooner. I got a dry socket in the tooth so it’s taking much longer to heal. In fact it still hurts a little bit but I am hopeful it will improve. It’s gotten better but now I have a mild ache that comes and goes. It is either in the tooth or the teeth in front. Sometimes I get mild shooting. It feels similar to what happened on the other side. The trauma from the extraction caused the molar next to it to abcess. The extraction was almost a month ago and I’m getting worried. It’s

So I’m just waiting, trying not to cry, and hoping for the best. Otherwise I know how to find you all :slight_smile:

As far as not showing up on the X-ray. The endo did not take an x ray for my follow up. He just did the tapping and endo ice on a cotton bud and poked around in there. He had great credentials but I’m doubting him now. Either way I’ll post back once I know more. You are all in my thoughts every day. I am amazed as how strong and encouraging you are. Thanks again.

Hi Niki
So glad to here from you again-thanks for letting us know.I do hope you feel better soon and that it is just(which is a BIG just )dry socket,which is super painful in itself.Fingers crossed that you will recover fully.