Which came first? TN/ATN pain or dental pain?

General General TN & GPN (Old Site)
21

Hi, I have a similar story. It started with a dental hygienist who was so rough she was brutal. She made my teeth very sensitive but she said that was normal and would settle down. It didn't . It got worse and worse and got to the stage where my teeth were so sensitive that all remotely hot or cold things were unbearable to eat or drink. Then I got my first TN shocks and everytime they occurred they were followed by the worst cramping pain in my jaw I have ever experienced. I too thought I had an abscess and went to the dentist. The tooth that I was indicating had a filling in it so the dentist took it out and had a look and said it was fine. She also xrayed it and said it was OK but the tooth in front of it was dodgy with a big cavity inside it. No pain in that one. She and her partner steadfastly refused to remove any teeth with no just cause. Then my doc said I had TN and put me on Tegretol. One allergic reaction and a month later i got out of hospital and went straight to my dentist to have my teeth checked again but it was a different dentist because the first one was on holiday. He found an inflamed nerve in the molar that she had checked and he did a root canal and my TN has gone from shocks to flurries with no other pain at all. He also found that the "cavity" in the one in front was actually packing! It looked just like a cavity on xray. I had a previous root canal that was never finished!

22

Newbie here, with a reverse experience from many here. I went to the dentist in April for a checkup and cleaning, the same week I thought I had sinusitis or allergies, but no medications worked. The dentist took x rays and said my sinuses were clear, and the hygienist put a treatment on some of my especially sensitive teeth, the cleaning was a bit painful. Two days later I had a migraine, with nausea, which was unusual for my migraines. When the migraine lifted (more quickly than usual) the real pain began, constant, and with attacks, for the next three days. My GP suspect TN immediately and sent me to a neuro very quickly. I repeated what the dentist had told me, that everything in my mouth was fine. The neuro examined my face and pretty quickly diagnosed me with TN, putting me on 200mg of carbamazepine, going up to 400mg within a week or so.

Since then I've mostly been pain free, aside from the frozen/fuzzy feeling in my face which I understand is the drug working its way through. Before my first checkup, I started getting quite a tight jaw, couldn't open my mouth as wide as normal, it was a dull stiff pain, so the neuro increased me to 600mg/day. I also had swelling in my cheek, but he didn't seem bothered by that.

At least a month ago I had more sensitivity on the same side of my mouth, along the gumline I thought, and what I thought was some kind of blister or canker sore (I now know it was an abscess). It was painful, but I didn't contact a dentist until this week. Two days before the appointment, I had sinus congestion again and the TN pain returned, and was constant. I also had a headache. My neuro is on holiday, but my GP advised going up to 800mg/day and refilled my prescription for Tramadol, telling me to alternate doses with paracetemol. The dentist this morning performed an emergency root canal.

I'm curious because the pattern this week is identical to when I was diagnosed with TN. Because of the abscess and root canal, I am wondering if I have been in dental pain all along, rather than TN? The pain hasn't ever just been in my teeth though, it's been above and below my jaw, from the joint almost to my chin. Is it just a coincidence to develop an abscess along with TN? I'd be grateful for any insight, because of holidays and my own business trip, I won't see my neuro until September. I'm also wondering if I should stay at 600mg of carbamazepine a day, since the abscess shouldn't be causing pain now, or bump it up to 800mg as per my GP (she didn't know about the abscess/root canal).

23

I don’t know, but I truly hope and pray it was just your tooth!!! That would be awesome:)!!

24

I would bet on coincidence in this case. The pain distribution you report doesn't sound consistent with abscess as the only causative factor. Recommend you follow the dose titration schedule recommended by the GP.

Likewise one FYI for other readers facing root canal: there is an ongoing controversy in the dental profession over the use of Sargenti Paste as a packing agent for the central tooth pulp removed by root canal. There is reason to believe the packing material may be extruded from the tooth and come into contact with adjacent nerves. Sargenti Paste contains a chemical closely related to formaldehyde, and which it is believed by some physicians, may be processed by the body to generate FREE formaldehyde -- a nerve toxin.

25

Thanks for the replies, and Red, as I'm in some pain today, several days after the root canal and in other parts of my mouth, I suspect you're right and it is all just a coincidence. Alternating Tramadol and paracetemol seemed to do the trick though last week. Sargenti paste appears to be illegal here in the Netherlands, but I will keep it in mind when I go to my own dentist for the completion of the root canal.


Today I am having tooth/jaw pain, and also congestion on the same side of my face (off to post on that thread as well). Very curious to see what my neuro says in September about the dental issues. I'm hoping it doesn't get so bad today that I need to start tramadol again.

26

Emily, you might want to ask your neuro about "SUNCT" headaches. They can be associated with unilateral congestion and tearing. One other thing I note: neither of the two drugs you name is an anti-seizure or tricyclic antidepressant med. If you are possibly dealing with facial neuropathic pain, then those classes of drugs are commonly the first employed.

Regards, Red

27

I’m thinking about you Lemily…When I have flares it’s the same as you…jaw/tooth pain and a feeling like a balloon is blowing up in that side of my face. I wish you luck.

28

Thanks Red and Jamie Leigh.

Red, I think I mentioned in a post higher up that I'm on carbamazepine, up to 800mg/day now; the paracetemol and tramadol are for pain management. My neuro's on holiday and I don't have a check up until September, but I will bring up the headaches you mention then.

29

Wups... should have re-read higher up, Emily. No hu-hu.... I simply answer too many postings on some days...

Regards and best, Red

30

Hi Lemily, I just wanted to suggest that with the sinus issue you might want to make sure you do not have an infection going on in there at this time as well. That can make one feel really crappy. I’ve had many. Peace, Min

31

Hi Melissa! My name is Mar. I have been diagnosed with ATN/TN. My issues started after having a root canal and then extraction of the same tooth a year later. My pain level really elevated after the tooth was removed.

This is my timeline~2001Nov. Went to the dentist for a routine cleaning. This was a day before we were losing our dental coverage through my husbands insurance. The dentist said he noticed in my x-rays that my upper right second molar needed a root canal. (Mind you, I had no pain at that time, but knowing that my insurance was being dropped the next day I decided to come in the following day and have the root canal done at less cost to us.)

Big mistake~I had boring, drawing, pain in the root-canaled tooth. I also noticed a creepy crawly feeling along my scalp and along the facial line from my right nostril to the right corner of my mouth. I had never had this before.

My sinuses also started to feel funny on the right side.

I put up with these symptoms for the next year. I went back to the dentist and complained 3 different times and he put me on an anti-biotic thinking I had a sinus infection. Friends and family members even noticed that at times my voice sounded hollow or nasaly. I went to my GP and she had me get a cat-scan of my sinuses and was told they were perfectly fine.

Dec.2002.

I couldn't take the pain any longer and insisted that the dentist pull my tooth. It felt as if there was pressure in the area and that if the tooth was pulled it would be released. Immediately after the tooth was pulled, I felt the pressure leave and I felt the best I had felt in a year...until 3 days later. The pain returned and it has not left for the last 10 years.

I went back to the dentist after the tooth was pulled and he told me that he thought I may have TN. I had never heard of it and went home and looked it up on the internet. I must have cried for about two days straight.

I have tried many different meds over the last 10 years, anti-seizure meds, anti-depressants, etc,

I am now taking Lyrica and Elavil along with Tramadol. I am in constant pain and some days are worse than others.

I don't believe that I am a candidate for Gamma-knife or MVD as I feel that my pain started after dental work.

Something that puzzles me is that I had deep ear pain from time to time when I would go out for walks on a cold day. I had this pain before my root-canals. My ear pain is still one of my symptoms. My scalp, forehead, eye, nose, cheek, teeth, gums and ear (all right sided) are affected by my pain. I get creepy-crawly, stabbing, crushing, gnawing, electric pains and there is no rhyme or reason to them.

I have no upper right teeth left. I have since had them removed after two more failed root-canals.

I just had a root-canal on one of my left upper teeth and am facing the same pain there. I am so glad to have found this site after suffering with this disorder for so long.

I am famiar with the book "Striking Back" and have learned alot over the last 10 years.

Sorry so long, Mar

32

Do you get the burning nail going up into your face pain? Or the hot prong all along your upper jaw line too?

33

The icepick pain deep in your ear might be a neuralgia of a different nerve: geniculate neuralgia. Same mechanisms, pretty much the same treatments...

Regards. Red

34

Hi Min~ if you are replying to me, yes, I get a stabbing hot knife feeling also as if someone is holding it through my ear and cheek into my head. Sometimes it is through my eye.

Min Czeschin said:

Do you get the burning nail going up into your face pain? Or the hot prong all along your upper jaw line too?
35

I get that hot knife feelin on my right eye tooth and has radiated upwards in my past. I cannot even fathom what you go thru with your ear…I feel lucky. I do get ear pain, but not that kind. It’s more a deep aching. I am sorry you have to go thru that every day. I wish there was a way our nerves could be zapped back into shape. Peace, Min

36

Thank you Min! I am sorry that any of us have to go though this type of pain. It is especially hard when most people can't fathom the level of it. I had never even heard of TN and I didn't realize that the nerves of the face and head could hurt so deeply, and give off so many different types of pain. I think the deep boring pain is the worst for me. Hope your pain is at a comfortable level today.

Mar

Min Czeschin said:

I get that hot knife feelin on my right eye tooth and has radiated upwards in my past. I cannot even fathom what you go thru with your ear...I feel lucky. I do get ear pain, but not that kind. It's more a deep aching. I am sorry you have to go thru that every day. I wish there was a way our nerves could be zapped back into shape. Peace, Min
37

Hey Mar, I’ve heard that term before many times, “boring”. I am not sure what people mean by that term. Is there any way that you can tell me in different words what that means? If you can, Thanks, Min

38

Hi Min~ The best way I can describe it ~ The sensation of something about 2 inches in diameter being driven into my ear and then held there by lots of weight (a Mack Truck) for instance. Lol Hope this helps with the word picture. :slight_smile: Mar

Min Czeschin said:

Hey Mar, I've heard that term before many times, "boring". I am not sure what people mean by that term. Is there any way that you can tell me in different words what that means? If you can, Thanks, Min
39

Oh my …It does. Thanks.