Atn and tooth pain

I just want to ask once again because sometimes I think I’m crazy for accepting the diagnosis of atn and that the doctors just really don’t know. I have no pain what so ever on the outside of my face . everything is only inside the mouth on the left bottom. Two to three teeth hurt but one in particular 24/7 for going on a year with inside cheek and gum burning. Nothing shows wrong with my teeth from several dentist endodontist oral surgeons etc. Is there anything else it could be or can atn truly cause only the symptoms I have? Please reply

Jennifer I have almost the exact same symptoms as you although my teeth don't ache all day every day. Sometimes just my front tooth, sometimes all the top teeth on the right hand side. What Is a constant though is the numb burning tongue.lip ( always bottom, sometimes top as well) and roof of my mouth. My cheek and lower jwa ache as well.

My Neuro diagnosed ATN and so that's what I have. I don't feel a need to question it and I've now read enough to know that there are several kinds of normal!

I've had periods of TN as well so I know the difference between the two. Don't let people mess with your head. ☺

I would reinforce Catwoman's comment: the symptoms you've described could be diagnosed as either "atypical trigeminal neuralgia" or "trigeminal neuropathic pain". There is really very little difference between the two labels. Both are treated in pretty much the same ways.

Go in Peace and Power


I was very very frustrated with my initial diagnosis of TN, because everything my doctor told me, and everything I read for the first two weeks didn't quite fit. I have constant aching crushing pain, that feels like it is in my bones and teeth in the left side. I had no "triggers" I had no "episodes" and I had no "shocks" so I didn't believe I could have TN. Then I found info about ATN and it fit really well. I went back to my doctor and asked about ATN, she had never heard about it, so she looked a few things up and agreed that that label fit better, but the treatments were effectively the same.

From my year talking to various ATN people we all have very different areas of pain, levels of burning, crushing or aching, and If we have triggers they vary too. From what I can tell each person is completely unique, there is no one size fits all set of symptoms. From my experience I would say ATN could do exactly what you describe. Pain is so hard to explain, good luck!

Thanx guys

I'd agree with you, I think you are crazy to accept a diagnosis of ATN after a simple dental procedure. Have you asked what causes ATN? I'm not trying to be antagonistic, but you haven't received any answers, something you might want to consider before any destructive procedures.

Jennifer, I wish you well with regards to pain relief and steroids,

As well as probably 50% or higher of people never find out why…doctors are don’t always have an answer for EVERYTHING . if all options have been explored then I guess they just throw you into that category. Like I said most of us will probably never have a 100% answer as to why.

Why does someone get cancer ? Why do they have seizures? Why do they have high blood pressure? Why do they get a tumor? These are all questions that most people will never know why and all drs can try to do is cure or make you live as normal as possible

One stat that may be revealing: when I analyzed our demographics three years ago, about a quarter to a third of the membership here reported first emergence of facial pain following a dental procedure. Dentists maintain stoutly that there is no relationship between dental injury and emergence of atypical TN. A lot of patients are by no means that sure. Complicating all of this, of course, is the reality that a dentist will often be the first medical professional that someone sees for facial pain -- and dentists in general are not well trained in the assessment of face pain of neurological origins. Of ~450 cases that I analyzed where a member associated dental work with emergence of pain, fewer than 120 were told that their pain wasn't dental in origin, and promptly referred to a neurologist or general practitioner.

Regards, Red

Red is your point that it is indeed a tooth etc causing the pain or that the dental procedure triggered something in the trigeminal nerve and its the nerve? Thanx

Also red please your opinion. I know your not a dentist…but in what you know can a tooth shift and be hitting a facial nerve causing pain? Every Dr/ dentist I’ve asked has said no but part of me thinks it is possible.

I can only share what I've heard from patients and read from literature. As for the tooth versus the procedure "causing" the pain of TN, I think we're likely dealing with a mixed bag that might be some of both. We've had very lively discussions on the site in past years concerning mis-application of anesthetic directly into the lingual nerve during root canal. Likewise of concern might be over-filling of the root with a compound that can leak into adjacent tissues through cracks in the tooth. One form of paste used in such filling is regarded as inherently toxic because it contains or can generate formaldehyde in the soft tissues around teeth.

With a tooth "shifting", I don't know the medical literature well enough to have an authoritative opinion. But we have to ask, "how adjacent is the distribution of the nerve to physical structures in the teeth?" I'd have to suspect that anything more than a millimeter away would pretty much put the nerve out of reach unless the tooth was shifted by blunt force trauma. In the event of trauma, one could be dealing with multiple effects of bruising, neuropathic injury and/or infection and inflammation. Sorting that out is a job for a GOOD maxillofacial surgeon.

Regards, Red

I feel the same as Jennifer. My pain is in lower right jaw, numb tongue and sometime lower lip. Most of time I just have numb tongue. Although I know I am lucky that this is the pain I have I wonder if and when it is going to get worse. Also, am I nuts not to have meds on hand? When I was diagnosed and told doctor if this is the pain I can handle it. He said go home and look up info on TN. I did and thought I did not have it. Thanks to this forum I have read how pain differs in each person.

Jennifer, I just joined. My pain is 100% only in my teeth. Feels like the worst toothache on Earth, and moves areas over time. I have had 4 root canals and 2 extractions in the last 9 months and am now out of pain on one side and in even worse pain on the other.

Wow it feels nice to finally hear from someone like me. My teeth kill me 24/7 I don’t know how much more I can take…is yours all day everyday? Do you know what caused yours? So the side you had the work on is pain free and the opposite hurts?

My story is long! i just posted it on the introduction page. Can you find it?

It is so nice to meet you too. From your picture I think you are young like me. I am 35.

I also don't know how much more I can take but I keep going for my kids, I have a 3 and 6 year old.

Mine started and stayed in a tooth for a year both times I have had tn. First when I was 29 and then at 37---it never left the second time. It has gotten a lot worse and has spread to all three branches. I have been diagnosed ATN but know that there are several terms that I could be diagnosed with. The truth is that no one really knows exactly what this is. I think there are many different causes of facial pain. Unfortunately, we are the guinea pigs. There is a lot of research going on and there are many different treatments being tried that are successful for some of us.

At some point, my focus shifted to treatments. After seeing so many doctors and so many specialists I realize that I cannot spend my whole life searching for an answer that isn't there. I am not willing to attempt any invasive procedures for now so I don't need to search for the best neurosurgeon. I think it's important to keep learning and trying different treatments, including alternative ones. Keep looking for answers and doctors that take you seriously.



I was reading your email. It is now 1 year. did you find any answer. I entered to this hell last year last year after a root canal. My life had been so beatiful with two beautiful daughter. Now i am dead person alive for my two girls. I am living for my girls. Initially i had pain only with one tooth area where i did root canal. I even extracted the tooth.i also did another root canal at the same time with front tooth. But i didn’t take it out. The pain with upper left extracted site was burning constant dull ache 24/7. I can’t focus do anything . I took several medicines. I was a healthy lady who didn’t preferred medicines. The fact that i am living on so many medicines made me more depressed. Then this year i did a filling on lower right side just diagonal to upper left. I have sever pain now. I have pain from three place. the front teeth is bearable. Right side where i have tooth is not bearable. Since the tooth is there, the medicines that works for right doesn’t work for left. Left medicines don’t work for right. Doctors have no clue. I am going to extract right even though i know tooth have no issue. Because to save one tooth i am not going to eat so much medicine and affect my organs and can’t take side effects. I often ask why why why. I am dying in the world of question why which would never be answered probably. other friends and relatives gives very positives suggestions but you guys probably understand me withought knowing me what i am saying than any body else… Please let me know how you are doing and what you tried. I have very similar situation like you…