Cavity Filling

I need a filling replaced on my upper left side. My atypical facial pain pain started with a wisdom tooth extraction, and a sinus surgery years later made my pain increase. Now I need a filling replaced on my upper left side one tooth away from the wisdom tooth extraction. I have discomfort on that side, but I am able to tolerate it. I am afraid of a novocaine shot in that area creating even more of a flare up. Has anyone had a cavity filled without novocaine? I take pregabalin, and am thinking that I need to increase it before the procedure. I’ve been putting off the appointment because I am afraid in of a pain increase.

Hey Goldensan,
Some people can tolerate Pregabalin without issue, for others there can be nothing but issues due to the drug. I would suggest some serious enquiries and investigation are needed, in consultation with your medical team. Having a history of FP and oral surgery you may find it difficult to obtain a direct Yes/No answer in regard to affect. ie will it cause a flare.

I’m in Australia and I know here sometimes they’ll use gas over novocaine for some dental work. Now, whether that’s an option for you, you’ll need to discuss this with your dentist. But I also think that the procedure itself could be a trigger. I’ve had dental work done that has caused no end of issues. TN (trigeminal neuralgia) has been one of my many diagnosis’ and again trying to pinpoint cause vs effect has been damn near impossible.

But, if you know dental work is a trigger for you, investigating EVERY option open to you before it gets to the point of emergency extraction would be highly advisable. You may need to discuss it not only with your Dr but also a pharmacist. Someone who knows the interactions between drugs.
Is there a dentist who does use gas in your area? Is a general anaesthetic an option? These are all questions that need to be asked of the professionals.

Please do let us know how it all goes.

Merl from the Modsupport Team

Thank you Merl for getting back to me so promptly. I have a call into my neurologist, and I will also speak to my dentist before the procedure. I don’t want to delay the filling replacement much longer. I very much appreciate your input, and will let you know how it goes. It helps to get support from others who have been through similar situations, and understand just how challenging living with atypical facial pain can be.

In answer to your question . No. However I find my pain can be exasperated just by having my jaw open for so long at the dentist, and I think it’s triggered by the muscles.I recently had a back tooth removed. I have GPN. I am not on the meds that you take. I get someone to drive me and take 1/2 to 1 Valium before hand, prescribed by my Doctor. That’s the only time I take it. I don’t want the gas, because I think Dentists are more gentle while we are awake. Muscle spasm from TMJ can increase for me after having dental work done. That results in chronic burning in gums, tongue, neck, head and throat, but it settles down in a few days to my average, ongoing pain. Sorry my post isn’t exactly on topic. I am hopeful for you that it won’t cause a flare up at all. For me, the anticipation is sometimes worse than the event. Good luck.

Fillings are different from extractions, ive had fillings done or fixed without any numbing before, you could try it. Talk to your dentist. That said i had to have a tooth repaired onmy TN side and the shot of novocaine calmed the nerve, ending the flare up i was having at the time, you might come out ahead! I always put on a lidocane patch before any dental work as well.

Thank you so much for your input! I need the filling replacement on a side which is giving me a dull, constant pain. I’m afraid the novocaine shot will result in intense pain. The last time I had a novocaine shot on a side which was calm at the time, the pain was excruciating. I don’t want gas. The idea of 1/2 of Valium is something to consider. I’m hoping the anticipation is worse than the experience. Thanks so much for sharing your experience with me. It helps to know that others understand how challenging it is to live with pain.

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Thank you so much for sharing your experience with me! It gives me hope that just maybe I can get through this without intense pain. The lidocaine patch is something I haven’t tried, but is something to consider.

I can understand your concern. My TN pain started after a dental procedure & still freak out for routine cleanings. I’ve had 2 MVD’s , the last will be 10 years ago in Nov, still pain free but very occasionally get a slight reminder. My dentist wants me to replace old crowns & am very hesitant till necessary. I have inquired with my dentist to sedate me but was more for the sound of the drill however you reminded me to consider the poof a flare up before having a procedure. Good luck & sounds like you are doing the right things.

Regarding the Lidocaine patch —I’ve had trouble keeping them on my face .
My local compounding pharmacy makes a 5% Lidocaine cream for me mixed in a base called “Activemax”.
The base makes a big difference in the efficacy.There are now 4% Lidocaine creams available —even in the Dollar stores —but I’ve found they were not very helpful on my face .

Hello. Talk to your dentist. He/she, if not already aware of TN will need to be. My dentist schedules longer appointment times for certain dental work so he can give me a break from having my mouth open so long. I also have a prescription for anxiety that I use before a procedure. Also ask about novocaine. I believe there is another injection that can be used that actually has smaller needles and faster acting medication. I love my dentist and hygienist but now have times when I have to cancel appointments until TN has settled down. They understand. Best of luck to you as I know you don’t want to put off this procedure.

I have had a filling replaced on my TN side with no problem…Novacain seemed to calm the area. Also Nitrus oxide could help. Getting a filling replaced is a good thing. Better that an extraction.

Thank you for that information! It is something I hadn’t considered before and it’s something that is worth a try!

Thanks for the information. I have already canceled the appointment twice hoping my left side will calm down. I am going to ask about the thinner needle. I appreciate you reaching out to me.