Dental Work with Trigeminal Neuropathy

Hi all,

I've just stumbled across this site through Google, and wondered if anyone can advise me on my problem.

Last year I was diagnosed with trigeminal neuropathy on the left side of my face following an apcioectomy in 2011 on teeth numbers 9 and 10 (my incisors on the upper left-hand side).

I'm not on any medication or seeing a specialist as the sensation is more numbness and discomfort rather than excruciating pain. However, the facial pain consultant at the Eastman Dental Hospital in London did warn me that any future surgery could worsen the nerve damage and that therefore I should avoid anything that isn't completely necessary.

Unfortunately though, I currently have an abscess in the gum above tooth number 8 (the incisor next to the where I had the previous work done) which requires a root canal.

I've got two main issues:

  1. My endodontist thinks that the root canal will not affect the current nerve damage, as the tooth is served by the other branch of the trigeminal nerve. Is this a valid assumption? Would you go ahead with the root canal?
  2. The long-term failure rate for apicoectomies is quite high. I'm very worried about what to do if the teeth that had the original work done become reinfected, as this would also require further surgery. Does anyone have experience of this eventuality?

Thanks in advance.

I recently had major dental work done and it did not put me out of remission. I had a root canal and four crowns. I was terrified because I thought things might get stirred back up. I did start taking the tegretol again for the weeks I had the work done just in case .... I do not know what caused my problem in the first place... as I am not aware of any nerve damage or injury to the nerve. Hope you are able to breeze through this...if you are concerned you could go on something just for some insurance against getting the nerve angry!

Check back with the person/doctor/neurologist who diagnosed you. They may try meds like Tegetrol a/Gabapentin/carbamazepine. One of these may help with the pain. See if meds calm you down prior to dental work as just being worked on can cause pain from the pushing and prodding that is done during a root canal
Also pick up Striking Back by Dr Ken Casey and look hi up on Google.
Glad you found this site we are all helpful and I personally detest dental work as I still get phantom pain or it is TN making my teeth feel numb and achy

Thanks for the responses. It's reassuring to know that dental work won't necessarily worsen my condition, and that pain meds may help to reduce the risk.

Hi fuzzy. What is a apicoectomies . Who do you see at eastmen. Is that where the best facial pain specialist is 'dr zak' . I attend Kings,but apparently eastmen is meant to be a fine hospital.

Since I was diagnosed I've had six (yes, SIX!) root canals. My regular dentist was typically able to just used a very high amount of anesthetic to put the nerve to sleep before working, but I had two teeth that ran very close to the nerve, so I was referred to an endodontist with experience with TN patients. She recommended knocking me out for the root canals. I had no pain, no inflammation of the nerve, and felt fine afterwards (my pain was actually kept at bay for a week or two afterwards, likely as a result of all the numbing).

I wonder if your endodontist might consider doing the same?

The tiny nerve brances in the TN are so far reaching that its possible your dentist might not even know how much facial space (and mouth space) is at risk. However, you might still be able to have it, if they are very careful.

Hi Barbara, an apicoectomy is a dental procedure that can be considered if a root canal fails:

Yep, Professor Zakrzewska is the head of the facial pain unit:

Thanks for your reply EasyBeef. I actually went ahead with the root canal yesterday, as I had a persistent abscess that kept bursting. It's pretty sore today, but so far there isn't any sign of further nerve damage.