Dental work

As I suspected from information by Dr Steven Graff -Radford DDS that invasive dental work does not cause TN, but they can often be the triggering factor that will initiate TN pain in a patient who is already predisposed to it. So this is why soon after my dental cleaning, actually 2days later pain started in gums and took of from there. I believe info is on this is a good read

Pebbles, there may be exceptions to the theory that dental work doesn't cause TN. There is certainly evidence that it is not the ONLY influence that can cause TN. But too many patients have reported emergence of TN pain immediately after having root canal or dental extraction. In some cases, injury is done to nerve endings in the jaw, in the vicinity of either the tooth being worked upon or the point of injection for anesthesia agents. And there is the long-standing scandal of Sargenti Paste -- a substance used in replacing pulp removed from teeth during root canal, and which contained an agent that is turned into formaldehyde by natural actions of the body. Over-filling of tooth roots has been associated with extrusion of paste into contact with the branch of the trigeminal nerve which passes along the jaw. And some people seem to react to Lidocaine and other anesthetics used to numb the same nerve.

So I for one am not satisfied that dental injury can be conclusively eliminated as one of the causes of TN, particularly in the mandibular branch of the nerve.

Regards, Red

I think what their trying to say is, That any work in the mouth is a trigger as long a you are predisposed to having TN to begin with. I had cleaning and it triggered this whole thing off. I believe anything in the mouth can cause damage to the nerves. You are absolutely right in you statement. I agree totally.

I had a root canal botched and the pain was immediate. Clear cause and effect. Few dentists seem to own up to it but what they should do is make sure it is prevented. There is not a single doubt in my mind that the oral surgeon damaged my nerve and destroyed my life.

Mine is curious - because it took 4 hours after oral surgeon yanked a backwards wisdom tooth that also had to have some jaw bone taken too ---- I have had many car wrecks from behind and I think the whiplash that he gave me was just the last straw --- the reason it took me so long to figure it out - because that's not stated on here or elsewhere a lot -- whiplash type thing -- because the TN is on the OPPOSITE side of where my face was worked on. I also found out he set off TN in at least one more lady - because he is known to work fast and furious - and he made her sound crazy in court -- so was it a direct hit from an oral surgeon - yes --- but it was because he affected my neck I truely believe - so it still falls under dental work - yes and no.

Sometimes I have to remember that I am on the road to forgetting and forgiving the WHY ME of this TN crap! It's hard not to still glance over my shoulder at yesterday - and concentrate on the lucky parts that I got a correct diagnosis very soon after - a med that killed the pain soon after - even though had to quit my brand new good paying job--that is lucky compared to some who cannot get any relief - I can only now try and help others -- and take it one day at a time with new MVD

Basically however this happened I don't like it. Horrible to be on meds for of my life, I am only 48. Its also an expense to be on meds even with insurance. Co-pays add up and before you know it, its another bill at the end of the month.

The meds are what Drove me to MVD --- was on 900 mg before -- now I just take 300 -- at 900 I could not work or interview ---- 300 only makes me a little forgetful -- enough perhaps for me to consider ketamine treatment, then another MVD

For anybody considering Ketamine, I'd suggest that you contact Dr Ken Casey, Chairman of the Medical Advisory Board of the TN Association. I understand that his clinic in Michigan has been trying topical forms of Ketamine with some patients. It may be useful to talk with him about their outcomes.

Regards, Red

i never understood that "TIGGER" thing... i mean -i know the literal meaning of the word...

but MEDICALLY - what does that mean ? it does not explain anything.

by the way - i've known a guy here is Israel that his TN also stated TWICE after a detal cleaning . mine was also after a dental cleaning + a simple root filling.

i'm not convinced of that TRIGGER thing.

something in the dental procedure went wrong :

it can be :
infection / inflamation / the head was positioned the wrong way so it pressed a nerve.. the injection could have hit a nerve.. the injection could have put an infection in the gums.. etc. etc. etc. etc.

i've also thought that maybe the "cleaning" or dental works inserted some infection to the gums.. which is only seen throght biopsy of the bone (which is rarely done).

I go to the dentist today because my neurologist wants to rule out any dental problems. I've just been diagnosed with TN. I plan to ask them to be careful. I'd appreciate your prayers. I haven't had a bad episode since I started on my medication. If an episode starts does the regular medication take it away in several hours or a day? Is there something y'all take different for episodes?

Some neurologists prescribe an additional medication specifically for breakthrough pain, Paulette. If you have any lingering problems after the dental appointment, call your neurologist. And be sure your dentist is aware that you have a diagnosis of TN. It may affect the methods he uses to check you out.

Regards, Red

What are some medicines given for break through pain?

Richard A. "Red" Lawhern said:

Some neurologists prescribe an additional medication specifically for breakthrough pain, Paulette. If you have any lingering problems after the dental appointment, call your neurologist. And be sure your dentist is aware that you have a diagnosis of TN. It may affect the methods he uses to check you out.

Regards, Red

Practice varies with respect to treating breakthrough pain. Some physicians will suggest a "booster" med like Baclofen, Valium, or Flexeril. Others will prescribe one of the NSAID medications or an opioid. It's best to let the doctor make the choice and try you on some things before making a decision on which med and how administered (e.g. all the time or only in response to breakthrough pain).

Regards, Red

Thanks Red,

That gives me some idea of what to expect. I left a message with the assistant at the neurologist but I haven't heard back.

The dentist appointment went well. He was a new dentist for me but he has patients who have TN. So everyone was careful. He adjusted my bite since I asked. My teeth were okay. He said they would put a star by my name for when I come back. So I guess I'm special. lol

do you think i could contact dr, casey for some help with my new meds. actually it would help the new physician greatly.

Elaine. It would be more in order to provide Dr. Casey's contact data to your new physician and suggest that Casey is an expert on TN and its treatments. Then the new doctor can decide whether to seek a consult. You're really not in a position to "help" your doctor unilaterally, and a good many would resent such "help" as a form of uninformed meddling. So a light touch is generally recommended...

Regards, Red

I have to have three teeth removed due to some infection . These are under an old bridge & my dentest says they have to be dealt with. Two have root canals. I will see an oral surgeon soon but am also having active TN pain, not breakthru pain but I am worriesd about this extensive dental work setting off such pain. The teeth are upper right side as is the tTN pain. What drugs could be taken prior to this surgery, will the oral surgeon know what to do if I go into severe pain. My GP is not giving me a referral for a neurologist saying he has no questions for one. Boy do I!Can you offer any help?

Boswell, one measure that is often recommended before dental work, is that you be temporarily tapered up on whatever medications you are using for pain control. That may not be useful if you are on opioids, but if you are being treated with anti-seizure meds or tricyclic anti-depressants, a temporarily higher blood level can help to suppress breakthrough pain.

Parenthetically, I think you need a new GP. Refusal of a referral for specialist help is outright malpractice, and few GPs have sufficient training to be of much use in complex neurological pain. Discuss tapering up for a couple of weeks with your dentist and then have him or her call your GP to discuss your case before extensive dental work.

Regards, Red