Living With Facial Pain

Oh No. Molar just crumbled/broke off on one side


I haven’t been on this site too much since my atn came back 2 years ago. I haven’t been to the dentist since either, but I am going to have to go now. I’m seriously freaking out.

A filled molar (not on my bad side) has broked off on one side where there was a filling? I am not sure what a dentist could do with it. Can it be filled, root canalled or will I need it pulled? I am well-controlled pain wise and the tooth that broke does not hurt. What is worse a root canal or getting it pulled? It’s a molar in the back so I won’t get implant and just leave the space.

This will be a new dentist (my husband’s) and he likes him. I am going to try to be calm as I can. I’ll get my old dentist’s records first, then make an appointment. I will do sedation for any work and have no needles. Anyone please chime in who has had dental work done please let me know how it went. Thanks. jazmin.



Hey Jazmin,
Having had a LOT of dental work done myself it is going to be an assessment only a qualified dentist can make. I have had damage where I thought the tooth could have been repaired only to be told it was not possible and yet had other teeth that I was sure would have needed to be extracted only to be told it could be repaired. It can depend on whether the surface involved is part of your bite and therefore need to be able to withstand bite pressure or not. Also it can depend on any decay around the area and how much may need to be removed to entirely clean the broken region of the tooth.

So, as a lay person (Non dentist) who cannot see the tooth, what does or does not need to be done is impossible to tell. Sorry.

Merl from the Moderator Support Team



Hi jazmin,
I am a nondentist too, and agree that only a dentist can tell what to do in that situation. I can say, however that my situation a few years ago sounds similar. I waited too long(from fear ) before I got it taken care of. I got an infection in that place in my mouth. It was very painful, and the meds. made me nauseous. I am glad that you have already decided to have it seen by a dentist. Hopefully you can avoid all that.
I chose a dentist who really understands TN. That was vital to my peace of mind. In my case, the tooth needed to be pulled. He medicated me very well, and I had a very quick recovery time, and no TN problems after that.

I am praying thaat you have the same.



As someone who has had a lot of broken teeth, I can tell you that the important thing is that you get to the dentist quickly, and protect the tooth until you see him (chew on the other side, no hard foods, etc…). Almost all my teeth have been able to be repaired with a crown, one also required a root canal. Keeping your teeth, even with a root canal, is always preferable to having it pulled (especially with the possibility of nerve damage).

If you do need a root canal, I highly recommend going to an endodontist. Hopefully your dentist has one that works with him who is really good. With a good endodontist, the procedure is not any worse than a large tooth filling, and will be done properly (very important with regards to nerve pain).

I recently had a bunch of work done on my non-ATN side, and was very worried about stirring up ATN on that side. I had to have a crown redone, then a molar broke up and I had to have that crowned also. Aside from spending a ton of money, everything went well and I’ve had no lingering pain after about a week.

So please don’t worry too much! I’m sure you’ll get this taken care of and have no other issues. Please let us know how it goes.

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Thank you everyone who replied. I was in such a panic that I hardly slept that night. The molar I broke is badly broken. Just by looking at it the mirror I can see that almost the whole side of it is gone. I can feel the pulp inside the tooth with my tongue. I saw the dentist and he said with all the decay around the tooth, he feels that if he just puts in a crown a few months later I might have an emergency appointment for a root canal.

He did xrays and told me I need at least four fillings and maybe another root canal. He sees an infection under a filled molar. This dentist has state of the art equipment and knows the other dentist/endo that I went to previously. He said that they invest in themselves and not in new equipment, so he can see more. The new endo will do my root canal and proceed slowly, and will give me a shot away from the trigeminal nerve (in the bone area). The dentist told me the endo has the latest equipment and will evaluate the old root canal, and the dentist will evalute the tooth that’s next to the root canal that is giving me the nerve pain. He’s asking for before and after the filling xrays from the old dentist.

The dentist said that the tooth that is giving me pain next to the old root canal has a cavity. This is my trouble tooth that was filled two years ago next to the root canalled tooth that was also done at the same time. By looking at the xray he said that he still sees a cavity. I replied that the cavity could have grown in two years. He was insinuating that the old dentist didn’t fill it completely.

I really like this dentist. He spent two hours talking to me about my teeth, called my doctor who’s handling the neuralgia, and called the endo to discuss my issues. I’m going to get all the work done over the next two months. I’ll proceed slowly and save the problem area last. I’ll allow the dentist to fill the tooth. He thinks the neuralgia will resolve, but I do not. But at least I found a great dentist as I was having anxiety during these past two years every time I though about returning for a checkup, cleaning, etc.
By the way, these drugs, ADs and gabapentin rot your teeth by drying your mouth out.
We need these though for the pain so it’s a catch-22. It’s all so stressful. jazmin.



I’m a big fan of having all dental work done all at once. I figure I’m risking a flare anyway, might as well get everything done at the same time so it’s one flare instead of risking another flare by going back for more work.

If I were you I’d talk to him about doing as much as possible in one massive appointment, then it will be over and done!



Good point azurelle. I have to think about that one. Mondays’s the root canal and then the dentist wants me back a week or two later for the crown. Maybe I’ll get some of the fillings done at that time. Thanks. jazmin.



It sounds like you have a great new dentist! Glad to hear you have a plan to move forward. I disagree with azurelle–I’d rather do small steps, so the nerve is not as irritated and has time to calm down between procedures. But everyone needs to make their own decision about how to proceed, maybe you could discuss it with the dentist and neurologist.

I know what you mean about the drugs drying your mouth out–I was on amitryptiline for 35 years, and it did a number on my teeth. Glad to be off that stuff!



Am in the same boat as Ziggy… 30 years of extensive dental work to save y teeth, now most have had root canal and crown or bridge. An endodontist is the best judge as too whether the to tooth needs a root canal. Perhaps it just needs a crown… But in any case you are risking nerve involvement and infection if it’s not taken care of. Good luck.!



Yes. flowerpower we should always try to save our teeth.



My root canal appointment is in a couple of hours. I’m a bit anxious about it but whatever. This is for the broken molar.

My dentist also sent the problem tooth xray to the endo. New dentist only saw a cavity. The endo looked at the xray and said it was infected and needed a root canal. Well it always felt this way since the filling two years ago. Old dentist took xray at the time and did not see anything wrong. Ugh. I’m scared that it will make it worse with a root canal and I pray to God that this will fix it. I guess I’ll have it done in a week or so after this one gets done. I’m about 50/50 it will work. I’m frightened now. jazmin.



Nah jazmin, have faith, you’ll be fine!

The great thing is it’s only a root canal and a root canal should make things better, not worse. The root canal procedure itself isn’t going to be around the TN branches so there’s no worry there. The worry is when you have extractions – those can get the TN branches involved and can even damage them.

Any TN flare you get will be from the position of your mouth while the work is being done, that absolutely can cause a flare. I’ve had it happen myself. But I’ve also had it happen where the root canal relieved ALL the pain, both from the tooth and the ATN flaring from the pressure of the infection. In fact, with the root canal I had two years ago it actually STOPPED the flare I was having – apparently the numbing from the novocaine gave the nerve time to settle down, by the time the novocaine wore off the flare had stopped and having the work done on the tooth removed the other aggravating factors such as ongoing infection.

You should be at the dentist right now as I write this so I hope by the time you read this you’re feeling better!



Hi azurelle. I am home now and had the root canal on the cracked molar. It hurts now but just like after having a root canal if you know what I mean. I’m going to take a couple Advil tonight. Not sure if I should take an extra gabapentin 100.

He wanted to do the trigger tooth root canal today also, but I panicked a bit about it and had a few tears. He said gabapentin was not a good drug and said that I have a chance of it disappearing. The endo said he had one patient that had neuralgia in their teeth and once he had a root canal it was gone. Once I described the pain as a burning pain he backed off and said yes that’s neuralgia. I mentioned that I also have that aching throbbing pain. He says you need to have it done quickly anyways because there is a large cavity above the filling and it’s very close to the nerve. The dentist feels that it may help.

I guess I will have to do it because when the decay hits the nerve I’ve read it can be extremely painful. I’ll make an appointment soon either this week or next week. He completed it in one day and it took only 45 minutes including waiting 15 minutes to get numb. The top tooth will only take 15 minutes. His assistants, young females, were making jokes and laughing during the root canal. I wanted to haul off and smack them silly. lol. jazmin.



It sounds like it went well! YAY!

Not sure what you mean “…gabapentin was not a good drug and said that I have a chance of it disappearing…” You mean the nerve pain could disappear after the dental work? That would be wonderful if it was discovered the nerve was reacting to an infection! Fingers crossed for that possibility.

As for the dentist saying gabapentin isn’t a good drug… well… considering no dental professional should be prescribing that med for any reason I tend to want to tell you to disregard his opinion, talk to you nuero and your pharm about that med, not a dentist.

My fingers are crossed it all continues to go well!



Thanks for the well wishes azurelle. If I read your comments correctly you had a root canal on a trigger tooth and it did not get worse but better? That’s a real good outcome.



Try not to worry… I had to have a molar pulled that was on my TN side. They wanted to do a root canal and I said NO…I had it pulled and he out mesh over it for 2 months. AVOID ROOT CANALS AND IMPLANTS. IT HAS BEEN JUST FINE WITH NO TOOTH.



I wouldn’t call it at trigger tooth, but it was on the ATN side, and YES, having the root canal stopped the flare.




I had a root canal on a tooth where the ATN was focused, and it made things marginally better (certainly not worse). Obviously I hoped it would completely resolve things, but there was absolutely no sign of infection or bad pulp, so it really was a shot in the dark.

I have to disagree about root canal vs. pulling tooth. In almost all cases, if you do not replace the tooth somehow (implant or bridge), your teeth will eventually start to move around or loosen and create more problems. Pulling teeth IMHO is much more likely to damage the nerve than a well-done root canal, in fact I believe that is what ramped up my issues with ATN (though I had no choice, the root was cracked).



Thanks ziggy. I remember reading you had an implant done. Was that done where your ATN tooth was? How did that feel afterwards? jazmin.



I agree with the critical importance of oral care.

First, I’m a bit of nut about that in general (thanks mom!). I have basically excellent teeth and brush my teeth 3-4 times a day… except for that period of about 10 months four years ago when I was in a horrible flare. I basically brushed my teeth only when leaving the house (and I work from home) or every four or five days, trying to make it through with various mouth washes.

Hello root canal. Now, I lucked out, and the root canal seemed to help settle it all down – or at least the novovaine did. Even so…

Now, no matter how much it hurts or how how much it aggravates the ATN I brush my teeth twice a day. The last thing anyone with chronic facial pain needs is dental problems!

I also have a new issue, I had a wisdom tooth pulled at the tender age of 40. Simply pulled and left it at that, well, now, all my teeth on that side are moving around! I have huge gaps developing and am going to have to go for a consult for a retainer or braces or something. Stupid. Don’t leave holes in your mouth where a tooth was pulled! You could end up like me, starting to look like Gollum…