Pulling Old Root Canal teeth

Hello,

New to this site and here for my grandma who has suffered with TN for over 10 years... She has sharp stabbing pain in the cheek bone area and side of face on fire.

She had had a root canal a couple weeks before this all happened and because she was older she was treated as if she had a stroke by her doctors... nobody believed her pain and still to this day laugh her off mostly. She is turning 90.... and if I would have known how long this was going to go on, I wouldve pushed to be more aggressive 10 years ago... but even then they were concerned about doing any surgeries because of her age.

My thought now, is to possibly have that tooth pulled and cleaned out by someone who knows what they are doing. I am wondering if anyone here has had this experience and if it has been helpful.

I have seen quite a bit of recent info online about root canals and the issues they cause for many health concerns.

I have been recently motivated to learn more because my husbands aunt has developed a TN with electric shocks and head pressure after having major dental work... so now I know there is something to it.

Any info is so greatly appreciated... you don't know how much! My heart goes out to everyone suffering and if there is any way I hope I too can help you.

TN usually happens in a few different ways.

TN after root canals etc, perhaps caused by dental work but nothing has proven but neither has it really been studied.

Lots of dental work because of pain and then finding out it wasn't a dental problem at all. In this case the dental work was not the cause but just trying to treat the pain because it sounds like dental problems.

MS, shingles or most likely, something wrapped around the trigeminal nerve.

First have an oral surgeon do it. Since the tooth is more brittle and could break an oral surgeon can get out any old roots. Next, extra meds before having dental work, depending on the med. Nitrous if available is also good.

About age and TN. They usually don't want to do surgery but there is gamma knife for TN that they use for patients where surgery is not an option. I don't know much about it but I'm sure others here can tell you more.

I just recently had a rootcanal tooth pulled. But my TN pain is in the upper left and the tooth was in the lower left. It took about 30 minutes to get prepped and about 15 seconds for him to pull it out. No extra flare up, no problem. However I had a root canal done IN the area where my TN pain is prevalent and it DID cause it to wake up, but not to a crises point.

About those doctors, if you should be there and it happens again I would give them a lesson in TN and about professionalism. Being abused by the medical community should not be allowed. However most medical people I have found to be very professional and my TN was actually diagnosed by my dentist who sent me to a neurologist. If you can find an oral surgeon with knowledge of TN or even better, has TN patients it would be a plus.

Another thing about TN that my neuro advised me. Don't wait until the pain is unbearable. Try and get ahead of it whenever possible since it's much easier to prevent pain than to get rid of it.

Thanks for your thoughts.

I definitely will not send her anywhere that is not a specialist. She is hesitant to do anything at this point ... she is afraid things won't work.

And I guess I would be afraid that doing more dental work could cause more pain.. it is hard to know what to do since she is in constant pain already.... it pretty much never goes away. Some days are better but it is always there. Functional days are ones where she can talk on the phone and do a few normal things... hard days are where shes crying and in bed or just miserable. Unfortunately the good days are still awful.

She does take a light pain med and some anxiety med... but thats about it.

You should probably have her try some meds that are known to help with TN pain before pulling a tooth. It's unlikely pulling the tooth will help, and it's possible it will make her pain worse.

Pain meds should help the dental pain but it rarely helps TN pain. Some anti-depressants help with neurologic pain - nortriptyline, amatriptaline, - anti-seizures help but have bad side effects but they are very helpful. She needs to see a neurologist. Since she's never been on these meds then they should work well. Please look into this. This pain is unbelievable unless you actually experience it and people commit suicide because of it. It's the worst pain known to man.

She has tried many different medications... anti seizure and heavy pain meds as well.

They didnt work and the heavy meds just drugged her... we thought she was dying at one point.

She has tried steroid shots a couple times and nothing...

She has seen a couple different doctors but again because of her age the options are limited.

Richard, what part of the advice from tkal are you referring to?

I am unclear as to what she should try at this point...



Richard A. "Red" Lawhern said:

I've talked with thousands of face pain patients during 18 years. I think Tkal's advice is sound. There's also an article here on site called "Who Gets TN". It's under the Face Pain Info tab on our menus.

Go in Peace and Power

Red Lawhern, Ph.D.

Resident Research Analyst, LwTN

These elements stood out for me...

First have an oral surgeon do it. Since the tooth is more brittle and could break an oral surgeon can get out any old roots. Next, extra meds before having dental work, depending on the med. Nitrous if available is also good.

Another thing about TN that my neuro advised me. Don't wait until the pain is unbearable. Try and get ahead of it whenever possible since it's much easier to prevent pain than to get rid of it.

Regards. Red

Thanks for clarification.

Now I am worried pulling the tooth will cause more pain...

And as far as getting ahead of it, its too late for that. Been lots of years.

I can't believe how frustrating it is to figure this out... and with the age issue, surgery doesnt seem to be an option...

We want her to feel better and live happily and not in misery but helpless is how we feel.

Here's an explanation of radiosurgery also called Gamma knife. I have never had it done but others have.

http://neurosurgery.ucsf.edu/index.php/pain_treatment_trigeminal_neuralgia.html#radiosurgery

You are not alone in feeling helpless. We all do.

A word of caution on Gamma Knife and Cyber Knife: when used in TN pain, the International Radio Surgery Association records that half of all initially successful procedures will result in a recurrence of pain within three years. If anybody needs the practice standard, I have it and can send it by private email. It's copyrighted so I can't post it here.

Regards,Red

Aye, it would be one on my last resorts. I'm 45 and don't really like the idea of even that small amount of radiation in my brain (I know, you get more radiation from living with another human being). But if I were 90 and nothing worked, I would look into it, not necessarily do it but would at least research it. We NEED more options.



Richard A. "Red" Lawhern said:

A word of caution on Gamma Knife and Cyber Knife: when used in TN pain, the International Radio Surgery Association records that half of all initially successful procedures will result in a recurrence of pain within three years. If anybody needs the practice standard, I have it and can send it by private email. It's copyrighted so I can't post it here.

Regards,Red

Hi helpgram,

I have just joined this group :)
A little background on me.... I am going into my 35th year in the dental field as a chair side assistant so from that perspective I will post a reply.


The coincidence that the pain occurred shortly after having a tooth root canaled in that same area may not be just a coincidence. A little FYI...... all teeth have what are called dentin tubules or accessory canals. These are tiny microscopic canals (literally hundreds of them) that line the inside of every tooth and because of their size and diverse curvy shape they are not accessible during a root canal procedure. Therefore these canals will continue to contain nerve tissue irrelevant of how well the rc procedure is done. Because the blood vessel and the nerves supplying this tooth with nutrients are closed off at the apex (root) of the tooth during the rc procedure, there in no longer any nutrients going into this tooth to feed those remaining nerves. So they become necrotic (dead) tissue. Unfortunately, this lack of blood renders the rc tooth chronically inflamed and infected. It's similar to the circulation being permanently cut off from a finger or other part of the body. The degree of inflammation and infection varies depending on the original state of the tooth prior to the rc... the health of the rest of the mouth... and the health of the person. It is not uncommon for dentists to hear complaints from their patients of various facial pain after rc treatment... sometimes for months or even years. Many times people assume their rc tooth will never feel "right" and just live with it until other symptoms like pain, swelling or radio graphic pathology shows up. It is unfortunate that the only way to "retain" an unhealthy tooth is to perform a procedure, root canal therapy, that is not capable of making the tooth healthy again. Root canal therapy is performed to "buy some time" and not intended to be a "cure all" procedure.


A couple of things come to my mind that you could discuss with her dentist...

1) What was the reason for doing the root canal?
2) Did she also have a sinus infection or problem as well? Is the sinus membrane located near the apex of this tooth?
3) Have x-rays been taken of that area and what do they show?
4) Did her dentist ever mention anything about the possibility of the apex of the tooth being perforated and/or an instrument being broken off inside one of the large canals? These incidents occur quite frequently and they can set off nerve like pain that radiates across the face.

I agree with others here in that a consultation with an oral surgeon would be warranted. Of course no one wants to put your grandma through oral surgery but I really think it may behoove her to have that consultation. He will take x-rays and tell you of his findings.

I hope you find this information helpful!

Bryanna

Thank you for your thorough respons!

I find your description of what a root canal does and that it is not a cure all procedure... I think most people think its a done deal. Myself included.

So if she goes to an oral surgeon, they may or may not decide to pull it based on all of the above? Or does she go when she is deciding to do it?

Do you have to be put under General Anesthesia for Gamma?

Hi helpgram,

It would be best for her to go to the oral surgeon now, rather than wait. The reason being is that there is no question that the rc tooth is not healthy and the bacteria will eventually proliferate beyond the tooth. Chances are that it already has. Whether this tooth is the only culprit to her facial pain or not will be difficult to determine clinically. It would be ideal to have the tooth removed and have her pain be completely gone! However if a neurological disorder has developed due to this tooth, because it has been long standing, the pain may or may not subside completely. Sometimes the damage is not reversible :(

Hope this helps a little bit...
Bryanna



helpgram said:

Thank you for your thorough respons!

I find your description of what a root canal does and that it is not a cure all procedure... I think most people think its a done deal. Myself included.

So if she goes to an oral surgeon, they may or may not decide to pull it based on all of the above? Or does she go when she is deciding to do it?

Red, could you send me the practice standard at ■■■■■■■■■■■■■■■■■■?

Dani... I'm on vacation at present,but I'll send you the standard after I return next week...