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Living With Facial Pain

Specialty dentist visit Monday-I need tips

Hi
First I would like to thank the moderators for adding this forum
My mouth pain started after I had 2 teeth pulled in November 2015.I thought be a big girl and go to the dentist.
I then started to have some pain in a tooth next to the front one I had pulled-after I had the new dentures made(I left the dentures out for 2 weeks to make sure it was not denture related)dentist decided I had 4 cavities and did the fillings with sleep dentistry.as soon as I woke up and the freezing wore off I was in excruciating pain in the original tooth.kept going back and finally had it pulled.Then the pain moved to another tooth,had it pulled and then had an iffy tooth pulled that actually had some infection under it(don’t ask,this is not a dentist slagging site-I tell myself)but that did nothing.Ended up at emergency after self medicating and have been on the treadmill going nowhere ever since.My specialty dentist just quit and I have a new one come Monday.
I think this is my last chance to get somewhere with the medical system in Canada and am eager for any or all advice.Two of my sisters will come with me as I am tired of being told that I don’t look too bad-when the side of the face in pain is so much better looking than the other side.It is almost like there is some slight swelling or something.\before this I took no pills,over the counter or otherwise and I don’t drink.Now I am a drugged out zombie-but since I have cut out the effexor-not a constipated zombie any longer.For some reason codeine does not affect me the way it does other people.And for that I am grateful.
So if anyone has any tips or advice-please let me know.
interested in anything
Please and thanks

Let me start by saying I don’t have facial pain from Dental Work but that not only is it something I fear and work hard to avoid. I have inflammatory disease (PsA) which has decided it loves my neck, face jaws and even some of “sinuses” where the nerves pass through. As result there are time when it feels like my teeth are going to blow out of my mouth. (I guess that is facial pain) Sort of like there are gremlins under my teeth trying to push them out… the inflammation has put pressure on my optic nerves to the point where I have visual field cuts, and a a loss of balance.

Needless to say visiting the dentist is very low on my list of favorite things to do. because the facial nerves and branches in my jaws are not always where they should be. Novocaine (generic term) is a non starter.

A skillful dentist know that the needle should never pierce the nerve sheath but rather the medication is supposed to flood the area around the nerve. Should the medication actually pierce the nerve all manner of bad stuff can happen including permanent pain.

Nerves that are physically irritated will repair (like from extractions)… It takes time - months to several years to fully recover. Its easy to blame the dentist when things go bad, but the fact is every mouth is different everyones nerves in slightly different place. Its no surprise bad things happen, it is a surprise they don’t happen more often…

I realize that is of little comfort to someone who has had bad things happen. I have been lucky in that I have never had local anesthetic in my mouth, prefering either gas or white knuckles for routine work. I had a dentist growing up who didn’t trust the local anesthetics and as I got older understood why…

Now that I require a bit more extensive work (more pain) things are complicated. Finding a general dentist who understands is near impossible, but I have managed. Goodness we have one that wants to numb you up to clean your teeth…

A specialty dentist is a good start. I personally go one further and go to an oral surgeon who is also an MD and completed a fellowship in anesthesia. These guys know nerves… Its worth a look and whoever you see ASK. Pain free dentistry is simply not an option (although general anethesia in an oral surgeons office is)

Pain meds by the way will make most neuralgia WORSE long term. For the same reason the necessary nerves that make your bowels work are knocked for a loop so are the rest. The best parallel is when you have a leg gp to sleep, it hurts like all BLAZES when it wakes up.

One of the thinks I would broach your specialist about is steroids either general or in the area. You are on the right track when you blame inflammation. There are multiple sources and they are a bear to track down but you can…

TJ

Mod–you bring up some very good points! I need to have a crown replaced here before too long, and I’m going to have to make a decision about how that work will be done. Very nervous about that, and I certainly am looking for options to local anesthesia. I should look into a dentist with more knowledge about neuropathic pain and anesthesia options. Also dental cleanings–do I go with my very gentle, experienced hygenist, or move to an dentist with more knowledge?

I totally agree that pain meds (of any sort–NSAIDS, acetominophen, opiods, even benzos) make things worse in the long run, and I personally believe they inhibit healing. It has been obvious to me that there is significant rebound pain from all of them. It makes total sense as anything that affects sensation is actually working on the nerves. But it does create a difficult situation when pain becomes really quite unbearable (too much or too relentless). I have to believe that it is possible that nerves can eventually heal, given the right situation.

Hi TJ
Thank you for your response.As someone who has had problems with dentistry
from the time I was a child I would not blame a dentist for causing pain.I
would blame the clinic for having no idea what the problem was and fluffing
me off for weeks after the fact…I do not want someone to go through what I
did-especially when it seems to be something that happens after dental
treatment to some people.It would have saved at least one of the teeth I
had pulled after the initial treatment.
The dentist I will be seeing is at one of the biggest hospitals in Canada
and I hesitate to call him a dentist because of all the other titles he
has.If you want to private message me(I don’t know how,but can figure it
out-maybe)I can give you the details.
I have also been taken on as a special needs client by the regular
dentistry department.Maybe that can be something that you can look at if
you have a major hospital available.
When my son got hit by a vehicle and had most of his right leg shattered
the trauma surgeon said that nerves do grow back ,very slowly,as long as it
was not the nucleus in the spine that was injured.
So that is what I am hoping for.
I really do not want to take the pain meds,it seems if I have a wee bit of
marijuana oil in the morning I can skip an afternoon dose-touch wood.
But when the tooth gets bigger than my head I need to take them.It feels
like I am in a funny house of mirrors and the tooth is being
distorted-along with the constant burn.If it just stayed the burn I could
get used to it.Then there is the front gum that if anything touches I curl
up into a ball.Not sure how the nerves have gotten so close to the
surface.Maybe the Waardenberg’s Syndrome.
Thanks for your response.I am in awe of your site and the fact that it is
an active site.
Elaine

Ellena5, sorry to hear about your having teeth pulled and other problems with your teeth and are still having pain in your mouth.

I suffered from whiplash in a car accident back in 1993. Afterwards I would have pain in my top front tooth when the pain started even though my mouth was not involved in my neck. By chance I found I could lighting touch a play at the base of my skull which would cause the same tooth pain. After doing some research of my own, it sounded like my 5th cranial nerve(aka trigeminal nerve) was the only thing that could cause the referred pain to my teeth. When I went to neurologist they told me that couldn’t happen. They recommended I see a dentist and since I knew how to cause the pain by touching my neck, there was no way I was going to see a dentist for the tooth pain. I ended up seeing a pain doctor and MRI showed I had lots of problems in my neck. But every once in a while a doctor would recommend I see a dentist for my tooth pain. After 23 years I was finally diagnosed with trigeminal neuralgia type 2. There are a lot of things I left out but just wanted you to know if it is referred pain coming from somewhere other than your mouth, it doesn’t matter what your dentist does in your mouth if the source of your pain is not in your mouth. That sounds obvious but most people aren’t familiar with referred pain and think if it hurts in one place then the problem is in that place which is not necessarily true. Anyway good luck with getting help with your pain problem. Wish I could tell you my pain is gone but that isn’t the case although it used to be worse than it is currently.

Hi
Thanks so much for your response.I am sorry that you are still in pain-but
wow-you rock.Figured it out on your own before the age of the internet(I
think)I may be wrong-but I think I have something wrong with the mental
branch offshoot of the trigeminal nerve.That is where my pain seems to
sit.And at the prior dentist appointment to this latest dental disaster was
about 10 years ago and a filling was done on the lower left side and that
tooth was so bad after,and it was not bad before-it was one of those things
where they say "seeing you are going to be asleep anyways let us do this"
and because I am terrified of them I just nodded my head.That tooth needed
to be pulled within 2 weeks and all pain stopped.That is why I thought-Ok
just pull the tooth-but then the problem would move.
I need to arrange my paperwork for tomorrow.please wish me luck

Good Luck!

Luckily when I hurt my neck which caused the pain in my teeth, I worked near the main public library in Columbus, Ohio. While I haven’t spent much time in the library, the time I have spent there has helped a great deal.

Again Good Luck!

Thank You
Just logged on before I go.
Wishing you wellness