To Go or Not to Go?

How do you know when to go to the dentist and when your TN is tricking you into thinking that you need to rip every tooth in your mouth out to stop the pain?!?!
I would think it would be foolish to think that a person with TN would never need a root canal or dental work, especially considering that some of the meds we take cause dry mouth, which in turn can cause dental problems. So the vicious cycle continues. That being said, I am deathly afraid, like many others in this community, to sit in that dentist chair that in some ways to me is akin to sitting in the electric chair on death row, and waiting for
A. The pain of the aftermath of that dental visit.
And
B. For some dentist to tell me that I need a root canal, or God knows what else.
Since a dentist misdiagnosed me in the first place and then treated me like a drug seeker, it is very hard to make myself go through that again.
My pain level has increased exponentially lately and it has migrated toward my teeth again. What to do…what to do…
To go or not to go?

Go for a panoramic X-Ray and consultation. Before you go, consult with the dentist by phone, to see whether he or she has any training in dealing with patients who have facial neuralgias. If the dentist is willing, ask him to call your neurologist to discuss the nature of your TN pain and its tendency to mimic dental abscess.

FYI: when you deal with pain throughout your mouth or all through one side, the odds are that there is no abscess involved. But the flip side of the issue is that generalized pain can DISGUISE a localized abscess issue. That's why you need evaluation.

Go in Peace and Power

Red Lawhern, Ph.D.

Resident Research Analyst, LWTN

If your have a good check up -- get prescription LIDOCAINE MOUTHWASH to help those nerve endings take a rest! From doctor or dentist

It's funny, I had the exact same conversation with myself last night!! I had a cold drink of water when I came home from work ( it's HOT down under) and it ripped through my top tooth and I thought " what if all this is a nerve in a tooth? What if I could pull the tooth and it all just went away?" But then a different tooth hurt and I was confused again.I do wonder if we have to wait till our faces swell like a balloon before we stop asking ourselves.

that's a great suggestion to get a panoramic x ray done. I am having a 300 dollar consult with an endodontist coming up and he will do this panoramic x ray I believe and do an evaluation to see whether or not I need a root canal or not in some teeth. Heres my question: I read again and again, I had a root canal only to find out I didn't need a root canal because the pain is still there. Cant these endodontists tell for sure if the tooth needs a root canal or if the pain is coming from trigeminal nerve instead of the nerve pulp? Am I going to be paying $300 for nothing because the endodontist science is not an exact science?

Richard A. "Red" Lawhern said:

Go for a panoramic X-Ray and consultation. Before you go, consult with the dentist by phone, to see whether he or she has any training in dealing with patients who have facial neuralgias. If the dentist is willing, ask him to call your neurologist to discuss the nature of your TN pain and its tendency to mimic dental abscess.

FYI: when you deal with pain throughout your mouth or all through one side, the odds are that there is no abscess involved. But the flip side of the issue is that generalized pain can DISGUISE a localized abscess issue. That's why you need evaluation.

Go in Peace and Power

Red Lawhern, Ph.D.

Resident Research Analyst, LWTN

Hi Kc Dancer, I saw a dr today and asked her for lidocaine mouthwash and cream. My insurance wouldn't pay for the cream so I got this stuff I am wondering if it is what you are talking about. On the bottle it says: Lidocaine Viscous 2%, use 5mls by mucous membrane route every 3 hrs.. No where on the bottle does it say mouthwash and she told me to not take to much because to much lidocaine can cause seizures...now I'm kind of afraid of the stuff.

Kc Dancer Kc said:

If your have a good check up -- get prescription LIDOCAINE MOUTHWASH to help those nerve endings take a rest! From doctor or dentist

S&A: dental and medical science are inexact. But high resolution panoramic X-ray is generally a reliable procedure. If there is no evidence in the highest resolution X-ray you can get for abscess or cracked tooth, then you would be well advised to refuse root canal unless the endodontist can present other conclusive evidence that what you are experiencing is NOT nerve pain.

Ask them to test the tooth by freezing it rather than by administering anesthetic to the nerve. If you still have pain after your tooth has been exposed to liquid nitrogen or oxygen in a swab, then I believe many dental professionals would suspect nerve pain rather than abscess. But definitely ask the question "how can you demonstrate that what I am dealing with is dental in origin rather than neuropathy or neuralgia pain in the nerve itself?"

Let us know how you come out.

Regards, Red

Thank you sooo much. I learn so much from you. So, I take it after they give you pain via cold, then exposure to liquid nitrogen or oxygen supposed to take it away in normal circumstances?? that's interesting. well, 6 months ago, a dentist put ice to this tooth and it hurt like hell for a wk afterwards, since then the numbness in my gum area has spread to about 60 percent numbness in this tooth(making this tooth feel Gigantic by the way)and it stopped hurting for a while and now pain has come back even though a lot of it feels numb, so its very strange. Plus, I had 100 degree temps yesterday and today and I still don't know if it was the Topamax I tried for the first time, or if I have an infected tooth and need a root canal..I'm very scared to have a root canal on this tooth because it is right next to the nerve damage site and I don't want them to put a shot in that area, and yet, I cant seem to find any endodonists that do general anasteia. As always, thanks for listening to my drama, and thank you soooo much for recommending Dr. Casey to me. I am so glad he was the first Dr. I saw, because now I can tell if another dr. knows this stuff or not. Plus, Dr. Casey has answered a couple of my emails now and he isn't even getting paid to do that... he called in a script for Topamax for me on a Sat morning after just getting back from over seas, and I know he has many many patients, so he is such a saint and so dedicated to helping others I feel very blessed in meeting him and in all your help!!!!!

To refine my earlier wording: when Liquid Oxygen or Nitrogen are used to "freeze" a tooth, normally it would go numb. If it's not, then there is likely some process of central nervous system pain or nerve inflammation going on, such as TN. FYI, an alternative to general anesthesia is "twilight" anesthesia administered with Nitrous Oxide

Ken Casey is a thoroughly decent human being and a gifted medical professional. I've several times observed him in patient seminar sessions, working real-time with patients. And from time to time he's been gracious enough to answer my emailed questions on behalf of patients who contact me.

Hang in there, Hon. From all that you write, it seems to me that you almost for sure are dealing with TN in the opthamal and mandibular branches of the nerve. Whether there is ALSO an abscess process going on, should be confirmed by dental imaging.

Regards, Red

Good to know, thanks Cleo!!!!

Thank you so much Red, for your reply. I too, learn so much from you. I am armed with your sage advice and ready to make my first dentist appointment since what I believe to be the unnecessary root canal I had at my last dentist appointment.

I am very interested in this freeze test. I am also very interested in some advice you gave on another thread in which you stated that if your tooth pain subsides at night that it is a clear sign that the pain is NOT dental in origin.

I am going to request the panoramic X-ray of course. But I am going to insist on gentle, TLC type treatment.

I have chosen a dentist that is a friend of my husband’s from high school. This is how I choose almost all of my health care professionals. I do not live in a large city where I can get the top-notch care. But I do know now from learning from my mistakes in the past, that I at least can find people who care about me as a person and don’t just think of me as another chart. Does that make sense? Anyway, sorry it took me so long to reply. The pain has been unbearable lately. Thanks for all the advice guys.

Kc- I do not have the lidocaine mouthwash yet because I haven’t been to the dentist and my neuro wouldn’t prescribe it. But he does prescribe me the topical kind and has been for a while now. About a week ago, I looked up the recipe for magic mouthwash and made some for myself. It is compounded using equal parts of topical mouthwash, Children’s Benadryl, and Mylanta. This may be something to share with those who do not have access to lidocaine mouthwash. Anyway, it works well sometimes for me. Although I can imagine the real stuff must work better. Just a thought.

Hello
I just had the same issue. Mytop molar which just got filled last year started to be sensitive to hot/warm and sweets. Also sharp pains here and there. I was positive it was the nerve dying. So today I went to the dentist and had him check it out. He looked at xrays and couldnt see anything. He melted wax and heldit on my tooth. Then put liquid nitrogen on my tooth. No reaction to either one. He said I had a little bit of exposed nerve where my gums had receded and that would cause sensitivity and pain. He prescribed prescription prevident toothpast to rub on my tooth. I also think some of the sharp jabs of pain is my face pain which originates in my tooth. So xrays , tapping on my teeth, hot wax and liquid nitrogen all kind of proved it wasnt an abcess or dying nerves. My teeth are sore now after that but I can kind relax that I dont have an abcess and dont need an extraction or root canal. Ihope you get up the courage to go to the dentist. Just for your piece of mind.