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Living With Facial Pain

Tooth does not respond to cold test at dentist

Hi
Has anyone had a problem with a tooth-that seems to be at the middle of the pain -not responding to the cold at dentist offices?
I will be going back in 2 weeks so he can try the super cold stuff.
What I would like to know is :has anyone had this happen and then what intervention(if any) did the dentist do.
I am still not convinced that this is totally a neuropathic pain problem and the tooth not responding to freezing (so far) kind of confirms it.But maybe it is something that people get with this bizarre ailment.
Anyone have this problem?

A tooth NOT responding to a cold test is not generally considered a “problem” The test is to determine pulpal inflammation and/or confirm the diagnosis of a necrotic pulp. That doesn’t mean there won’t be pain only that the tooth itself is not the source. The two major reasons for no response but pain being present are neuropathic or referred pain. Occasionally in the case of systemic inflammatory disease, that might be the cause.

I would agree–the fact that it doesn’t respond (or isn’t bothered) by cold would actually support the fact that it is probably neuropathic pain. I’ve been through this several times, looking for issues in the teeth. You could still have pulpitis, but it is much less likely.

Thanks for the responses.
The tooth feels dead in my mouth.For some reason when the dentists do the cold test they want me to say it hurts.If I don’t say it hurts the test swabs get closer to my gum until I jump and then the exam is over.Without me ever being 100% sure that it was my tooth not my gum making me jump.This has happened more than once with more than one dentist.(different people at the same hospital)
The specialist will repeat the cold test with colder stuff in a couple weeks and if no response will do it again a week later.
This is a pretty bright guy.And he is not charging for the repeat visits.

Whenever I need to have dental work done and the dentist numbs the side of my mouth where I feel my TN pain, my teeth and gums get numb, but the TN and burning pain is still there.

Hi
When they freeze that tooth-I have asked once for that-I have no pain for 2
or three hours. Just the numb.That is what is befuddling my mind.I like to
learn.I like to understand.But this seems to be beyond comprehension.That
is why I have gone back to square one.

Sorry-I think the title should have read differently.Stupid brain.
The freezing I am referring to is the one where the dentist tests the tooth with a freezing cold substance-not the freezing done with anesthetic.If I could change the title I would.

I took it that way… In any event I have magical powers LOL, what title would you like?

You amazing-OMG
My very own magic person.You know what I prefer you take away-but this is pretty good.
“Tooth does not respond to cold test at dentist”-might be better.
My brain is so mush.If you guys can come up with a better title -please do that.
Thanks

I assume thats not the title so I used “Tooth does not respond to cold test at dentist” although today is brain mush day for me so i can relate. FWIW my dentist stands WAAAAAY behind me now when he does a cold test after an unfortunate incident/reaction several years ago.

Same thing when the doctor checks my back.Stick something in the sore spot.make me flinch.Really bad flinch.You would think they would know better.

My teeth are all good ,my first symptom was upper & lower teeth severe pain,went to dentist like most everyone who has TN ,he was smart said go to neurologist I did not cause I didn’t think it was.Fast forward many trips to GP ,back to dentist after 11 months emergency room ,3 days hospital diagnosis TN still didn’t think so,but I took Tegretol, bam all the pain went away it was so great.I weaned off after a while, 5 weeks later pain is back

Hi
I am so glad that you can take tegretol.For me even at 100mg I am super constipated.the tylenol 3’s and codeine don’t affect me that way-same with the trileptal.
If the tylenol 3 did not help me so much I would be more convinced it was tn related.
I just keep on thinking if they did a root canal all my problems would go away-just like when they took out the bony island that was coming up through the same gum the pain stopped.And this was after a dentist poo-pooed it as neuropathic pain.This is why I don’t trust the diagnosis-even though no one has told me specifically what it is-after more than a year.
I was baby sitting my grand niece and she bumped into my mouth and I was hoping she would knock out that tooth.That is how bad it is.maybe I will go sliding on the ice.Hope you can get peace on the tegretol.Lucky you

I f you are getting consistent relief from tylenol 3, its likley NOT neuropathic pain. Have you seen an endontist??

That I have not seen-I have seen the specialist department at Mount Sinai hospital dental people and they are of the opinion it is neuropathic pain-from my history of the dental work and one tooth being pulled and the pain then being in another tooth,and the tooth burning.
I would be totally p***** and totally grateful if someone were to determine it is the tooth fault.And just to clarify the recipe I use is 2 tylenol 3’s,200mg gabapentin and 1200 mg methocarbanol(which I get by taking back pain medicine apart-I do tell the doctors I do this and show them what I need to do and still they will not prescribe a low dose muscle relaxant)Just the tylenol 3’s on their own don’t do it.
I will see what the specialist says when he tries to get the tooth to react to cold.I will ask him about an endontist.
Thank You.

The pain also went way down on the amitryptiline-however at doses above 30mg my hands would go numb at night.
I stayed off it for about 4 months and then started taking it during the day-hoping it was the large dose at night that caused the numbing.However the numbing started again when I needed to get up to 40mg to control the pain.Same happened with nortiptyline.I told my doctor that if the tegretol did not work I wanted to try other tricyclics until I found one that did not cause that bizarre reaction.

I am not sure how these pills work with other people -but they tend to work on me the same day or the next-not the building up in the bloodstream that my doctor thinks should be happening.(example-no effect until a week after taking them)

That interesting, in my world (rheumatology and orthopedics) when tricyclics are used, its generally at very low dosages and only at bedtime as they have a better chance of of regulating the stuff they are supposed to during sleep. They are often used with SNRIs such as: Effexor XR, Cymbalta and Savella. Its almost a miracle combination for related neuralgias.

They avoid SSRIs except for fluoxetine (Sarafem, Prozac) which may just be a possibility for you. for reasons not quite understood, fluoxetine really boosts the effect of amitryptiline. It may be that you could get relief from 30mg or less of the Amy with a fluoxetine “chaser.” I really hate seeing anyone taking that much tylenol especially mixed with methocarbanol. You are just daring your liver/kidneys to misbeahve.

It just seems that my family doctor does not want to do any mixing of meds.So I am just left to find something that works and that is what works more or less.Enough for me to crawl out of bed.Until I had the bone scan of my jaw back in July I did not need pain killers until the afternoon.Something went wrong with the bone scan-whether it was my neck position or the tooth pushing up against the top teeth for the 15 minutes I needed to stay completely still.My tooth was sore right then and it has not improved.I really wish I knew what happened.
I have had to stop the tegretol because the constipation was bad on it and I have all of these weird sores showing up on my right side.They look as though they are mosquito bites that have been scratched.The ones on my arm I scratched but not my leg.Very sore looking things They do not feel itchy or anything.I am putting polysporin on them.And I phoned up my doctor this morning but no response yet.
Just fed up with it all.Waiting for the dentist to test the tooth.I have an appointment with a neurosurgeon the beginning of April and I want to be 100% sure that it is the nerve and not the tooth.
Thanks for the info-I hope my doctor will listen to me if I say I want to try a combo.
I really,really appreciate this web site
Thanks again

Have they done a flat screen of your belly? Even if things are “moving again” those “weird sores” makes me think you are still impacted some in the Bowel. USUALLY the sores show up on your belly from just below the ribs and down (even on your leg) But always on the right side. Also “nerves” can cause a shingles outbreak (they don’t always itch)

TJ

Thank you again.
What do you mean by flat screen scan?Is that an ultrasound?
I have not had one,but should research about before asking my doctor.The
right
side thing was a puzzle.