Trigeminal Neuralgia etc -- any experience?

cnp55 · 07-05-2008, 09:56 AM

Does anyone have any experience with this?

My dentist has me scheduled for an extraction on Monday -- it's a tooth *he* wants out of the way, as he terms it, a totally useless molar with a big filling that is going to cause problems eventually. He is correct about it being totally useless. And since I am presenting with what I thought was tooth pain in that general region, he's recommending it come out NOW, even though he could not replicate the pain with his testing. It's cold and chew sensitive, but with cold on the tooth and hitting the tooth, he couldn't make it hurt the way it does about 20 times a day when I eat, chew, or get a cold breeze on that side of my face. In other words, sometimes an incapacitating pain that lasts for 2-3 minutes on the whole side of my face.

So -- a little googling being a very dangerous thing -- and it being 4th of July weekend when I can't easily call the dentist, the oral surgeon, or my doctor, I am asking you guys ...

The other thing the googling turned up was chronic paroxysmal hemicrania -- another nerve thing that also may cause conjunctivitis and eye tearing -- which I had last week. This one is fairly rare. Apparently may appear in conjunction with the TN.

Trying to decide if I should cancel or postpone the oral surgeon ... and wondering if my googling is turning up junk or good stuff. Opinions welcome.

twomules · 07-05-2008, 10:13 AM

My mother has had TN for maybe 30 years. Yes it can sometimes make you feel that there is a bad tooth in there. I'll try to get her to post something here for you later today. There are very active support groups out there if a neurologist visit comes up with TN.

cnp55 · 07-05-2008, 11:54 AM

Not TMJ ... TN is a nerve thing.

Wikipedia says (although I read many other sites with info, this one is pretty basic.

Quote:

Trigeminal neuralgia (TN), or Tic Douloureux, (also known as prosopalgia) is a neuropathic disorder of the trigeminal nerve that causes episodes of intense pain in the eyes, lips, nose, scalp, forehead, and jaw.[1] It is estimated that 1 in 15,000 people suffer from trigeminal neuralgia, although those numbers may be significantly higher due to frequent misdiagnosis. TN usually develops after the age of 50, although there have been cases with patients being as young as three years of age [2].

The condition can bring about stabbing, mind-numbing, electric shock-like pain from just a finger's glance of the cheek. Believed to be among the most severe types of pain known to humanity, the most common forms of TN affect 1 in 15,000 to 20,000, but 1 in 5,000 are thought to suffer from some type of facial pain.

Apparently it is commonly misdiagnosed as a dental condition.

Bigredmed · 07-05-2008, 12:17 PM

TN in my limited experience is a lot more constant, much more frequent and much easier to elicit than what you've described. The two patients I've seen with it, mainly touching the face (not from inside the mouth though) created the pain. Doesn't mean you don't have it, as there are always variations of normal.

Please be careful with googling medical conditions. To quote Mark Twain:

Quote:

Be careful what you read in health books, you may die of a misprint.

jym626 · 07-05-2008, 12:20 PM

Trigem is REALLY painful, and it doesnt sound like what you are describing. Sounds like what you are describing is the nerve in the tooth-- you may need a root canal, not a tooth extraction.

** Additionally, trigem pain usually follows the path of the trigeminal (facial) nerve- across the cheek moreso than in the tooth. People used to suicide secondary to the pain experienced by trigem. Really-- as someone who has had a gazillion root canals (and probably needing another-- with a tooth that sounds similar to yours) and recently had a back molar extracted, check the root canal possibility out first-- don't extract the tooth unnecessarily, unless it is a wisdom tooth. Then you might want to get it "out of the way".

aghast · 07-05-2008, 12:35 PM

My sister had great results with acupuncture, chinese medicine.

aghast · 07-05-2008, 12:37 PM

Trigeminal neuralgia.

jym626 · 07-05-2008, 12:37 PM

acupuncture for which condition, aghast?

ucsd_ucla_dad · 07-05-2008, 12:44 PM

Maybe you should go see another dentist for a second opinion. Let the dentist examine you and give you an opinion before you bias them with the 'tooth extraction' conclusion. Assuming it's the tooth doing it, it could be that a root canal and crown would be better or maybe it really would be better to extract. Regardless, you'll probably feel more comfortable if you hear the same diagnosis from two different dentists who aren't affiliated with each other. There are lots of dentists around.

cnp55 · 07-05-2008, 01:43 PM

There is no way I am doing a root canal and/or crown on this tooth. It's the last molar on the upper jaw with no opposing tooth. It's not a tooth that is serviing any useful purpose ... i.e. I'm not chewing with it. It's just sitting there. The dentist x-rayed the whole side of my jaw ... and said he didn't see anything that would indicate decay or abscess in any of the teeth on that side.

I'm having extreme pain ... as in have to leave the sales floor and go sit in my office with a warm compress on it for several minutes, or pull over to the side of the road and press my hand to the cheek to continue driving. I think the trigger point is not on the cheek, but rather inside the mouth. That's why cold and pressure from eating make it react so much.

When I am having one of these pain attacks, it's the whole side of my face up to my eye ... all the teeth from the incisors back to the molars hurt. And ... of those, two are root canals, and two are missing with a bridge.

cnp55 · 07-05-2008, 01:46 PM

I completely get that there's a lot of miscellaneous and potentially misleading info on the net and that it's hard to sort things out for onesself via googling -- that's why we pay the docs, who have spent *years and years* learning how to sort these things out for us.

It was just that yesterday, as I am pulled over in a rest area doing Lamaze breathing with a warm cloth on my face, that I was thinking this was not like any sort of tooth thing that I've had. And maybe, rather than just having the tooth pulled ... that would be the useless tooth that my dentist wanted to pull 6 months ago but shows no signs of new decay or abscess ... I should google facial pain tooth and see what popped up.

audiophile · 07-05-2008, 03:30 PM

Quote:

It's the last molar on the upper jaw with no opposing tooth. It's not a tooth that is serving any useful purpose ... i.e. I'm not chewing with it

Pulpitis (pain in the nerve of the tooth) symptoms can be very similar to TN. Since the tooth needs to be extracted anyway (assuming it is a 3rd molar or no plans to replace the opposing tooth), have it done. If the pain continues after the extraction, then evaluate further.

audiophile, DMD

jym626 · 07-05-2008, 03:50 PM

I was wondering if you'd catch this thread and share your wisdom, audio!

cnp55-
The additional info you shared in post #11 was helpful. When I had a back upper molar extracted recently, they told me that if that tooth was necessary to provide any biting surface for a lower tooth, then they would want to put in a post and go from there, as without it I could experience a shift in all of my remaining teeth. Luckily the next tooth over hits part of the surface of the lower tooth so I could safely have the tooth extracted without needing sinus lifts, bone grafts, implants, etc. That would have been no fun.
Trigem is also no fun, so lets hope audio is right and its just a problem with the tooth nerve.

cnp55 · 07-05-2008, 04:06 PM

Thank you audiophile ... I appreciate your input.

twomules · 07-05-2008, 05:48 PM

I have had TN since 1978. Had a tooth pulled and it was healthy. Still had pain. Your symptoms are classic for TN. Since I have also led TN support groups for 10+ years, I have talked with many who have TN. The best resource is the national TN Assn. (Health & Medical Domain Names for Sale - Domains for Doctors, Surgeons & Health Care Providers) and toll-free 800-923-3608. You can talk with someone in the office and also be referred to a local support contact. If the tooth is really bad, maybe it does need to come out -- but I would get a referral to a neurologist who is familiar with TN (not all are) and get that opinion before taking any action on the tooth. Sometimes having tooth work done can make the TN worse. Best wishes! The pain is real and is not TMJ