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Dental work

Is there anyone else who had dental work (in my case, a root canal) and had TN result from the dental work? At least, I know that I never had any pain or any complications of any kind until just after having a root canal.

Tags: Dental, anaesthetic, care, local, pain, teeth, tn

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Permalink Reply by Liz K. on April 15, 2010 at 10:27pm

Robyn,
I think I have heard of this happening. But someone here may correct me.
Liz

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Permalink Reply by Kerry on April 15, 2010 at 10:48pm

Hi Robyn,

Like Liz said - I have heard of situations where people stated their TN occured as a result of Dental work, then have also heard that Dental work may sometimes "trigger" TN for the first time in some people that were already either pre-disposed to getting it, or already have the arterial or vascular compression of the Trigeminal nerve. In the medical community, there is a great deal of debate over the issue when you read up on research regarding dental work and TN - so there are no definitive answers that I've learnt of as yet. So, I believe Dental work can cause or contribute to TN starting, but I'm not medically trained in any way shape or form - this is purely just an opinion.

In my case, I got the dental work done because I was having problems / pain in my teeth. That resulted in more pain and more dental work to where I ended up losing 5 teeth to extractions that were never actually needed, simply because no one thought I had TN as I was in my early 20's at the time. TN simply didn't exist for people my age at the time as far as Doctors or Dentists were concerned. Actually, I have met some Doctors now who still don't believe it..

I'm sure also as Liz said - there will be a few people who may have other information to give you - once they read your query.

All the best at getting the answer you're looking for! May I ask - purely out of curiousity, what reason was there for you getting a root canal? Did you have dental x-ray's that showed a root canal was required?

Best wishes to you for many pain free days!

Kerry xx

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Permalink Reply by Kerry on April 15, 2010 at 10:56pm

Hi again Robyn,

I just want to add that I'm rather heavily medicated on both the TN meds & painkillers at present due to TN pain and the procedure I had to try and treat it just a few days ago. The anesthetic they used fully wore off day before yesterday and I've been suffering rather intense attacks as a result of the surgery itself, which happens apparently, doctor told me this would happen, that "sometimes" the pain can actually get worse after the procedure, before it gets better.. :-( bummer.

The reason I added this, is just in case I've sounded rude or anything, cause right now, I can't tell if I'm saying the right thing or not.

Cheers ~ Kerry xx

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Permalink Reply by robyn holder on April 16, 2010 at 6:03pm

Kerry, you didn't sound rude at all! I'm just so angry right now that this has disrupted my life. I'm a single mom and an elementary school teacher. I'm having such a hard time just making it through the day. The meds make me lethargic and affect my memory. If one more family member tells me that I'd feel better if I went back to the gym, I think I'll scream! I did see the xray so I needed the root canal. My MRI didn't show any abnormalities. Actually, I went out with a dentist and he is the one who suggested that I mention TN as a possibility to my doctor (who subsequently sent me to a neurologist).

Many thanks to all who reply. I truly am appreciative. I'm scared of losing the ability to function as a good teacher. I already know I won't be winning any mother of the year awards this year.

Kerry said:

Hi again Robyn, I just want to add that I'm rather heavily medicated on both the TN meds & painkillers at present due to TN pain and the procedure I had to try and treat it just a few days ago. The anesthetic they used fully wore off day before yesterday and I've been suffering rather intense attacks as a result of the surgery itself, which happens apparently, doctor told me this would happen, that "sometimes" the pain can actually get worse after the procedure, before it gets better.. :-( bummer.

The reason I added this, is just in case I've sounded rude or anything, cause right now, I can't tell if I'm saying the right thing or not.

Cheers ~ Kerry xx

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Permalink Reply by Julie on April 18, 2010 at 12:32am

Hi Robyn,

I actually went to 3 dentists after my teeth cleaning because I noticed that air conditioning seemed to be affecting my teeth. The first dentist did a root canal, but on the other side of the mouth. That was not fun, I still had pain. The other two said there's nothing there. I had all the same pain I would normally have for a toothache, but there was already a crown there. It wasn't cracked. They were endontists. I finally sought the advice of a dentist (friend of the family) who said I had tic deloureux / trigeminal neuralgia. He told me to go to a neurologist, which coincidentally I was for my migraines. Sorry to have such a long comment, but I do believe that dental work can affect the TN. I never had the pain till after I was getting my teeth worked on. The pain has always been it feels like coming through my teeth. Everything is connected I believe.

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Permalink Reply by Kerry on April 18, 2010 at 12:51am

If you look at the below picture here - and look closely along the lower jaw at all the mini branches that come off the main branches of the Trigeminal nerve and how they run along and attach to the base of the lower teeth you can draw your own conclusions.

But just as a side note - an MRI will not always show a compression - you can ask many here who've had the MVD - a lot of them also had a clear MRI but where their surgeons found compression only on doing the actual surgery. The MRI is only done - to make certain that there isn't a tumour pressing on the nerve or that MS is the culprit. There is no other reason - if the radiologist happens to see a compression also - then bonus points. But a compression can and does often still exist even if it does not show on any scans.

I'll leave the rest up to you guys :-)

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Permalink Reply by Debi on April 18, 2010 at 12:35pm

I have TN pains on lower left side. X-rays have shown a small cavity on the upper right side and I am afraid to have it fixed. I don't want the novacaine to start causing pains on the right side. Any comments on this??

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Permalink Reply by robyn holder on April 18, 2010 at 7:43pm

My neurologist said absolutely no dental work until I get to a point of managing the pain. I haven't gotten there yet. You can get some temporary filling stuff from the drug store you can do yourself. I need another root canal next to the tooth i had my first root canal which started this for me. I'm very scared. The tooth is dead. I had it looked at and had zero pain when they touched the tooth, yet as soon as they tried to rinse my mouth out, I wanted (and almost did) scream out. I was told to only get dental care if it was an emergency .

Debi said:

I have TN pains on lower left side. X-rays have shown a small cavity on the upper right side and I am afraid to have it fixed. I don't want the novacaine to start causing pains on the right side. Any comments on this??

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Permalink Reply by Debi on April 18, 2010 at 10:00pm

Thanks for the info!!

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Permalink Reply by Kerry on April 19, 2010 at 2:18am

There is a tip sheet on dental care - may try and get a new page started here to add information from everyone about tips on this area, as it is important for all of us to know and be able to use this kind of information - so Robyn, this was a great post to put up, thank you for doing that!

What I have learnt is when we are in a position to get the dental care as required - like you suggested Robyn, only doing it as necessary, when we are already in pain free time is great - here in australia some dentists do what is called sleep dentistry, where they use only a light kind of general anesthesia that puts you into a half sleep, not fully under - here it's called twilight anesthesisa and it's what they used on me when I had my PRF procedure. You are still able to communicate to the dentist, but you actually recall "nothing" whatsoever afterwards! I love it, because it works really well and you recover quickly, though you still need someone to drive you home afterwards.

Another point is that the dentists now have access to different local - you often have to phone ahead and ask for it to be used, because sometimes they stock it, and sometimes they don't. What you have to ask for is a local that does not use epinephrine. Epinephrine is the component that can trigger TN in a person already with TN.

I hope that is helpful, I'll find the tip sheet on dental care and add it here also.

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Permalink Reply by Kerry on April 19, 2010 at 2:21am

TNA Tips for Keeping Dental work as painless as possible:

° Go to the dentist when you're not hurting. Make sure your dentist knows you have TN so he or she will be flexible to schedule your appointments (maybe even on short notice) during periods when your pain goes into remission. This will also help the dental staff to understand in case you have to cancel in the event that your pain flares up right before an appointment.

° Be well medicated. If you don’t have remissions or must have dental work done during an active pain cycle, consult your doctor so you’re on an optimal dose of medicine. To prevent a breakthrough, your dentist may want to increase the dose of any TN medications you are taking for a day or so before and after the procedure. Also try to schedule your appointment during the time of day when you’re least likely to get pain or when your medication is at peak effectiveness (usually about one hour after taking a dose). Several hours before the procedure, take a pain-killing medication such as codeine. Take it again after the procedure. The goal is to have at least five hours after the procedure during which you’re pain free.

° Topical anesthetics. Most dental patients need numbing compounds mainly for tooth repairs, crown work, extractions and the like. However, even teeth-cleaning and exams may bring on pain for facial pain patients. Topical sprays or gels can be used to temporarily numb the gums.

° Touch the sensitive area last. If there’s a trigger zone that usually sets off the pain, ask the dentist or hygienist to examine and clean everything else first.

° Switch local anesthetics. If you need treatment, discuss with your dentist the type of anesthetic to be used. Ask your dentist to use Mepivacaine 3% or Carbocaine 3%, neither of which contains preservatives or a vasoconstrictor. You may want to ask in advance, because the average dentist doesn’t keep this particular drug in stock.

° Epinephrine is a vasoconstrictor; it’s sometimes added to local anesthetics to prolong their numbing effect. Epinephrine can trigger nerve pain, especially in cases of trauma-induced TN. In these cases, ask your dentist not to inject a vasoconstrictor with local anesthetics in the area of nerve damage.

° Consider the injection point. Ask the dentist if possible to inject the local anesthetic at a site as far as possible from known, active TN trigger points.

° A knockout. If all else fails and you absolutely need dental work, discuss the possibility of a general anesthetic (either IV or inhaled) to put you to sleep while the work is being done. This type of anesthesia can reduce emotional trauma.

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Permalink Reply by robyn holder on April 19, 2010 at 5:17am

Thank you so much for adding the tip sheet information!

Kerry said:

TNA Tips for Keeping Dental work as painless as possible: ° Go to the dentist when you're not hurting. Make sure your dentist knows you have TN so he or she will be flexible to schedule your appointments (maybe even on short notice) during periods when your pain goes into remission. This will also help the dental staff to understand in case you have to cancel in the event that your pain flares up right before an appointment.

° Be well medicated. If you don’t have remissions or must have dental work done during an active pain cycle, consult your doctor so you’re on an optimal dose of medicine. To prevent a breakthrough, your dentist may want to increase the dose of any TN medications you are taking for a day or so before and after the procedure. Also try to schedule your appointment during the time of day when you’re least likely to get pain or when your medication is at peak effectiveness (usually about one hour after taking a dose). Several hours before the procedure, take a pain-killing medication such as codeine. Take it again after the procedure. The goal is to have at least five hours after the procedure during which you’re pain free.

° Topical anesthetics. Most dental patients need numbing compounds mainly for tooth repairs, crown work, extractions and the like. However, even teeth-cleaning and exams may bring on pain for facial pain patients. Topical sprays or gels can be used to temporarily numb the gums.

° Touch the sensitive area last. If there’s a trigger zone that usually sets off the pain, ask the dentist or hygienist to examine and clean everything else first.

° Switch local anesthetics. If you need treatment, discuss with your dentist the type of anesthetic to be used. Ask your dentist to use Mepivacaine 3% or Carbocaine 3%, neither of which contains preservatives or a vasoconstrictor. You may want to ask in advance, because the average dentist doesn’t keep this particular drug in stock.

° Epinephrine is a vasoconstrictor; it’s sometimes added to local anesthetics to prolong their numbing effect. Epinephrine can trigger nerve pain, especially in cases of trauma-induced TN. In these cases, ask your dentist not to inject a vasoconstrictor with local anesthetics in the area of nerve damage.

° Consider the injection point. Ask the dentist if possible to inject the local anesthetic at a site as far as possible from known, active TN trigger points.

° A knockout. If all else fails and you absolutely need dental work, discuss the possibility of a general anesthetic (either IV or inhaled) to put you to sleep while the work is being done. This type of anesthesia can reduce emotional trauma.