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Lingual and Inferior Alveolar Nerve Damage Discussion Site

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Karen
unregistered user
Jan-12-05, 08:04 AM (CST)
 
"Pain in front tooth"
 
   Im looking for some answers. Two years ago my front tooth started hurting for no reason. The dentist said the tooth was fine and sent me for a root canal. One endodontist said the nerve was fine and wouldnt do one, so i went to another endodontist who in fact did a root canal. Pain still persists. The endodontist said the tooth was probably cracked above the gumline and that the opening and closing of the crack was causing me pain and send me to have the tooth extracted. I went to an oral surgeon who extracted the tooth and inserted an implant. I still have pain. Now they are sending me on to an ENT. I am a healthy 44 year old women with no major medical problems. My front tooth has never had a filling or an infection. It just hurts somewhere up inside the gum or higher perhaps. When I talk or cup my lip to take a drink, that pulling sensation causes pain as well. I "manage" the pain with ibuprofen but have been on it for 2 years on and off and dont like taking it. Has anyone ever heard of such pain? Im desperate for relief with an answer.


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  Subject     Author     Message Date     ID  
  RE: Pain in front tooth Reesatay Jan-12-05 1
  RE: Pain in front tooth Ellen Jan-13-05 2
     RE: Pain in front tooth Dr. B Jan-13-05 3
         RE: Pain in front tooth Ellen Jan-13-05 4
     RE: Pain in front tooth Karen Mar-01-05 5
         RE: Pain in front tooth Reesatay Mar-01-05 6
         RE: Pain in front tooth Ellen Mar-02-05 8
             RE: Pain in front tooth Karen Mar-11-05 22
     RE: Pain in front tooth Hope Mar-03-05 9
         RE: Pain in front tooth Ellen Mar-04-05 10
             RE: Pain in front tooth hope Mar-04-05 11
                 RE: Pain in front tooth Ellen Mar-04-05 12
     RE: Pain in front tooth Karen Mar-11-05 23
  RE: Pain in front tooth dawn Mar-02-05 7
     RE: Pain in front tooth Anita Mar-07-05 13
     RE: Pain in front tooth Ellen Mar-08-05 14
         RE: Pain in front tooth dawn Mar-08-05 15
             RE: Pain in front tooth Ann Mar-09-05 16
                 RE: Pain in front tooth Ellen Mar-09-05 17
                     RE: Pain in front tooth DrCSK Mar-11-05 19
                         RE: Pain in front tooth Dr. B Mar-11-05 20
                             RE: Pain in front tooth Ellen Mar-11-05 21
                                 RE: Pain in front tooth Dr. B Mar-11-05 24
                     RE: Pain in front tooth Ann Mar-12-05 25
                 RE: Pain in front tooth dawn Mar-10-05 18
                     RE: Pain in front tooth Ann Mar-15-05 26
                     RE: Pain in front tooth Ellen Mar-16-05 27
                     RE: Pain in front tooth Reesatay Mar-16-05 28
                         RE: Pain in front tooth Anita Mar-16-05 29
  RE: Pain in front tooth Frances Apr-15-05 30
     RE: Pain in front tooth Dr. B Apr-15-05 31
  RE: Pain in front tooth kelly Jan-18-06 32

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Reesatay
unregistered user
Jan-12-05, 11:35 AM (CST)
 
1. "RE: Pain in front tooth"
In response to message #0
 
   Karen,

I just put some links down for unusual tooth pain. Maybe this will give you some insite on what may be wrong. Here is the link to my posting. I hope you can find answers and treatment to your pain.

http://www.sciential.net/dcforum/DCForumID6/792.html

"T"


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Ellen
unregistered user
Jan-13-05, 01:20 AM (CST)
 
2. "RE: Pain in front tooth"
In response to message #0
 
   Hi Karen,

Can you describe the kind of pain on the tooth? Is it dull, tender, sharp, burning, continuous or intermittent? Did it hurt more after each of the dental procedure (you mentioned root canal, extraction and implant ) you have had or stay the same?

I am having a similar mysterious dental pain but it is from my two upper lateral incisors. It all started about 2 years ago when I went in and had a bridge put on them. After the dentist prep. the teeth, they just started to hurt and ended up needing root canals few months later. After the RCT the pain improved but not abate. One tooth is constantly sore like an infection going on, the other is increasingly giving me intermitent sharp pain. I have gone to see different dentists and doctors to try to figure out what's wrong, and recently a neurologist and an oral-facial pain dentist concluded that I " might " have developed neuropathic pain due to trauma to the teeth. They said "might" because there is no test can confirm such diagnosis, but rather base on patient's history and also the fact that there is no radiographic or clinical finding that explains the source of the pain. One dentist even suggested it's psychological. Very frustrated to say the least.

I am taking Nortriptyline 40mg at nighttime which helps reduce majority of the pain but don't want to take it forever. Please keep me posted on your progress.


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Dr. B
unregistered user
Jan-13-05, 09:46 AM (CST)
 
3. "RE: Pain in front tooth"
In response to message #2
 
   See a Prosthodontist and have the bridge evaluated.


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Ellen
unregistered user
Jan-13-05, 02:06 PM (CST)
 
4. "RE: Pain in front tooth"
In response to message #3
 
   Hi Dr. B,

I have seen numerous dentists including a well known prosthodontist, they first suspected the bridge had structural problem or my abutment teeth were not strong enough to hold the bridge. They took out that bridge and put in a temporary one, also adjust the temp. one many times such that now it's not touching my lower teeth even if I grind or clench as they suspect I do, but no improvement. I wanted to take out the teeth to just to find out but was warned of the consequences: teeth out, pain persists; or pain gets worse or spread to another area if it's infact neuropathic pain. Now,I am considering doing retreatments on the teeth.


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Karen
unregistered user
Mar-01-05, 08:15 AM (CST)
 
5. "RE: Pain in front tooth"
In response to message #2
 
   Ellen,

I am currently going through a series of injections into the implant site. The medications used are a combination of a steroid and something else because an ENT suggested that my cause of pain maybe from "chronic inflamation" which is caused by continual trama to the area and because the area was not left "alone" for an extended period of time a "chronic state" has insued. I've had two shots so far and am better. Tommorrow is my third. My goal is zero pain...


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Reesatay
unregistered user
Mar-01-05, 09:12 PM (CST)
 
6. "RE: Pain in front tooth"
In response to message #5
 
   Karen,

I'm glad to read these injection are helping. Zero Pain is the only good pain.

"T"


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Ellen
unregistered user
Mar-02-05, 04:44 PM (CST)
 
8. "RE: Pain in front tooth"
In response to message #5
 
   >Ellen,
>
>I am currently going through a series of injections into the
>implant site. The medications used are a combination of a
>steroid and something else because an ENT suggested that my
>cause of pain maybe from "chronic inflamation" which is
>caused by continual trama to the area and because the area
>was not left "alone" for an extended period of time a
>"chronic state" has insued. I've had two shots so far and am
>better. Tommorrow is my third. My goal is zero pain...


Hi Karen,

I am glad you've come back and responded to this thread. I also have mysterious and unresolved pain on my front teeth after putting on a bridge on them. Root canals were done and recently also had them retreated but the pain remains. An oral-facial pain specialist concluded that I "might" have neuropathic pain, but I am not too sure since my pain is localized on the teeth, not the surrounding gum and is not the burning, severe pain as many in this site describe. The first root canals reduced some of the pain and I read that would argue against neuropathic/ phantom tooth pain, I guess.
Some dentists also suspect that the pain is a bite issue and the periodontal ligaments are inflammed. The bridge has been adjusted several times yet no improvement.

Can you tell me more about the type of injections you have? How often do you have it and what kind of doctor to see to get the injection? Also did your pain get worse after the extraction and implant, or does it stay the same?

Ellen.


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Karen
unregistered user
Mar-11-05, 03:09 PM (CST)
 
22. "RE: Pain in front tooth"
In response to message #8
 
   Ellen,

When my tooth first began to hurt, it was at a pain level of 9/10 (1 being minor and 10 being worst)...After the root canal, still a 9/10....after extraction and implant the pain was reduced to an 8..Advised by an ENT, my Implant surgeon is the one injecting the implant area with Xylocaine and Decadron. It was recommended that it be done once a week but my surgeon did an injection then waited 3 weeks before injection #2. Now he has me waiting 2 weeks in between injections. This next week will be injection round #4. I can say that the "level" of pain has decreased and I peek at around 6/7. The first 4 days after the injection my pain level is around 3/4. My dentist says that if I will continue the injections that one day I may have a "break-through" and the pain will completely stop.

So for now I am going to continue with the injections and praying for permanent relief.

Karen


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Hope
unregistered user
Mar-03-05, 04:18 PM (CST)
 
9. "RE: Pain in front tooth"
In response to message #2
 
   I too have a similar pain, however my upper palate and lips also burn.
I just went to an orofacial pain doctor who was very empathetic and a good listener. He started me on 10 mg of nortriptyline, and am to increase in two weeks to 20 mg. So far I have not noticed any difference. Mine is a upper front tooth that had a crown replacement 2 years ago, then a root canal, then the crown removed and a temp put on, then the root canal removed and medicine put in 3 times over the last year. There has been no change in the pain in my tooth. The dentists are baffled. The orofacial pain doctor thinks I have nerve damage. I would like to keep in touch with you and hear of your progress.


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Ellen
unregistered user
Mar-04-05, 01:20 AM (CST)
 
10. "RE: Pain in front tooth"
In response to message #9
 
   Hi Hope,

Can you tell me when you upper palate and lip(s) started to burn. Right after crown replacement or root canal? Why did you need to replace the crown in the first place? Did the tooth under the old crown start to hurt?
I am at this point beginning to feel desperate and want to take out the teeth to see if the pain would go away. I have spent like $6000 out of my own even though I have dental insurance( it hardly covers much). It's been a torture for me the past 2 years, as you probably know what I mean.
I am taking Nortriptyline as well. The pain relieve started to kick in when I gradually increased to 30mg. I hope it will give you pain relieve as well. Like to hear your progress too.


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hope
unregistered user
Mar-04-05, 09:14 PM (CST)
 
11. "RE: Pain in front tooth"
In response to message #10
 
   I had the crown replaced 2 years ago because it was cracked. At that time the injection was very painful, going up the left side of my face, nostril and into my eye. The dentist said it will go away. It did, but my tooth started hurting and my mouth started burning, mostly around the papilla. He said "wait" I had the root canal done 6 months later. It too, hope the Nortiptyline will work. I think the orofacial pain doctor is thinking about adding neuontin if it doesn't. I don't really want to start that. Do you take anything else? My mouth pain is worse toward evening but the tooth pain is ongoing. I hope you are doing OK.


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Ellen
unregistered user
Mar-04-05, 10:09 PM (CST)
 
12. "RE: Pain in front tooth"
In response to message #11
 
   Hi Hope,

I take Nortriptyline and sometimes add two 500mg Tylenol if the pain gets bad. Somehow the only over-the-counter drug Tylenol has the added relief, others like Advil, asprin did nothing. A neurologist also prescribed Neurontin to me but I am reluctant to take it because worry about some of the sides effects I heard. Some said that it makes them feel like a zombie and worse yet it causes depression and violent thoughts, however, others said it works well and hardly gives any side effects. If Nortrityline alone does not help maybe you can try to add Neurontin to see if it works for you. The oral-facial specialist( Dr. Michael Martin of University of Washington) said it's important to have the pain under control with medications as it can aid the healing process. Another thing that he said that is encouraging is that a lot of the time the nerve pain burns out after about 5 years. I hope you will find relief soon.


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Karen
unregistered user
Mar-11-05, 03:15 PM (CST)
 
23. "RE: Pain in front tooth"
In response to message #2
 
   Ellen,
When my tooth first began to hurt, it was at a pain level of 9/10 (1 being minor and 10 being worst)...After the root canal, still a 9/10....after extraction and implant the pain was reduced to an 8..Advised by an ENT, my Implant surgeon is the one injecting the implant area with Xylocaine and Decadron. It was recommended that it be done once a week but my surgeon did an injection then waited 3 weeks before injection #2. Now he has me waiting 2 weeks in between injections. This next week will be injection round #4. I can say that the "level" of pain has decreased and I peek at around 6/7. The first 4 days after the injection my pain level is around 3/4. My dentist says that if I will continue the injections that one day I may have a "break-through" and the pain will completely stop.

So for now I am going to continue with the injections and praying for permanent relief.

I may ask my doctor next time about me taking Nortriptyline because my surgeon gives me nothing saying nothing will helpmy pain.

Karen


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dawn
unregistered user
Mar-02-05, 08:52 AM (CST)
 
7. "RE: Pain in front tooth"
In response to message #0
 
   My son suffers from neuropathic pain in the gum area next to his front tooth. It really drives him crazy. He takes neurontin at night and advil during the day, but it has very little effect. There are topical things that will freeze the area but it only lasts for an hour. He had a marcaine injection with steroid that worked for only 3 wonderful hours. Inquired about glyceral injection - was told not appropriate. He can't tolerate the drugs and wants a local solution. His periodontist might open the flap and take a look but is reluctant and wants a consult with a neurologist which is taking forever to get an appointment. all in all, a very bad scene. You are not alone.


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Anita
Member since Nov-24-04
136 posts
Mar-07-05, 09:02 AM (CST)
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13. "RE: Pain in front tooth"
In response to message #7
 
   Are u trying to get a Neurologist at a hospital to see your Son?
I am just wondering because you wrote it is taking forever to get an appointment. Hospitals generally tend to be quicker at giving out appointments then those in Private Practise.

Anita


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Ellen
unregistered user
Mar-08-05, 10:57 AM (CST)
 
14. "RE: Pain in front tooth"
In response to message #7
 
   Dawn,

Can you tell me more about your son's condition? How does the pain feel like? Burning, sharp, continous? How did it all started? I have persistent pain on my two front teeth after putting on a bridge and later root canals. The pain on one tooth is very sore and continuous, like infection going on; the other is intermittent but kind of sharp and I feel it's only centered on left side of the tooth, like from the periodontal ligaments. Numerous x-rays but haven't found any abnormalty.Does anyone know if neuropathic pain always accompany with burning sensation? I don't feel like any burning though. I am about to schedule an appointment to have both teeth pulled hoping that would get rid of the pain but afraid pain would get worse. Can anyone give advice? Thank you.


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dawn
unregistered user
Mar-08-05, 06:58 PM (CST)
 
15. "RE: Pain in front tooth"
In response to message #14
 
   Ellen,
In response to your question, my son's pain is continuous, burning and very localized to an area of the periodontal ligament adjacent to his front tooth. In his case it was post-traumatic starting 7 years ago and then going away for several years only to return last summer - steady since then. It has really affected his life and I'm very concerned. He has had several dental assessments - all xrays and bone scan are normal, so the conclusion is that it's nerve damage and for that they give meds - which he can't tolerate. He wants periodontal surgery to just remove the painful area - but it's not something they do for nerve pain. We're waiting for a consultation with another neurologist at a pain clinic who supposedly specializes in dental-facial pain, but I'm sure it will just be more intolerable meds.
I hope you have better luck.


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Ann
unregistered user
Mar-09-05, 00:19 AM (CST)
 
16. "RE: Pain in front tooth"
In response to message #15
 
   I have neuropathic pain in teeth following an injection into the nerve with Septocaine, It has been two years and the pain is sharp and constant with out meds. With meds it is better and sometimes I feel it not at all. The meds can seem intolerable but if you ramp up very slowly you should gradually find relief. The slow ramp up is to allow your body to accept the drug - cause less side effects. over the counter pain killer are not effective usually.
Neurontin is a weaker drug, easier to tolerate but unfortunately for me is was too weak. There are many drugs to be tried and I'd get started now on trying them. The longer you have the pain and the more chronic it becomes, the harder it will be to treat it. Eventually you will find one where the pain relief outweighs the side effects. Sadly you can not replace teeth that are pulled. You can however stop a medicine that you can't handle. I have a couple of pulled teeth and it did not relieve the neuropathic pain. I hated the thought of meds too but I truly believe you need to get on them sooner and not later. You may be given a combintation of drugs to try at the same time even. JMHO, Ann


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Ellen
unregistered user
Mar-09-05, 01:42 PM (CST)
 
17. "RE: Pain in front tooth"
In response to message #16
 
   Ann,

Sorry for your injury. When you were getting the shots of Septocaine, did you feel it unusually painful? I got a copy of the dental record, it appears that they had used more than one kind of anesthesia on me since my abutment teeth were hurting every time they tried to fit a bridge on me. A total of four times! They wrote something like, 2% Carbo; 2% Scand; 2% Polocain. I don't know if these anesthesia have higher nerve damaging effect like Septocaine or not, perhaps someone can shed some light.

Can you tell me a little more history about your pain? Which teeth are involved? You said you had two teeth out to try to rid the pain, did the pain stay the same or worse after the extractions? Or has it jumped to other areas? Any burning sensation? Sorry to ask so many questions. I am trying desperately to figure out if I really have neuropathic pain as a couple of dentists suspected I have. They warned me that for neuropahtic pain, taking out the teeth would not get rid of the pain, worse yet it spread to adjacent or other areas of the mouth. The specialist also mentioned sometimes after extraction the pain may be gone for up to two months but only later come back and hurts more.

It's been very hard, but this site is wonderful, providing a lot of helpful info and support for us facial pain sufferers. I am grateful for this.


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DrCSK
Member since Dec-21-04
102 posts
Mar-11-05, 06:41 AM (CST)
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19. "RE: Pain in front tooth"
In response to message #17
 
   The three anesthetics you list are the same. They are all mepivicaine. They are just marketed by different companies hence the different brand names.

It is a short acting anesthetic meant to only last about an hour or less.


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Dr. B
unregistered user
Mar-11-05, 08:57 AM (CST)
 
20. "RE: Pain in front tooth"
In response to message #19
 
   I agree with CSK and wondered why this was used. Are you sensitive to epinephrine?


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Ellen
unregistered user
Mar-11-05, 10:59 AM (CST)
 
21. "RE: Pain in front tooth"
In response to message #20
 
   DR.B and Dr.CSK,

Thanks for your answers. The dentist used those anethesia on me at four different appointments to try on a bridge as my teeth were having pain after the prep. work. I don't know if I am sensitive to epinephrine because I had it with root canals, it seemed okay afterward.

I have another question. If a person can get nerve damage when a nerve is hit by injection anywhere in the mouth ( based on what I read here so far, injuries could occur at upper or lower jaw ), then would procedure like a dental implant be risky as it is inserted so deeply into the jaw bone? I am confused because when I asked a periodontist about it, she said parathesia is not a concern when implants are placed on upper jaw. Can you please clarify? I'd appreciate very much.

Ellen.


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Dr. B
unregistered user
Mar-11-05, 04:12 PM (CST)
 
24. "RE: Pain in front tooth"
In response to message #21
 
   There are no large nerves in the upper to hit as in the lower. However, in the back of the mouth one must be careful of the sinuses.


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Ann
unregistered user
Mar-12-05, 00:33 AM (CST)
 
25. "RE: Pain in front tooth"
In response to message #17
 
   Ellen, Yes I felt electric shock pain at the time of injection.
The teeth affected were my back molars, upper and lower. They were extracted at different times. The pain just traveled to the adjacent teeth. I remember after the second extraction of the lower back molar , the pain was gone for a couple weeks but it did come back, don't know if it was any worse. Yes I do have burning sensation. I also get stabbing pain.
Hope this finds you feeling better.
Ann


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dawn
unregistered user
Mar-10-05, 09:28 PM (CST)
 
18. "RE: Pain in front tooth"
In response to message #16
 
   to Anne,
I'm just wondering what combination of meds worked for you and didn't zonk you out completely?


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Ann
unregistered user
Mar-15-05, 09:37 AM (CST)
 
26. "RE: Pain in front tooth"
In response to message #18
 
  
I am taking a combination of Neurontin and and Elavil.
Neurontin alone did not work very well.
The Elavil zonks me out but I take it 9hours before bedtime; none during the day.
I have tried Topamax which did not help me.



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Ellen
unregistered user
Mar-16-05, 02:58 PM (CST)
 
27. "RE: Pain in front tooth"
In response to message #18
 
   Dawn,

I hope you will soon find the right medications for your son's pain. Like others here suggested, don't give up on trying different pain med so easily. When I first took nortriptyline even at 10mg it made me very sluggish too. I endured it and slowly reached to taking 40mg, the pain started to ease up a lot and sleepiness is gone. I was prescribed Neurotin also but hasn't tried it yet. I don't know if your son has tried it but I talked to a nerve pain sufferer who told me when she first tried Neurontin it did not help the pain much and also made her soooooo sleepy she almost about to quit. Well, she persisted and she found out that the pain relief finally started to kick in and the side effects has become minimal to her.

If you want to try the medications, ask your family doctor or a neurologist, and start out maybe like 100mg of neurontin and slowly building up. Don't ask OS or dentists, my experience told me that they really don't know much about nerve pain or treatments and are also reluctant to give out medications. Good luck and keep us posted.


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Reesatay
unregistered user
Mar-16-05, 06:41 PM (CST)
 
28. "RE: Pain in front tooth"
In response to message #18
 
   Dawn,

I've found that every med I tried gave me some type of zonked out feeling, at least temporarily. It took me months before I didn't have some type of side effect. Usually the side effect was fatigue, memory fogginess and dizziness, etc. The longer I take my meds the easier it has been for my body to tolerate them. Unfortunately, everytime a dose is increased the side effects can start back up until your body adapts again, but this usually doesn't last long. It is hard to take these meds and sometimes it doesn't seem like it is worth it, but if you can persist through the rough times it does get easier.

I'm currently on Trileptal and Effexor. These meds have helped me a lot.

I hope you find a medication that can be tolerated. What have been the problems?

"T"


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Anita
Member since Nov-24-04
136 posts
Mar-16-05, 08:26 PM (CST)
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29. "RE: Pain in front tooth"
In response to message #28
 
   T,

I'm glad the Trileptal & Effexor are helping you.
I was wondering about these meds effects on the liver long term.
Like how long term can one take the meds before your liver just gives out? I know that probably varies from Person to Person but I still wonder.

Anita


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Frances
unregistered user
Apr-15-05, 09:05 AM (CST)
 
30. "RE: Pain in front tooth"
In response to message #0
 
   Karen,

I have pain in my tooth #8 also. Had it extracted 4 weeks ago, and pain is still there. How is your tooth?

FranK2405@aol.com


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Dr. B
unregistered user
Apr-15-05, 11:16 AM (CST)
 
31. "RE: Pain in front tooth"
In response to message #30
 
   You should not be in pain still. Have you gone back to the dentist?
What dothey say?


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kelly
unregistered user
Jan-18-06, 11:31 AM (CST)
 
32. "RE: Pain in front tooth"
In response to message #0
 
   yes- I had a car accident when young and damaged both front teeth. One had a crown, now an implant. I have so much pain and now even jaw pain. What is strange is that it comes and goes. One dentist told me I had nerve damage, but knowing that did not help much. I guess i do not have much answers either..just know what you are going through.


in pain too,

kell


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