Root Canal Pain and Trigeminal Neuralgia

[JJ_8613]

Hello.

I have a question about root canal pain and Trigeminal Neuralgia.

In the last three months I’ve had three teeth with root canal symptoms. They’ve all had cold/hot sensitivity that lingers, pain with biting/chewing, constant toothache pain and throbbing toothache after coming in contact with cold. All of these teeth have been treated with root canal treatments and have all felt better after treatment.

Now for the last 3 weeks I have another tooth, an upper right front molar, #3 that is showing the same symptoms. I saw my dentist who referred me to an endodontist and a neurologist. I’ve already had the consultation with the endodontist and he wants to wait and see what the neurologist says before deciding to do a root canal treatment or not.

I am able to differentiate two different types of pain. I have a constant pain on both sides of my jaw that has episodes where it gets worse and will go into the ears. Other times it’s just that constant jaw pain.

The other pain I can tell is separate and is coming from a specific tooth. The pain in the tooth responds to certain stimuli as mentioned above.

My appointment with the neurologist is coming up on April 27, 2018. He’s going to see me for these toothache related problems and chronic jaw pain. My dentist referred me for possible Trigeminal Neuraglia.

Have you ever heard of Trigeminal Neuraglia causing root canal type symptoms?

What advice can you give me regarding this? Are there any specific symptoms that would tell me if this was Trigeminal Neuraglia or not?

Thank you.

JJ

 

[MattKW]

Trigem neuralgia is usually one-sided, and described as a "lancinating" pain. What did the endo say about the quality of your existing RCTs? Do you have any Xrays?

 

[Busybee]

I'm not a dentist but I think you have some sort of bite misalignment or TMJ issue. I had transient trigeminal neuralgia years ago and yes it was on one side. It was an excruciating pain even though it was just a shooting and temporary one. I would be in a panic if I had no painkillers. It coincided with the onset of my jaw clicking on one side. The neuralgia subsided in about three months (thank goodness) but the click remained.

There's no cure for TMJ, just management of symptoms. It's one of those conditions where no dentist agrees on the best approach. A way to diagnose this would be trying a bite splint. If a splint relieves your symptoms then it's a bite issue.

What happened before you had the root treatments? Were you symptom free?

 

[JJ_8613]

Trigem neuralgia is usually one-sided, and described as a "lancinating" pain. What did the endo say about the quality of your existing RCTs? Do you have any Xrays?

Hi.

Thank you for your reply.

No it's not that kind of pain. It's more of a dull ache in the jaw. The tooth symptoms are classic root canal symptoms like, sharp pain with cold that leaves a throbbing ache afterwards that lingers.

The endo said that my other RCTs look fine.

Here's the x-rays my dentist sent to the endo.

Also, the tooth that is currently hurting has two older fillings in it.

Thank you.

JJ

 

[JJ_8613]

I'm not a dentist but I think you have some sort of bite misalignment or TMJ issue. I had transient trigeminal neuralgia years ago and yes it was on one side. It was an excruciating pain even though it was just a shooting and temporary one. I would be in a panic if I had no painkillers. It coincided with the onset of my jaw clicking on one side. The neuralgia subsided in about three months (thank goodness) but the click remained.

There's no cure for TMJ, just management of symptoms. It's one of those conditions where no dentist agrees on the best approach. A way to diagnose this would be trying a bite splint. If a splint relieves your symptoms then it's a bite issue.

What happened before you had the root treatments? Were you symptom free?

Hi.

Thank you for your reply.

I have been previously diagnosed with TMJ. Had it for 4 years now.

So, of the 4 teeth there have been two on the upper right, including the one that is currently hurting and the other has had a RCT. One other tooth was on the upper left and the other was the lower left and both have had RCTs. Before the RCTs they had the typical root canal symptoms and after they felt great.

Is a bite splint like a night guard? I have one of those already that I use.

Thank you.

JJ

 

[Busybee]

Yes I meant a night guard. It's good that you have one already but may be worth checking whether it's not contributing to the problem. I'm convinced that it was a badly thought out guard that gave me a clicky jaw and the neuralgia. You've had a lot of work done so it may not fit so well now.

 

[JJ_8613]

Hi all.

Not sure if I posted this update already.

At the time this thread was posted I saw a Neurologist who said I did not have Trigeminal Neuralgia.

I eventually had a root canal treatment on that tooth.

Thanks.

JJ