Teeth problems freak me out anyway, now I have CRPS I am petrified.

My dentist remarked quite a while back (pre-CRPS) when I had problems with a molar (including a botched root canal - not by him), that even if he was able to do a successful root canal on the tooth, it might last as much as 10-15 years at best, and that in the end he would have to take it out anyway, and it was best to just get rid of it cleanly now rather than possibly end up doing several painful and ultimately unsuccessful procedures first to try and save it.

I've never forgotten that, and I've heard enough stories from friends and relatives to be extremely glad he did just take it out. I had sedation back then (told you I was petrified ) and although it wasn't pleasant for the next couple of days, it was still preferable to the alternative.

With CRPS, I don't think it is worth mucking about at all. The risks are too great. Take your dentist a print out on the main symptoms of CRPS, and a list of treatment protocols. Make sure he understands that the main aim is to cause as little tissue and nerve damage as possible, and for the procedure to take place as calmly as possible, with minimal pain. He will need to numb the area twice as much as he normally would, both before and after the extraction. I would strongly advise sedation, because anxiety can cause CRPS to worsen and there is more risk of spread. The risk of spread is what marks the risks to a CRPS patient out as different to someone with a heightened sensation of pain due to a nerve problem. My dentist had heard of that, but had not heard of CRPS - I had to explain the distinction.

The only other thing you can do is make sure she has some strong painkillers on hand for a week or more afterwards so that any post-extraction pain is kept under control. Might be worth a visit to her GP to discuss is he can give her something stronger than usual. Oh, and take 500mg vitamin C twice daily for at last a two weeks afterwards (with food), to help prevent spread.

Really good luck to her. Tell her to try not to panic - I've read quite a lot about this because I'm so scared of it, and I truly believe that if your dentist is prepared and the procedure is properly planned, everything should be ok.

Bram.