Amit,

I am going to re post some of your thread and answer in bold type.

<<My brother aged 35 went to see a dentist on 11th February,2014. He had a composite filling on his upper left sixth premolar which had broken. He visited the dentist .The dentist said it was a deep cavity but said there was still small space till the infection reached the pulp. Actually while drilling she hit the pulp nerve. She filled the deep cavity with GIC filling very tightly(I suppose). My brother complained of pain after 4-5 days. He went to the dentist again.She said,the pain would go away slowly. He waited for a month but the pain did not go away. He again went to the dentist.She said is the
pain unbearable ? He said No. So she said it is not required to remove it. He then kept filling for 3 months.>>

TO ME THIS SOUNDS LIKE THERE WAS INFECTION STARTING PRIOR TO THE DENTIST DOING THE FILLING BECAUSE IF SHE WAS ABLE TO GET INTO THE THE PULP THAT EASILY THAN THE DECAY HAD ALREADY PERFORATED IT. BECAUSE THE PERFORATION WAS SMALL SHE FIGURED SHE WOULD PUT IN SOME MEDICATED MATERIAL AND HOPE THE PULP TISSUE HEALED. HOWEVER, IF THE TOOTH WAS ALREADY INFECTED AS I SUSPECT IT WAS, THEN THE MEDICATED FILLING WAS NOT GOING TO HELP. SECONDLY, THE VIBRATIONS FROM THE DRILL AND THE PACKING OF THE FILLING MATERIAL WOULD HAVE CONTRIBUTED TO FURTHER TRAUMA OF THIS TOOTH WHICH IS WHY HE CONTINUED TO HAVE PAIN.

<<The pain passed into the back of the head (occipital nerves) and became severe. Finally he said I can no longer take this. He asked the dentist to remove it.She removed it. While extraction ,my brother said,he had a shock like sensation.>>

HE WAS GETTING REFERRED PAIN FROM THE TOOTH BEING INFLAMED AND PERHAPS SOME NERVES WERE OVER STIMULATED BY EITHER THE TRAUMA OF THE INITIAL DRILLING AND/OR THE EXTRACTION OF THE TOOTH. THE SHOCK SENSATION COULD HAVE OCCURRED FOR A NUMBER OF REASONS. IT COULD HAVE BEEN ACTUALLY AN INJECTION SHE GAVE HIM IN THE PALATE OR IN THE UPPER VESTIBULE ON THE FACIAL SIDE. SHE COULD HAVE INJECTED ANESTHETIC INTO THE SOCKET AS SHE WAS REMOVING OR JUST AFTER SHE REMOVED THE TOOTH WHICH COULD HAVE HIT A BUNDLE OF SKELETAL NERVES.

<<After removal,my brother had severe burning pain where the tooth existed and above it which went into the superior alveolar nerve . This pain was constant and unbearable. My brother visited an orofacial pain specialist in Mumbai. She took his history and diagnosed it as Trigeminal Deafferentation pain. She said the Central Nervous system is involved in this type of pain>>

YES, SHE COULD HAVE NICKED THE ANTERIOR OR POSTERIOR SUP ALVEOLAR NERVE IF THIS WAS AN UPPER PRE MOLAR AND ESPECIALLY IF THE NERVE WAS ALREADY INFLAMED. I WILL ATTACH A DIAGRAM OF THE NERVES SO YOU CAN SEE WHERE THEY ARE LOCATED AND YOU CAN ALSO SEE HOW EACH TOOTH IS INTRICATELY CONNECTED TO A NERVE THAT ALSO CONNECTS TO OTHER BUNDLES OF NERVES. I AM NOT WELL VERSED ENOUGH TO DISCUSS TRIGEMINAL PAIN DISORDERS IN GREAT DETAIL. HERE IS A VERY INFORMATIVE LINK THAT MAY HELP YOU OR HIM TO COMMUNICATE BETTER WITH HIS OROFACIAL PAIN DR....
https://www.dartmouth.edu/~dons/part_2/chapter_19.html

<<The pain specialist said this pain may abate or may last for a lifetime.My brother refused to get a nerve block done last year.He said he wanted to wait and try other methods. He also fears getting a nerve block. He also did not take a stent and a mixture of Lidocaine based anaesthetics to be applied topically which the pain specialist provided.>>

I CAN UNDERSTAND WHY HE WOULD HESITATE TO TAKE THE STENT AND NERVE BLOCK.

<<He has been trying some B vitamins (B6,B12,folic acid,myoinositol,L carnitine,Benfotiamine) for the last one year to see if nerve pain goes away. He has tried Pregabalin, Gabapentin, Amitriptyline - even antidepressant duloxetine but no effect. The pain has reduced but is still there. He is bearing it. I advised him to go to the pain specialist and get her Lidocaine based paste to be applied topically inside the stent.

VITAMIN B WORKS BEST WHEN IT IS TAKEN AS COMPLEX AND NOT AS INDIVIDUAL B'S. A VERY GOOD VITAMIN B SUPPLEMENT IS BY THORNE AND IT'S CALLED B COMPLEX #12. HE CAN TAKE 3 A DAY IF NEEDED. VITAMIN C IN DOSES TO BOWEL TOLERANCE, D3 MINIMUM OF 4000 IU'S A DAY ARE ALSO VERY HELPFUL FOR NERVE REPAIR. VITAMIN C SHOULD BE TAKEN AT 250 MGS AT THE ONSET AND THEN ANOTHER 250 6 HOURS LATER AND REPEAT AGAIN. IF THIS GOES WELL, THEN INCREASE TO 500 MGS 3 TIMES A DAY. ONE OF THE BEST VITAMIN C SUPPLEMENTS IN MY OPINION IS PERQUE POTENT C GUARD POWDER. IT IS ABSORBED EASILY AND YOU CAN REGULATE THE DOSAGE YOURSELF AS IT IS IN A POWDER FORM. I TAKE MY IN PLAIN WATER AND MY DAILY INTAKE AT THIS POINT IS 3000 MGS A DAY.

<<My brother complaints the dentist has destroyed his life. He says he wants to jump in front of a train and end his life and pain once and for all.>>

I IMAGINE HE IS VERY UPSET AND JUST WANTS THE PAIN TO STOP. HOWEVER HE HAS TO TAKE MEASURES EVERY DAT TO TRY TO REPAIR THE NERVES. IT MAY NEVER GO AWAY COMPLETELY OR IT COULD TAKE MONTHS OR YEARS TO CURE BUT THE SOONER HE GETS REGIMENTED WITH A PROTOCOL THE BETTER THE CHANCES WILL BE.

<<From what I have gotten off the internet, applying Lidocaine seems to be the only solution. But again the pain is inside in the nerve and the pallette has bone ,so Lidocaine cannot reach there,if at all in small amounts.>>

LIDOCAINE MAY BE HELPFUL IF USED TOPICALLY BUT IT IS NOT GOING TO REPAIR THE NERVES IN ANY WAY. IT IS ONLY MEANT TO DULL THE PAIN.

<<Are nerve blocks successful ? I have heard there are serious complications if not done properly including something called as ANAESTHESIA DOLOROSA which is painful numbness though very rare>>

NERVE BLOCKS ARE RESERVED FOR THE EXTREME CASES WHEN OTHER LESS INVASIVE TRIALS HAVE FAILED. THEY CAN WORK TO SOME DEGREE BUT THEY CAN ALSO ADD INSULT TO INJURY.

<<Bryanna, What is your advice on this ? The pain is burning pain which is felt in the superior alveolar nerve. My brother is extremely restless.>>

I RECOMMEND THAT HE SEEK HELP FROM A NUTRITIONIST OR AYURVEDIC PRACTITIONER. THEY WILL GUIDE HIM WITH NOT JUST SUPPLEMENTS AND FOOD BUT LIFESTYLE CHANGES TO HELP HIM RELAX HIS NERVOUS SYSTEM.