I started having some dental work done last spring. Over time, my face has become numb (paresthesia). Symptoms include prickling, lack of taste, cold/hot, little electrical currents and some mild shooting pains when I tap my teeth together. Feels like my mouth and lips are covered with grease that has been mixed with sand. Not horrible pain, but constant (not intermittant) irritation. It feels somewhat like when anesthetic is wearing off, but it never does.

This has now been going on for over 7 months. Dentist has no ideas, oral surgeon has no ideas, PCP has no ideas, and neuro has not ideas. I had an MRI that was completely negative. I am wondering about a reaction to the anesthetic used?? This numbness goes from the outer corner of my right eye down my cheek across my upper and lower lip, chin, lower edge of nose and half way up the left cheek. It also includes my tongue, inner lips, and along the gingiva both upper and lower. It is really frustrating as food tastes like saw dust. With my eyes closed I can't tell if I am chewing filet mignon, chicken or rubber, not to mention the irritability it causes. I find myself constantly licking my lips and running my tongue around my mouth.

I am taking Vitamin B3, C, fish oil, CoQ10, garlic.

Anybody have ideas or suggestions?

Why B3?
What type of B3....straight niacin? or niacinamide?

If it is niacin, you could be having nerve symptoms ... it causes flushing and tingling. I would stop the B3 for a while and see what happens.

I'd get testing for B12. And see if you are low. Some paresthesias on the face are low calcium related to low Vit D status. So getting D tested is a good idea too.

The nerve distribution you describe sounds like trigeminal involvement. Did you get inhaled flu vaccine? Have you had chicken pox in the past? Herpes Zoster can activate and give pain symptoms without the rash. You can ask for blood work to measure Herpes titres to see if they are elevated.
Inhaled flu vaccine has been implicated in Bell's palsy which involves the trigeminal nerve. But your description is only sensory, which suggests shingles without rash.

I can't comment on the dental aspect of this, but I am sure Bryanna will be here when she gets a chance.

Haven't started the B3 yet, was just recommended by the oral surgeon on Friday, so not that.

Had flu shot, not nasal spray, so not that.

Bells Palsy has been ruled out, as has stroke, or anything to do with the brain or brain stem.

Have had chix pox, but no rash currently, so herpes zoster doubtful. Nobody has yet suggested that as a possibility.

Am seeing a specialist at Harvard next week.

Neuro says inflamed trigeminal 2 and 3. Question is why and what to do. Can't imagine that this might be permanent.

Zoster without rash is called Zoster sine herpete.

If you Google that you'll find some explanations.

One thing you can try, is when you see the doctor next:
Ask to try amitriptyline. In low doses, 10 or 25mg a day, this can help with nerve problems and healing. If it works, it points to an injury to the nerve or viral actions.

Have you tried ice on that side? Ice typically puts Herpes into
remission for some. 20 minutes tops... 2 or 3 times a day.

A diet high in arginine may encourage herpes to activate.L- Lysine helps quiet it. So taking some lysine may help. If it works, then viral cause is likely. Try 2 grams a day. You should see some effects within a week or two, if it is going to work.

Just to clarify, this is both sides of my face, not one sided. Googled Zoster sine herpete, but I have had no fever or illness at all - I very seldom get sick at all, so to me it seems unlikely, but...... Ice does not sound appealing, ironically heat sounds better, but I'll try anything. Heat hasn't helped. Will work on L-Lysine and talk with Dr. about amitriptyline and see what he says.

Actually the oral surgeon suggested the B3, as he said it has been shown to help CP when the nerves demylinate (sp?). He did say to start slow with 1000mg and that I could actually go up to maybe 5000mg if it seemd to be helping. He seems very knowledgeable about vitamin therapy. He said starting too high could make me light headed. I haven't started the niacin at all yet, its on my list to buy tomorrow.

Never heard about that.... B12 yes... B3 no.

5000mg of B3 is toxic to the liver over time.

I'd call him back and confirm.

B12 + folate and B6 help remyelinate nerves along with fish oil.

Not B3. You need to do some research on this. And get tested for B12 and Vit D deficiency. Something is not right here... some miscommunication or something.

A normally healthy person would not need 5000mg of niacin for anything! IMO

Hi breezy,

I would like to try to help you with this. I have some questions if you wouldn't mind answering...

1) What dental procedures did you have done and was any of it a re-do or re-treatment?

2) Were mercury (silver colored) fillings removed? Were special precautions taken to limit the exposure of the mercury?

3) Where in your mouth...what teeth?

4) What anesthetic did they use?

5) Were you ill just prior to having any of the dental work done or anytime during the work?

6) When did the sensations first begin... after the first injection... midway through treatment...?

7) Where did you notice the initial sensations, how long before it spread?

8) About how old are you? Just for outside chance it is something related to thyroid or hormones.

9) Have you ever had a negative reaction to a local anesthetic anyplace on your body? Or a long term effect... more than a few hours?

10) Did you have difficulty getting numb... did the dentist have to keep giving more anesthetic on any particular procedure?

Your description of your mouth and lips... grease and sand.... is one that I have not yet heard! I'm trying to imagine what that would feel like.

The fact that the sensation has crossed the mid-line would generally rule out anything in the shingles family. But I'm not completely sure about that.

I've sent a note to Stacy who is a member here and also a pharmacist. She may have some insight into the supplements and meds.... etc. I know Mrs D is concerned about the vitamin b3 and perhaps with good reason.

Look forward to your reply when you get the chance.
Bryanna

Okay, here goes:

1, 3 and 4. Dental procedures were on 30 and 21. # 30 had a crown and they (dentist and endo) decided it needed a root canal - unfortunately, the canal was calcified so after two sessions the endo decided that the tooth would fail as root canal - not possible. So tooth was extracted by oral surgeon with plan for an implant. That side of mouth has had a block 4 times (2 for rc, one for tooth extraction and one for implant insertion) - my understanding was that it was a long lasting block. I specifically asked and was told that articaine or septacaine was used. Each time it seemed that they had to use 3 cartridges for anesthetic doing both a block and then infiltration (I think it is called). On the other side, tooth #21 was part of a 3 unit bridge, so bridge was cut off and then options were a 4 unit bridge (as #21 was removed) or 2 implants. This side also was anesthetized 4 times again articaine was used.

2. No mercury

5. I never get ill, however, I had the flu shot this year and had a reaction that needed to be reported - hot flush, weakness, nausea about 3 hours after injection. Was fine the next day.

6. Seems like the anesthetic went away quickly and a few days later this tingling started and it has now been ongoing - since June after extraction. First it was on the right side only and now on both sides. Treatment has been ongoing.

7. Initial sensation was in right upper cheek near TMJ, but I am not good at recalling exact details. It gets confusing as I was seeing dentist, endo and oral surgeon and each was doing his thing.

8. I am 65 and I do have hypothyroid, which is under control.

9. I have never had a negative reaction to any anesthetic (was actually surprised by the reaction to the flu shot this year).

10. I did have difficulty getting numb and as I said above, oral surgeon used 3 cartridges each time. He seemed surprised at the lack of total numbness after 7 to 10 minutes.

The sensation is awful, again, not horribly painful, but irritating and the loss of taste is annoying. I keep chewing my cheeks and biting my tongue.

With the concern being expressed I'll hold on the B3 until I hear more. But, am sure he said niacin.

Also, have had 3 implants placed with bone graft on 20 and 21. # 20 implant failed and was removed along with the graft. In April oral surgeon is planning a bone graft from my lower jaw to the implant site. I am really concerned about having more dental work done, but at the moment I am having difficulty chewing the food that I cannot taste. It has been difficult and any help will be appreciated.

Thanks

Vaccine injury ...not good.

Vaccine injuries affect the nerves in some people.

This can be autoimmune, or it can be due to increased inflammatory cytokines that are stimulated by the adjuvants in the vaccines which continue at high level in some people after the initial vaccine injection. This is called a cytokine storm.

Anti-inflammatory response with steroids or NSAIDs may point to this type of inflammation and calm it. If you ask for a Medrol dospak, and it works some for you, that would point to inflammatory reactions.

If you would like to learn more about vaccine injuries and how they happen, Dr. Blaylock is very active in interpreting the medical data on this problem which is becoming very common lately with the push to get more and more vaccines.
If you are interested, check out all four of these YouTubes:
This is the link to the first one:
http://www.youtube.com/watch?v=--nWrqIspnQ
Part 2 after this, goes into how vaccine reactions can harm people.

We have had people on these forums who developed nerve damage following vaccines.

And do get the testing for B12 and D. If you use acid blocking drugs for long periods of time, OR, use Metformin daily, you could be low in B12 levels. You will want to know the results in numbers because testing lab ranges go LOW in US and you can have nerve damage at low "normals". New low level in recent medical CME's is now 400. When B12 goes low, nerve repair, cannot proceed well if at all. Your body can store about 5 yrs worth if you were doing well, but that varies from person to person. The blood tests are simple, and very useful. Many people are also low in Vit D and that upsets calcium metabolism and can cause paresthesias, as well.

I would NOT follow the Niacin B3 recommendation at this time until you clarify it. The doses you quote are however, in the range for oral B12 supplementation, and safe for B12. (not Niacin).

So far today we have two current posters with vaccine histories with painful Peripheral Neuropathic problems.
One from Adult Pertussis vaccine and one who received the H1N1...

This problem you have may initially be connected to your dental injections, and the injury may progress because of the inflammation going on in your body. But that is difficult to say.
Only...7 months is too long for an initial injury to heal, so something may be going on beyond it.

This is my B12 thread:
http://neurotalk.psychcentral.com/thread85103.html
Please look at it, as it explains, alot. And has medical links for you to read too.

We have a Vitamin forum here, that you can also visit, if you choose.

http://neurotalk.psychcentral.com/forum49.html
The net has many good sites you can research your Niacin issue.
I suggest this one to start:
http://lpi.oregonstate.edu/infocenter/vitamins/niacin/

There is a huge difference between Niacin and nicotinamide. So when you discuss this with the doctor please be precise and write down what he says. Nicotinamide is less problematic than Niacin (B3).