I posted this in Trigeminal Neuralgia too but thought maybe someone here can assist too.

In 2013, I had two cracked fillings (#5 & #14) replaced and ended up with TN. I saw a specialist who told me that I would eventually need root canals and I've been able to hold off until now. I was diagnosed with root sensitivity, irreversible pulpitis along with a fracture in #14.

I also have CRPS and needless to say, I am very nervous about seeing the endodontist next week. I have been able to keep the pain under control with medication until a month ago when a hard bump appeared in the gum. I want to make sure I provide the endodontist with information on both TN and CRPS. Is there any documentation that I could share with them?

I appreciate any information you can provide.

Were those fillings replaced with silver or white filling? I would skip the root canal and have it extracted.
What kind of tn symptoms do you have?

Replaced with white fillings. I have been thinking about having the teeth extracted but can't afford dental implants. I also don't want to set off the TN.

I have shooting pain that stems from near the ear and sends pain above the eye, cheek and jaw bones. I take Tegretol ER and it helps somewhat.

I had a feeling that was white filling. White filling should have never been used on the molar in the first place. I'm sure you paid a high dollar for that already? The abscess is due to infection that has already spread beyond the tooth. If the tooth is already fractured? Root canal should not even be attempted! The tooth is most likely already damaged beyond repair.

Hi HockeyMom,

I am going to re post some of your thread and answer you in bold type. It just makes it easier to follow.

<<In 2013, I had two cracked fillings (#5 & #14) replaced and ended up with TN.>>

WERE THE ORIGINAL FILLINGS SILVER COLORED (MERCURY) FILLINGS? DO YOU REMEMBER IF THE DENTIST JUST DRILLED THE FILLINGS OUT OR DID HE FOLLOW THE BIOLOGICAL SAFETY PROTOCOL? ALSO, WAS THERE ANY INDICATION OF TN PRIOR TO REPLACING THOSE FILLINGS? DID YOU SEE THE DENTIST AFTER THE FILLINGS FOR ANY BITE ADJUSTMENST?

<<I saw a specialist who told me that I would eventually need root canals and I've been able to hold off until now. I was diagnosed with root sensitivity, irreversible pulpitis along with a fracture in #14.>>

WHAT TYPE OF SPECIALIST DID YOU SEE, AN ENDODONTIST?
ROOT SENSITIVITY DOES NOT WARRANT A ROOT CANAL, HOWEVER, IT DOES INDICATE POSSIBLE GUM TISSUE RECESSION WHICH IS PROGRESSIVE IF THE CULPRIT OF THE PROBLEM IS NOT DIAGNOSED.
IRREVERSIBLE PULPITIS MEANS THE NERVES ARE INFLAMED AND BACTERIA IS SETTLING IN.
FRACTURED TEETH CAN SOMETIMES BECOME FUNCTIONAL IF THEY ARE COVERED BY A CROWN.
IF THE PULP IS INFECTED AND/OR THE FRACTURE IS BELOW THE GUM LINE AND/OR IS DEEP INTO THE INTERIOR OF THE TOOTH, THEN A CROWN OR A ROOT CANAL IS NOT GOING TO PREVENT FURTHER PROBLEMS WITH THE TOOTH.

<<I also have CRPS and needless to say, I am very nervous about seeing the endodontist next week.>>

HOW LONG HAVE YOU HAD CRPS AND DO YOU KNOW WHAT THE CAUSE OF IT IS?

<< I have been able to keep the pain under control with medication until a month ago when a hard bump appeared in the gum.>>

THE PAIN MEDS ARE SIMPLY COVERING THE SYMPTOMS. AS I MENTIONED ABOVE, PULPITIS AND CERTAIN FRACTURES IN TEETH WILL GET PROGRESSIVELY WORSE AND OBVIOUSLY THE INFLAMMATION AND INFECTION IS PROGRESSING. THE BUMP CAN BE A CYST OR THE FORMATION OF A HARD FISTULA.

<< I want to make sure I provide the endodontist with information on both TN and CRPS. Is there any documentation that I could share with them?>>

THE MAIN PROBLEM IS THAT THE ENDODONTIST IS MOST LIKELY GOING TO TRY TO SELL YOU ON ROOT CANAL THERAPY IRRELEVANT OF YOUR CRPS AND TN. WHY? BECAUSE HE MAY NOT REALLY CONSIDER ANY ASSOCIATION BETWEEN ROOT CANALED TEETH AND THOSE ISSUES SIMPLY BECAUSE HIS LIVELIHOOD IS PERFORMING ENDODONTIC THERAPY AND HE KNOWS THAT THE TEETH CAN ALWAYS BE REMOVED AT SOME POINT. THERE IS PLENTY OF INFORMATION CIRCULATING ABOUT SYSTEMIC HEALTH AND NON VITAL TEETH BUT IT IS COMPLICATED AND MOSTLY WRITTEN FOR THE EYES OF DENTAL AND MEDICAL PROFESSIONALS.

I DON'T KNOW WHAT YOUR EXACT CONCERNS ARE OTHER THAN THE CRPS AND TN OR IF YOU HAVE KNOWLEDGE ABOUT THE SYSTEMIC CONSEQUENCES OF RETAINING NON VITAL (RC) TEETH. SO HERE ARE SOME THINGS YOU CAN DISCUSS WITH THE ENDODONTIST THAT MAY OFFER YOU ENOUGH INFORMATION TO MAKE AN INFORMED DECISION AS TO HOW YOU ARE MOST COMFORTABLE PROCEEDING:

1) DOES A ROOT CANAL TREATMENT GUARANTEE THAT THE TEETH WILL BE HEALTHY AGAIN?
2) ARE ROOT CANALED TEETH STERILE AND COMPLETELY FREE OF BACTERIA?
3) DO TEETH NEED LIVE NERVES TO KEEP THEM FROM BECOMING VULNERABLE TO INFLAMMATION AND INFECTION?
4) WHAT IS THIS BUMP ON MY GUM AND WHAT CAUSED IT?
5) WHAT HAPPENS TO THE TISSUE AND BONE AROUND THE RC TOOTH IF THE TOOTH IS NOT ALIVE?
6) HOW WILL NON VITAL TEETH AFFECT MY CRPS AND TN?

I know this is a very difficult thing for you to go through. Keep in mind that retaining non vital teeth is similar to having a body part that has no circulation. Eventually the lack of blood supply in any affected area will affect areas beyond the original one. Extracting infected teeth have systemic risks also but extraction is the only way to remove the source of the infection. So you have to weigh out the information that you learn with what you feel is in your best interest. I'm sorry there is no easy answer here.

Perhaps before you make any decisions, you would consider consulting with a biological dentist as this is a dentist who considers how the teeth are intricately connected to the rest of the body. You can go to iaomt.org for a listing of these dentists and look for one near you.

I wish I could offer you more specific information but what you are seeking is just not readily available to the public.

I am responding in red text. I am mostly concerned about a flare of CRPS or the TN pain becoming worse than it already is. I have some of your questions already in my notes but will add the others. Thank you so much for taking the time to write a detailed response. I really appreciate it. I wish I could afford implants because I don't want gaps in my mouth if I have the teeth pulled but don't want pain either.

Hi Cleo,

Composite dental fillings, referred to as white fillings, are commonly used on posterior teeth because they are extremely durable. They intricately bond with the tooth making the restoration very strong.

May I ask why you think these fillings should never be used on posterior teeth?

Bryanna

Hi HockeyMom,

I can understand your concerns about the rc causing a flare up and possibly increasing the intensity of the TN. Both of which may or may not occur immediately after the rc procedure. However, they are both significant systemic risks which would stem from the inflammation and chronic infection that resides in root canaled (non vital) teeth. More than likely the endodontist is not going to discuss those issues with you in detail because that would be like admitting that root canal treatment renders the teeth unhealthy, even though that is exactly what the procedure does.

Regarding dental implants, due to your CRPS and TN, you may not be a good candidate for them for similar reasons to having the root canal treatment. The systemic associations with (rc) non vital teeth is a chronic burden on the immune system. Dental implants are a foreign substance that also irritates the immune system. So in someone who has a chronic condition like CRPS and/or TN going on, the added burden of any other chronic irritant could be too much for the immune system to handle.

It would be wise to discuss replacement options with your general dentist for both of those teeth should you decide to have them extracted. I cannot give you viable options here because I do not know the condition of the rest of your teeth, gums and oral health. Your dentist would need a recent full mouth series of xrays and he would need to do a complete comprehensive examination to offer you replacement options.

Bryanna

2 year life of the restoration didn't benefit the patient.

Cleo,

Composite fillings on posterior teeth should last 10+ years, even longer if the patients bite is in proper alignment. The only time they would need to be changed is if the tooth developed additional decay or the filling broke for some reason or they wore down due to a bruxing habit. Otherwise they are very durable, less toxic than mercury fillings and they actually bond with the tooth.

May I ask, what gave you the impression that these restorations had such a short life span?

Bryanna