hello everyone...

I am a 55 year old female in good health

Dental history – in my early 20’s, I had my 4 wisdom teeth extracted – all extractions were done under local anesthetic - a hideous experience that still haunts me – the upper right tooth broke during the extraction and the dentist therefore had to ‘dig out’ the roots. I have been told (and seen on x –rays) since my current issue surfaced that a very small part was left behind, but advised this would not be the cause of my current problem.

Approximately 7-8 years ago, I had gum surgery as I did have a receeding gum issue that was at it’s worst in that area. I see the periodontist every year for a checkup and he is always pleased with my ongoing care and the state of my gums.

I do grind my teeth at night and have worn a mouth guard at night for the past 5 years.

My problem - 4 years ago, I started to notice a ‘leaking’ feeling in the upper right part of my mouth – it seemed to be coming from the upper back molar on RH side (sorry, I am not sure on tooth numbering). I would then take a little bit of extra care in flossing and it would subside. Then, one day it simply did not go away and has remained ever since along with the other symptoms that emerged.

This is my ‘pain in the face’ that runs and ruins my life – it is a dull ache that never goes away. It varies in intensity, sometimes escalates to a full on throb – occasionally, I will get the sudden ‘electric shock’ type jolts . But, it is always there, pushing, aching in the background. My tooth aches intermittently but the leaking , drainage from the tooth area has never gone away. This is accompanied by the most horrible tastes in my mouth –some days it is sharp and bitter and burns my tongue and mouth, other days it is sweet and salty, other days it tastes ‘phlegmy’ – some days the drainage feels thick and lumpy like phlegm also. If I suck in my mouth, I can feel the fluid drawing down from the tooth area. At night, if I lie on the left side of my face , I can feel it running down across my mouth – if I lie on my right side, the pressure builds up and wakes me up during the night with a numb face.

And so began my expensive, exhausting 4 year journey for an answer. My long term dentist (who has just retired now unfortunately) had been very patient with me. I initially had the old original fillings removed and replaced. However, she told me that I was ‘imagining’ the drainage/taste in my mouth. When I broke down and cried and cried and cried, she could then see how much this was impacting me. She thought it was possible that there is a crack in the tooth or a root fracture, and advised me if that is the case, it can take years for this to become apparent, if at all.

I have had my salivary glands checked, I have seen 2 ENTs – one diagnosed it as GERD and told me to not eat tomatoes and elevate my bed – I took GERD tablets that made me sick and did nothing else. I had sinus surgery as there was a polyp and I had a deviated septum – no change. I have had MRIs , CT scans....umpteen X rays ....nothing..nothing. The periodontist did a one of those full circle scans....nothing. I went to the TMJ specialist – he could find nothing wrong with my jaw other than it is a bit ‘clicky’ but could see that there is some nerve damage in my face as the right side of face has a bit of a ‘droop’. In between all these appointments, I give up and just live with it.

It hurts, day in, day out. It hurts when I smile, it hurts when I chew on something in just the wrong place , the drainage gets worse when I brush my teeth, it gets worse with stress with my job (I probably grind more at night when I am stressed. I cannot drink wine anymore as it reacts with the fluid and burns. I shy away from close contact with other people because I am certain that my breath must be really bad with all this and there is nothing I can do to stop it.

I am certain the drainage is coming from in between my back molar and the one next to it. The ONLY time it stopped for an extended period was when my dentist stuck some dental cement in between them when I explained that by wedging food in there or sticking chewing gum over there stopped it briefly.

I was referred to a facial pain specialist who diagnosed me with trigeminal neuropathic pain and advised there is little that can be done for this condition at present – I had some some success for the pain with capaiscin cream but the drainage continued of course. The specialist told me this was ‘adrenaline’ from the nerve, but I was not certain about that diagnosis.

That was over 1.5 years ago and I have just been dealing with it – whenever I get down and realize this is a life sentence, I will cry for hours.

About 2 months ago, the gum above the tooth was extremely painful and I was concerned that maybe an abscess was forming, so I went back to my dentist for a checkup. I found out she had just retired and I am now with a new dentist at the same practice, so all my records were available. I went through it all again – she was leaning more towards the crack possibility, so the filling was removed again, a temporary put in and put an orthodontic brace on the tooth – this has had no impact on the symptoms. She also referred me to an endodontist , who I saw the other day.

He listened carefully to my symptoms, did a few checks and an x ray. He informed me (and showed me) that the pulp in the tooth is very inflamed but there is no sign of infection. He was very interested in the drainage as he said he has had patients with tooth cracks describe this and he explained how if a cracked tooth flexes, it can draw in mouth fluid, and then when it expands again, the fluid is expelled. However, he could not see a crack but feels it is possible one of the roots is fractured and the crack may start near the gumline....

His recommendation is either one of 2 options – a root canal to remove the inflamed pulp – he feels that this is a trigger for the facial nerve pain and if it is removed, there is a ‘good chance’ the facial pain will subside (but as the facial nerve is obviously damaged, can’t guarantee it) but this would not solve the drainage/taste issue. It would then be likely a crown would be needed. The other option - the only likely way to stop the drainage issue would be extraction (but again, no guarantee of success)

When I told him I can live with the pain (I am used to it and can deal with it – heat packs, pain killers etc) and that the drainage/taste is what is my main concern , he said extraction is therefore a 'legitimate option'. I have asked over the past 4 years about the possibility of having my tooth extracted – everyone has advised against this and said there is no guarantee it will do anything and losing a tooth should only be a last resort. The endodontist also explained how extraction will then put more pressure on the next molar and similar issues may develop.

So, here I am now, being finally offered the option to have the tooth extracted. I do not want a root canal - I had already decided that before I went to see him. I know that, based on much reading over the past few years, that this can exacerbate trigeminal neuropathic pain. The root canal treatment is expensive and I have already spent approximately $5000 on surgery, appointments etc in the past 4 years and do not want to throw more money away.

If the tooth is extracted and it does not change a thing, at least the lingering doubt that has always been in my mind that the tooth is the cause will be gone. Or, I can continue to do nothing and once and for all, give it all up as a lost cause and resign myself that this will never go away and it is indeed a life sentence.

I am not asking for someone to tell me exactly what I should do – I would like to know if anyone has had anything similar to this or can give me any insight or an informed opnion.

Thankyou so much for reading this.