[danyell]

Hello, new here trying to find a bit of advice for a problem that seems mysterious to me.
Sun. night, I started having strong tooth pain on the top left hand side where I had received a root canal 2 years before in short intervals. In the
the morning I was mostly Normal with just a bit of pain throughout the day.Monday night it got stronger and only got 2-3 hours of sleep total, so I phoned the dentist first thing in the morning. Got appointment for the next afternoon. I began various home remedies to get me through to Wed. and was able to sleep a bit better Tuesday night.
On Wed. the pain was beginning to be unbearable with longer intervals. The Dentist after xrays and exams said there was nothing wrong with the root canal itself but it was probably infected beyond the tooth itself. She gave me antibiotics and said to come back Fri. Morning. Wed. evening I found something that seemed to dull the pain quite well, chewing raw garlic. I was able to get a bit of sleep. Thurs. the pain was almost constant and the garlic trick was losing effect. The pain was so intense that I rushed to the hospital Thurs. evening to see if I could at least get some stronger pain killers. The doctor there gave me injections around the tooth and another pain killer. Thurs. night I got home and my left upper jaw was numb, but somehow the pain persisted. I found that holding cold water in my mouth alleviated the pain substantially but could not do this while sleeping without choking. Again no sleep.
Fri. morning I returned to the dentist and had additional xrays and exams.at this point she told me the problem was not my tooth. She called in 2 other dentists to double check. They told me I need to see a neurologist. At the hospital The neurologist after exams prescribed me with carbamazepine 200mg. And told me to try it for awhile to see if it helps but as far as they can tell. The Problem is unlikely to be alleviated, and I'd better go back to the dentist. Now 1 night after beginning carbamazepine and 3 nights after beginning antibiotics, the pain was still strong but substantially less and seemed to be respondiwell
to pain killers which before were doing absolutely nothing. The most mysterious thing is that the pain seems to have switched teeth from top to bottom. The top root canal tooth feels almost normal whereas now it is the second wisdom tooth from the outside on the lower jaw that has pain.
I should also add that I am currently living in Germany with only rudimentary knowledge of the German language, which only adds to my confusion as not every doctor speaks perfect English.
Anyways I'm happy to finally have some relief but I am not at this point sure if it was the antibiotic or the carbamazepine that is helping
. I am also unsure how to proceed, if I need to go back to the dentist next week or should I see my gp or another doctor...

[Bryanna]

Hi danyell,

I am in the dental field and can offer you some information here.

#1) There is no mystery regarding the pain that you had or have in the root canaled tooth because all root canaled teeth harbor dead nerve tissue in the hundreds of microscopic canals that cannot be removed during the rc procedure. This nerve tissue becomes infected and eventually the infection spreads beyond the tooth. So your original symptoms on sunday night and the progression and intensity of the pain is typical of an infected or a root canaled tooth. For the dentist to say the root canal is fine simply means radio-graphically it looks like the rc procedure was done well. However do not mistake that to mean that the tooth is healthy. For her to tell you that there is infection beyond the tooth DOES mean that the tooth is infected and the infection has spread beyond the tooth.

2) Antibiotics cannot cure this infection because it is caused by the trapped nerve tissue inside of the microscopic canals. Re treating the tooth with another root canal or having a surgical root canal called an apicoectomy will not favorably alter the status of the infection because the tiny canals are not accessible.

3)The garlic did not reach the infection in the tooth or the bone. But it did temporarily boost the immune system to reduce the inflammation.

4) The antibiotic may temporarily subside the inflammation and reduce the pain. But those meds cannot get into the areas of the tooth that harbor the infectious bacteria nor can they cure the infection that has spread beyond the tooth because the infected tooth is what is keeping the infection very much active.

5) Carbamazepine is an anti seizure medication and is prescribed in cases that are definitively diagnosed as nerualgia. It dulls the pain because that is what the drug is meant to do. However, it is most certain that the infected tooth and infection beyond the tooth is the cause of the pain and taking this drug is not going to cure the infection.

6) You may have also something going on with your lower wisdom tooth, that should be xrayed. However, it is likely the pain from the upper infection is traveling down along the different nerve meridans which is typically seen in dentistry.

Here lies the problem and why the 3 dentists came up with the same conclusion. Dentists lack systemic knowledge beyond their dental curriculum and because they are taught to "save" teeth with root canals, unless they see evidence of a botched root canal procedure, they automatically assume the tooth is fine and the infection is miraculously coming from some other source. Unfortunately this short changes the patient because the cause of the problem is not removed in time to prevent further progression of the infection. The only means of eradicating the infection is to remove the source which is the tooth.

Is it possible for you to be referred to an english speaking oral surgeon? As that is the specialist that you would need to see to remove this tooth.

Please take a look at this link of a book written by Dr George Meinig a former endodontist. The link allows you to open the book and read the preface and first several pages. It will explain everything I have said here.

http://www.amazon.com/Root-Canal-Cov...+george+meinig

Please let us know how you are doing.
Bryanna





QUOTE=danyell;1141237]Hello, new here trying to find a bit of advice for a problem that seems mysterious to me.
Sun. night, I started having strong tooth pain on the top left hand side where I had received a root canal 2 years before in short intervals. In the
the morning I was mostly Normal with just a bit of pain throughout the day.Monday night it got stronger and only got 2-3 hours of sleep total, so I phoned the dentist first thing in the morning. Got appointment for the next afternoon. I began various home remedies to get me through to Wed. and was able to sleep a bit better Tuesday night.
On Wed. the pain was beginning to be unbearable with longer intervals. The Dentist after xrays and exams said there was nothing wrong with the root canal itself but it was probably infected beyond the tooth itself. She gave me antibiotics and said to come back Fri. Morning. Wed. evening I found something that seemed to dull the pain quite well, chewing raw garlic. I was able to get a bit of sleep. Thurs. the pain was almost constant and the garlic trick was losing effect. The pain was so intense that I rushed to the hospital Thurs. evening to see if I could at least get some stronger pain killers. The doctor there gave me injections around the tooth and another pain killer. Thurs. night I got home and my left upper jaw was numb, but somehow the pain persisted. I found that holding cold water in my mouth alleviated the pain substantially but could not do this while sleeping without choking. Again no sleep.
Fri. morning I returned to the dentist and had additional xrays and exams.at this point she told me the problem was not my tooth. She called in 2 other dentists to double check. They told me I need to see a neurologist. At the hospital The neurologist after exams prescribed me with carbamazepine 200mg. And told me to try it for awhile to see if it helps but as far as they can tell. The Problem is unlikely to be alleviated, and I'd better go back to the dentist. Now 1 night after beginning carbamazepine and 3 nights after beginning antibiotics, the pain was still strong but substantially less and seemed to be respondiwell
to pain killers which before were doing absolutely nothing. The most mysterious thing is that the pain seems to have switched teeth from top to bottom. The top root canal tooth feels almost normal whereas now it is the second wisdom tooth from the outside on the lower jaw that has pain.
I should also add that I am currently living in Germany with only rudimentary knowledge of the German language, which only adds to my confusion as not every doctor speaks perfect English.
Anyways I'm happy to finally have some relief but I am not at this point sure if it was the antibiotic or the carbamazepine that is helping
. I am also unsure how to proceed, if I need to go back to the dentist next week or should I see my gp or another doctor...[/QUOTE]

[danyell]

Thank yours much for writing such detailed help.
I am now on my second day being mostly pain free, with just sensitivity on the lower wisdom tooth I mentioned. I am attempting today to discontinue taking the carbamazepine. To see whether it was that or the antibiotics that are giving me relief.
After reading your response I remember the doctor at the hospital(who was an oral surgeon/specialist) who I saw briefly, after looking at my xrays mentioned that even though the antibiotics should kill the infection enough to relieve the pain I would in a couple of months need some kind of operation on my upper jaw to completely fix the problem.
I think I was delirious from the pain medication and overwhelmed from the pain and somehow forgot this advice.
Perhaps the best thing would be to try to get another appointment with this doctor instead of my dentist.
At the moment I am relieved to be mostly pain free as that probably the most excruciating I have endured.
Thank you again for your help.

[Bryanna]

Hi danyell,

Yes, the meds will temporarily relieve the pain because they reduce the inflammation. But once any lingering effects of the meds wears off the inflammation will return because the infection is coming from the root canaled tooth which can only be eradicated if the tooth were removed.

The oral surgeon who mentioned a surgical procedure was referring to an apicoectomy. This is basically a surgical root canal. However, it accomplishes the same thing as a conventional root canal with the exception that it involves making an incision and hole in the jaw bone above the root of the tooth and instruments are then put into the tooth from the root down... as opposed to the instruments being put in from the biting surface of the tooth up towards the root tip. The apicoectomy does not solve the infection that resides inside of the many hundreds of microscopic canals as they remain inaccessible. The apicoectomy removes some of the cystic infection at the tip of the root but that infection will reoccur because the tooth is infected. I hope I have explained that clearly for you.

Did you take a look at the book by Dr Meinig? He explains this whole thing really well since he was an endodontist who not only performed root canals but taught students how to perform them. He also was one of the founders of the endodontic society. So he knew everything there is to know about root canals and was not shy about sharing the information. I think you would find it helpful.

I hope you remain pain free until you can get this problem resolved.

Bryanna

Originally Posted by danyell

Thank yours much for writing such detailed help.
I am now on my second day being mostly pain free, with just sensitivity on the lower wisdom tooth I mentioned. I am attempting today to discontinue taking the carbamazepine. To see whether it was that or the antibiotics that are giving me relief.
After reading your response I remember the doctor at the hospital(who was an oral surgeon/specialist) who I saw briefly, after looking at my xrays mentioned that even though the antibiotics should kill the infection enough to relieve the pain I would in a couple of months need some kind of operation on my upper jaw to completely fix the problem.
I think I was delirious from the pain medication and overwhelmed from the pain and somehow forgot this advice.
Perhaps the best thing would be to try to get another appointment with this doctor instead of my dentist.
At the moment I am relieved to be mostly pain free as that probably the most excruciating I have endured.
Thank you again for your help.