Trigeminal Deafferentation pain after premolar extraction -it's been 1.5 years
 

Bryanna,

I have never heard of anything like this. I wish to ask if you are aware of anything like this.

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.

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.

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.

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.

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.

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.

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.

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 .

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.


Regards,
Amit.

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.

This sounds horrible. I had heavy duty pain after a dental procedure three years ago. I had zero pain going into the procedure. It went from bad to worse. I too asked a dentist to pull the tooth, out of desperation. This did not help at all.

After trying many medications that either didn't work or had too many side effects, I ended up having a cream made especially for me that I rub on my jaw and ear area 3-4 x a day and the back of my neck 1x a day. In this cream is lidocaine, Capsaisin and Gabapentin. The cream is made by a compounding pharmacy and requires a doctor's prescription. Much less side effects using a cream like this...but this (a customized cream) is not available everywhere.

I also take certain tablets (pills) by mouth. One is Desipramine (most folks take Elavil) and I also take Baclofen. All of this has really helped me. (I'm taking five medications)

Very generally, the two or three meds that seem to help many folks with this type of situation are: Gabapentin, Elavil and Baclofen. I've seen these meds mentioned over and over again and folks getting varying degrees of pain relief. Some people do well on just one medication. It seems your brother has tried some of these..he might need a different dosage or various combinations of meds. Again, I take five medications for this pain.

There is a lidocaine applicator for inside the mouth called Kanka that is a little helpful. You can get it on amazon.

Good that he is taking these vitamins. I have found the B's (a good B multi plus extra B12 and magnesium possibly a little helpful, I'm not sure) I also did acupuncture, which helped a little...but ended up being expensive and only helped a very small amount.

I have known people who have attempted suicide from this pain. It is not to be taken lightly. If he is not getting better, he WILL need meds to help with pain relief ASAP.

I personally think time and medication has made my pain more controllable.

It might be a matter of trial and error with the meds, plus time.

Sending healing thoughts. Check out the TRigeminal Neuralgia site here for possibly more insight.

Diagram of trigeminal nerves
 

Amit,
Here is the diagram showing the trigeminal nerves and how they connect to nerves that branch off of the teeth.

I stay in Mumbai,India. Thorne supplements are available here. They are imported from US.There are Indian brands also.

My brother has some questions ON VITAMINS.

The good thing about Thorne is it does not have Folic acid. It has Methyl folate. I have heard folic acid is dangerous if taken for long time in large amounts.

Can somebody tell the safe level of folic acid per day for men ?
In India,all Vitamin B supplements have 1.5 mg or atleast 1 mg of folic acid per pill in them. The RDA is just in micrograms Is this safe ? My brother fears taking B complex because of this.

Also,Is cyanacobalamin (form of vit B12) safe or is METHYLCOBALAMIN safe ? There are many B complex vitamins with cyanacobalamin that are dirt cheap here but dont know if they are safe ? I READ IT HAS CYANIDE MOLECULE WHICH IS POISON.

I dont know if Bryanna can answer these but these are questions my brother has in his mind about vitamins.

One more thing.
I did not get why you have asked to take Vit C and Vit D. Do they help in nerve repair or regeneration. From what I have learnt,it is just vitamin B that is useful.

Vit D is for bones and calcium absorption and Vit C is an antioxidant from what I know.

-Amit.

Hi Amit,

First let me explain that when someone is very healthy with NO genetic, auto immune or chronic problems, they live a happy, peaceful, stress free and active lifestyle and their diet is impeccably clean and nutritious, their need for daily vitamin and mineral supplementation will be minimum. Anyone outside of those categories, would most likely benefit from supplementation and the individual needs will vary. It is unfortunate that most of the population probably falls into the category of needing help. So when something goes awry such as a dental problem that involves infection, inflammation and nerve pain, the need for help increases.

As you are aware, everything that goes on in the mouth has a systemic affect on the entire body. Therefore, it's important to nurture the whole body and not just that one tiny area of his mouth. As you can see by the "nerve" diagram that I provided, the nerves are all intricately connected and that connection does not stop at the face, head, or neck. It travels throughout the body.

I personally use and recommend Thorne and Perque brands as the quality is consistently remarkable compared to most other brands. I also use and recommend Biotics Research Bio D Mulsion Forte as I have found it to be the most readily absorbed form of supplemental vitamin D.

B vitamins are water soluble meaning the body utilizes what it needs and then excretes what is left over. Therefore it is beneficial to supplement with it 2-3 times a day. Providing that the quality of the supplement is pure and without toxic chemical fillers, etc, (as with Thorne products) a vitamin B complex is very safe to take in high dosages for long periods of time for both men and women. When you take B vitamins in a complex form, they work synergistically to compliment the digestion and absorption of each other which actually reduces the likelihood of any unpleasant side effects. When just taken singularly, there is no synergistic affect and that is when absorption is poor and unpleasant temporary side effects can occur. So it always makes sense to take B vitamins in a complex form. You can always add more of a singular B to the complex if needed.

Vitamin C is a water soluble vitamin as well and the body excretes vitamin C rapidly. Therefore it is beneficial to supplement with it a few times a day. It is essential to every living organism in the body to have plenty of vitamin C circulating throughout the body on a continual basis. Vit C acts as a catalyst which means it increases the rate of a chemical reaction such as absorption of other vitamins and minerals without changing it's own chemical structure. So when you take vitamin C, you not only get the benefit of the absorption of other nutrients, you get the full anti oxidant benefit of the C itself.

Vitamin D is extremely influential and beneficial to nearly every single cell of the body, not just the bones. Vitamin D3 is cholecalciferol which is the natural form of D that we obtain from sunlight. This form of D is virtually non toxic as compared to the synthetic form of D2 which is toxic. However, the blood levels of vitamin D should be tested with a specific blood test called 25 (OH) D every 3 months during high dosage supplementation until the optimal blood levels are achieved. Then the daily dosage can be lowered and monitored once a year. The most easily and readily absorbed supplement form of Vit D3 is via an emulsified liquid as it gets into the blood stream quicker than pill form and can be taken once a day with a fatty meal or on a spoon in olive oil for best absorption.

When you take supplements that compliment each other, as B, C and D do, you get the full benefit of each supplement. When you have trauma or injury that involves the nervous system, you need to not only rescue the area that has been affected but you need to nurture the rest of the body so it can help repair and rejuvenate the injured area to be well again. Focusing on the symptom rather than the deeply connected causes and contributing factors of it, only serves as a topical and temporary solution. This is why using medications or surgery alone without proper nutrition and nurturing of the systemic connections will not be able to cure the problem.

Amit, I am curious... how is the health of the rest of his teeth? Does he see a dentist regularly or just when something hurts? Does he have root canaled teeth or periodontal disease?

Bryanna

My brother's oral health is absolutely fine - no root canaled teeth or periodontal disease.

He is obese.

He has mild depression and severe anxiety . He used to take Clonazepam (benzo) for that. He took it for 6 months. But that was 4-5 years back.He stopped it because he felt hew might get addicted . He had horrible time coming off it - withdrawal symptoms.

He takes Escitalopram SSRI 10 mg for depression. He tried duloxetine for pain but that did not work.So he reverted back to his favourite- escitalopram.


He took Nuhenz as advised by a neuro here (twice a day) by La Renon for 2.5 months - www.larenon.com

NUHENZ
mecobalamin 1500 mcg,
Alpha lipoic acid 200 mg,
Benfotiamine 200 mg,
Folic acid 1.5 mg,
Chromium polynicotinate 200 mg,
Myo-inositol 100 mg,
Pyridoxine hydrochloride 3 mg.


He also tried Becosules (Vitamin B complex) by Pfizer once a day for 1.5 month - http://www.pfizerindia.com
He was taking Mecobalamin (vit B12) separately 1500 mcg twice daily during this time. He takes this even now.

Becosules :
Calcium pantothenate 50 mg,
Vitamin B12 15 mcg,
Folic acid 1.5 mg,
Thiamine mononitrate 10 mg,
Riboflavin 10 mg,
Pyridoxine hydrochloride 3 mg,
Niacinamide 100 mg,
Vitamin C as Ascorbic acid 150 mg,
Biotin 100 mcg,

Becosules is a very famous brand in India by Pfizer (it is actually American).
Is the folic acid content of 1.5 mg OK for long term use ?

He is not sure how long to take vit B complex ,vit C.

He just takes a Becosules pill sometimes nowadays and a Vit B12 pill. But he is not taking any Vit C supplement.

Regards,
Amit.

It is very, super, incredibly interesting Amitsa that your brother has no root canalled teeth. My tooth wasn't root canalled, but I had others that were. I don't think it had anything to do with root canaled teeth. And I had very good oral hygeine as well and went for my cleanings religiously every six months.

Again, I have found medication and time to be very helpful with this nerve pain. Vitamins and good, clean eating has helped somewhat as well.

Blessings.

Vowel Lady,

I've talked about the correlation between infected teeth and nerve irritation many times on this forum. Infected teeth do not have to be root canaled, although that is often the case. They can have deep decay as a source of the infection as was the case in the brother of Amit.

Tooth decay takes time, months or even years, to become deep. Therefore someone can have (unknowingly) for a long time. In that time frame, bacteria would begin to migrate in the area around that tooth maybe even as far as into the alveolar nerves. Therefore, when the tooth is extracted there is already infection and inflammation occurring. Any extraction of an infected tooth, root canaled or not, is more complicated than extracting a tooth that was not infected. An example of a tooth needing to be extracted other than root canaled or infected .... a fractured tooth, a recently broken or injured tooth, or teeth removed for orthodontics.

Perhaps you could share the reasoning as to why you needed to have teeth root canaled since your oral hygiene was very good and you had routine dental care every 6 months? What happened to the teeth that ended up root canaled?

Bryanna

Hi Amit,

Thank you for sharing that information regarding your brother. It sounds like he has some difficulties that he's been experiencing and it's really kind of you to try so hard to help him :)

Regarding his health, I would be remiss if I didn't mention to you that obesity is a health problem. People who are obese are often malnourished due the excessive high calorie, high sugar, and low nutrient rich foods in their diet. One does not need to be thin to be malnourished as it is the quality of the food that predisposes someone to malnutrition, not the quantity.

In the medical profession known as Functional Medicine, obese people generally have what they refer to as "diabesity". This is a term that references obesity to common health complications such as diabetes, elevated blood sugar and blood pressure and elevated bad LDL cholesterol. These things are normally found in obese people because their diets are poor, their activity level is lacking, their self esteem is low and their organs are working way too hard.

It is interesting how many people tend to try an overlook their own or someone elses obesity problem. I personally think we do that because we have become accustomed to seeing so many obese people that it just seems normal. But the fact is, obesity is a huge health concern.

I don't know if you are aware of this or not, so I will share it with you. Your brothers mental health problems are commonly found in people with diets lacking in nutrition. Some mental health issues are genetic, but a family member is most likely to only experience those issues to any disabling degree when they are nutrient deficient. The medications that are given can only mask the symptoms of the mental illness as they do not in any way alter the deficiencies that are present. This is one reason why the meds only work for a period time before they are increased or changed or new ones are added to the regimen.

You are asking me if a particular dosage of a vitamin is adequate or perhaps too much for him. In all honestly, due to his obesity there is no supplement or amount of supplements that are going to be of much help to him for the long term even just pertaining to the nerve pain. The reason being is that he is most likely severely deficient in many vitamins, minerals, enzymes, etc. Truly the best thing he can do is get help to lose the weight, eat healthier meals and exercise. Initially this will be hard, but once he sees a positive change and that will occur quickly, he will feel SO much better.

Regarding the Becosules supplements, they are an over the counter drug made by a pharmaceutical company. The ingredients used to make their products are sourced from chemicals, not food or any other naturally occurring substance.

I sincerely suggest that he seek help from a Nutritionist and/or an Ayurvedic Physician. I hope that you can maybe help him with that :)

People don't realize how inflamed their bodies, organs and central nervous system is when they are obese. I wish I could offer you more, but he needs to address his obesity and vitamin/mineral deficiencies as they are all contributing factors to his non healing nerve pain. Otherwise he is going to be prescribed an arsenal of medications that at best will only give him some temporary relief.

I hope I have not offended you, him or anyone else. My intentions are sincerely to offer you helpful recommendations and guidance.

Bryanna

Vowel Lady,

Yes.You are right. It has nothing to do with root canaled teeth. My brother talked to the orofacial pain specialist. What she said is really surprising.

The specialist explained to him in layman's terms.
She said that the alveolar nerve tip was possibly compressed and damaged . Since the filling was for 3 months,she says that the nerve there has been trained to act that way. My brother OFTEN tells me he feels as if the filling still exists (the nerves give him that feeling) whereas the tooth has been extracted. The pain specialist told me the nerves have been trained that way .

But I just wonder. For all the 34 years in his life,his nerve was trained to be quiet and how come in 3 months ,it has learnt to create a burning pain for such a long time.

Amit,

I may be able to offer you some insight as to why it's hard to understand how this pain could be "trained" to now occur all of sudden.......

<<But I just wonder. For all the 34 years in his life,his nerve was trained to be quiet and how come in 3 months ,it has learnt to create a burning pain for such a long time>>

Yes, his nerve was silent when his tooth was healthy. However, that all changed when the decay in his tooth became deep enough to reach the pulp tissue. Tooth decay is a bacterial infection and it causes inflammation to occur in the tooth. The progression of tooth decay is fairly slow as it takes weeks, months, and sometimes even years to reach the pulp. As the decay progresses, the tooth becomes more and more inflamed. This inflammation eventually progresses to the nerves extending from the tooth. When the doctor said that the nerve was being trained to react with pain she was referring to the chronic irritation that the inflammation was causing the alveolar nerve. Keeping the tooth for instance with a root canal procedure would have contributed to further infection and further inflammation because that procedure does nothing to repair an inflamed alveolar nerve. Removing the tooth also removed the original source of the problem which is a positive thing as it stopped the progression of bacteria and at least gives the irritated alveolar nerves a chance to get better. However, the surgery to remove the tooth was unavoidably irritating to the already inflamed nerves due to the intricate connection between the tooth and the alveolar nerves.

Ideally his pain will become non existent in a short amount of time. But unfortunately no one can determine the longevity of it and it may not happen all on its own. If "any type" of healing is to occur, it has to come from measures that he takes to purposely repair and rejuvenate the nerves. Not just that nerve, but his nervous system in general as they all work synergistically throughout the body. This is where nutrition and nutrient supplementation comes into the picture. Just taking medications may help but at best that will be short lived and then they will need to be increased or changed. Similarly to what he has experienced with his anti depressant meds in the past. Drugs can be used in combination with a whole body healing program. But he needs to be guided by a practitioner who can take him on a wellness journey for the betterment of his health and one who can also work with the pain management doctor along the way.

I know you understand what I am saying about healing the body and how important healing is in order to be a healthy person as you are trying to do that with yourself.

I truly wish you and your brother all the best.

Hi Amitsa, I suspect, in my case, there was trauma to the nerve by one, possibly more than one dentist.

It's very difficult to say what happened in my case and probably that of your brother's case as well.

It's been my experience that most dentists and even dental professionals like surgeons, have limited experience, education and knowledge when it comes to nerve damage. Sometimes they even become frightened, because they are afraid of lawsuits. All of this together, tends to cause lots of misinformation.

I was very lucky because the last dental professional I saw about my severe nerve pain was an oral surgeon who by luck was also a MD (Medical Doctor). He apologized for the dental profession and told me to see a neurologist.

After it happened, I saw other dentists, but they did not help me and may have made my pain worse. Thank goodness the oral surgeon/MD told me to see neurologist.

My neurologist is wonderful and has helped me greatly.

I don't know why the nerve is causing so much pain for your brother. Trauma is a possibility. Has the neurologist offered an opinion?

I think based on my own treatment and that I have seen with many others, it usually seems to take trial and error with medications and time. Of course, much patience is needed with such bad pain. Whatever you do, don't let him pull any more teeth because of this (unless there is clearly something wrong with the tooth).

I also think taking good vitamins and eating in a healthy manner can lesson severe pain to a certain extent. This pain is too severe to rely on this alone, but every little bit helps. I suspect the nerve might be able to heal or at least partially heal over time, so I'm trying to give my nerve/ body the best environment to heal as best as it is able. I've greatly reduced eating sweets, for example and don't eat junk food. I also eat a LOt of vegetables and drink a lot of,water. Every little bit helps on this road to recovery.

Your brother is very fortunate to have you by his side. I hope he can find a treatment plan that will help him to feel much better. And good thoughts that in time, he will be healed.

There is a section here called "Trigeminal Neuralgia," where you can get more information. Some people have pain that is more "atypical." Sometimes it is called facial neuralgia, etc. but it still involves that extremely bad pain of the Trigeminal nerve in the facial area.

Trigeminal neuralgia is a condition associated with a nerve compressed by a vessel or vein at the brain stem and is not the same as nerve trauma induced by dental infection, procedure, ect...

What was the age of the restoration before cracking off?

I didn't read that burning nerve pain was present prior to the procedure that exposed the pulp. Did the burning nerve pain start when the filling cracked?

Did xray indicate GIC in the pulp chamber or beyond? Did you see the condition of the tooth after it was extracted? Was there bone necrosis?

Cleo,

The age of the restoration before cracking off was 3 years.

There was no burning pain or any pain even slightest when the previously existed filling fell off.

When the dentist removed the existing filling(which was composite) ,she said there was more decay . So she drilled to remove it. My brother said,she hit the nerve while drilling.

She then applied some ozone or something .She used GIC filling over the exposed pulp (or may be near to it) . She said in due course of time,there would be a calcified layer developed above the GIC filling.

Nothing of that sort happened. My brother developed pain within a month in the occipital region on the side of the tooth (left side) so severe he says he cannot describe it. The pain in the occipital region decreased slowly after the tooth was extracted. There is still pain in the occipital region but not severe. It is very less.

No,GIC filling was uptot he start of the pulp chamber but not beyond.
There is no bone necrosis I think. Atleast the OPG done a few months back did not show anything. I know OPG cannot conclusively tell that. A cone beam CT will be required.

The pain in the alveolar nerve just above the tooth is what is bothering .

It is due to trauma to the nerve while drilling and the filling 100%. No doubt abt it. It is burning pain along the path of the nerve.

I myself have never seen such a thing. I am myself surprised.

Regards,
Amit.

I know I am jumping in the middle of this but I have to say that Trauma from dental work dose cause t.n. be it from drilling to deep or tugging to much and digging to retrieve broken off bits tooth BUT ALSO infection that travels from abscessed tooth or even a sinus infection CAN travel all those also be the cause of damage to the Trig nerve and or the occipital nerve .If i have a serious infection I must be very careful and get on antibiotic because if the infection worsens it CAN travel to my leads in my lower jaw and I would have to remove my neuro stim and get rid of infection! This is a fact!!!!! if the burning pain is still affecting Amit's brother I would see a neuro doc if it last more then 3 months. I DO take vit b and vit C and D the vit B mostly for my nerves . Vit B was the first thing my gp and my neuro told me to take form nerve health. There are many people who have gotten nerve damage and face pain... t.n. at.n. etc from dental work sometime ones have had unnecessary work done and or teeth pulled hoping it will stop the pain and it only makes things worse. so If you think your brother has tn or nerve damage He should go to a neuro and there maybe have MRI and that may help see if there is compression or damage to the nerve. there are plenty of meds to help if it is t.n. or o.n. there is hope so do not give up.. if you have questions about T.N. please visit our t.n. forum http://neurotalk.psychcentral.com/forum26.html and post questions I will be glad to help.:grouphug: PEACE BMW

3 year shelf life of an expensive composite filling is why amalgam is still be being used in the USA today.

He may have had better luck had the tooth been removed instead of tampered with in the first place. removal of the tooth in the first week after the insult may have resulted in better outcome also. You didn't mention the condition of the extracted tooth?

I have a traumatic trigeminal (mandibular) nerve injury due to a bad day at the dentist over a decade ago. The type of pain I have is known as anesthesia dolorosa or dysesthesia depending on which doctor I was with. Nerve healing (neuroregeneration) in my case is over.

Nerve block didn't kill the pain of my nerve damage and neither did topical lidocaine.

I thought TDP was usually a diagnosis made upon the result of intentional nerve destruction procedures designed for the classic form of trigeminal neuralgia. Maybe where you live it has a different meaning?

Vowel Lady,

You mentioned Magnesium is very vital for such a case. Is 400 mg Magnesium supplement daily sufficient or is it too much ?


Regards,
Amit.

Cleo :hug: you kinda know my story and my face pain is from face slamed into windshield and steering wheel my lower jaws snapped and broken on each side... plates n screws on both sides of lower jaw.... I AGREE 200% with your post especially the last statement of it being called something different where you live. I will even say it depends on what Doctor you see too. I have been told I have T.N. then when pain didnt go away but got worse I was told A.D anesthesia dolorosa got the neuro stim aka PNS then told I dont have TN or A.D. I really had RSD which freaked me out because I had been doing and getting support for T.N. and I felt like a phony like why am I in the T.N. forum ...I should be in the RSD forums... So did research for sure its NOT RSD . Then new oral surgeon told me I have A.D. Ha Ha Ha. Stuck with that for quite a long time. Then ugh ya know Cleo just recently that MVD issue with the TNA . I read and did searches n stuff. I was told I have classic T.N. SO I just said in nice term w.t.h. none of the docs neuros surgeons really knows what to call it. I am just going with I have T.N. face pain due to head and facial trauma treatment / PNS implant. I am just done trying to keep up with all the switching and changing of names to call it. Its nerve damage. Once ya got it who cares what they call it. I think if you have multiple. Surgeries to purposely injury the nerve your paying the docs to give you A.D. because the more the nerve is manipulated the more permanent damage can and is usually done leading to... A.D. So for me and how I look at other people with face pain ... it is what it is a ugly crappy pain monster. Call it whatever you want . It dosent matter to me . Also I know my injured nerve willnot regrow but taking vit B had helped over time with my nerve misfiring . So I keep taking to stay healthy . Not because I am trying to grow or fix my permanently damaged nerve. A bad sinus infection could mess me up . Infection is at the top of my list of NOT to get. Sending low pain to everyone :grouphug:. PEACE BMW

Tooth decay... amalgam vs composite
 

Cleo,

The filling broke because the tooth was decaying. Not because it was a faulty restoration. Dental decay progresses slowly which means for it to be deep near the pulp, as Amit stated it was, then the tooth was decaying for quite some time. Not everyone has symptoms, or pays attention to mild symptoms, of a tooth problem until the decay gets close to the pulp. If this person was under preventive care with a dentist who was taking check up xrays once a year, this decay would have been found on an xray long before it became deep. Taking all of that into consideration, this tooth had plenty of time to become inflamed long before the dentist drilled into it.

The real reasons amalgam is still being used for dental restorations in offices that do not care about the toxicity of the mercury in the amalgam is because it is cheap for the dentist to use and it takes less chair time to put in the tooth. So the profit margin of placing amalgam fillings over composite fillings is higher. These same offices will tell their patients they use amalgam over composite because amalgam lasts longer. The truth of the matter is a well placed composite restoration can last 10-15+ years without any problems. Whereas an amalgam filling, which is all metal, begins to corrode within the first 2-3 years of placement and it expands and contracts from hot and cold temperatures causing micro fractures to occur allowing bacteria to get in underneath the filling.

Bryanna,

My brother last visited the pain specialist 3 months ago. She said the only thing that can help you is Yoga,Pranayam and ayurveda.
That is a 100% cure.

Though India's 5000 year old Ayurveda (based totally on herbs) is good, it has limitations. The reason being most of the
diseases today were not present 5000 years ago. There needs more research on Ayurvedic herbs. There is no Research in India.
That happens only in USA because USA is a rich country. So Ayurveda is fast being neglected even here. Doctors wish to go to Allopathy
because it is lucrative - money making business.

Actually what allopathy does is it tackles the symptoms not the disease. eg Lidocaine would tackle the pain which is a symptom
but not the disease. The disease is nerve damage. Ayurveda addresses the root cause of the issue,never the symptom. But this takes time
and patience. It cannot happen overnight.

Today people dont have patience. They want fast results - fast relief. Come on. I have to go to my office tomorrow.
I have hell lot of deadlines to meet and am going to overwork. I have to answer my boss.I want relief today itself.
That cannot happen with Ayurveda.

Ayurveda is 99.99% safe - no side effects but takes time. It has dietary restrictions during the course of recovery.
It does not happen overnight.Ayurveda takes a holistic look at your body. As you earlier said, if your entire body is functioning
properly,it will correct the existing nerve pain. Ayurveda aims at doing exactly this.

Also Ayurveda has many herbs for nerve regeneration. Nerve regeneration techniques using herbs have been documented very clearly in ancient
Ayurvedic books. These herbs accelerate nerve regeneration a million times.

There is a syrup called 'Mentat DS' by Himalaya. It contains some of the herbs for nerve regeneration and repair. But they are not all .Again nowadays ,ayurvedic companies add chemical preservatives like methyl paraben and propyl paraben and sodium benzoate . That ruins ayurvedic
medicines. Mentat Ds contains these parabens as preservatives.

Also it is very difficult to find a GOOD Ayurvedic practitioner even in India - to be true.

Amit,

I understand, time is a factor for most people as their patience is thin most of the time. When people have become accustomed to masking symptoms and problems of obesity, depression, and so on it is then difficult to change that behavior pattern. However, a person needs to decide for themselves whether they want to mask symptoms or cure the problem. Only they can decide what is in their own best interest and then seek guidance on that particular journey.

So the pain specialist recommended yoga, pranayam and ayerveda? That is interesting as that is what I also suggested because it sounds like those things would be the most beneficial to your brothers overall health and probably cure the nerve issue. Once the body becomes healthy ... harmonic with the mind, body and spirit.... miraculous things occur. I have personal experience with this happening and know many others who have had it also.

You are concerned about finding a quality practitioner and I understand why. Can the pain specialist recommend a good ayervedic practitioner to your brother?

Bryanna

Nerve damage due to botched dental procedure isn't a disease.

Buyer needs to be aware of internet scammers claiming 'cure nerve damage".

http://www.fda.gov/ForConsumers/Cons.../ucm050798.htm

Amitsa, I do think magnesium might be helpful for those of us suffering for this painful nerve condition. I see that 400 mg. is recommended for men, so that is likely a good dosage. I take approximately this amount, although I am female. I also eat lots of green leafy vegetables and they tend to be high in magnesium. Magnesium is often low in many people. And being low in magnesium can cause a variety of issues.

I think the B vitamins are very important.

Always best to double check this with
A medical professional as soon as you are able.

http://lpi.oregonstate.edu/mic/minerals/magnesium

Bryanna,

The orofacial pain specialist my brother sees in Mumbai is actually educated in USA though she is Indian. She has done Masters in Orofacial Pain treatment from Rutgers University,New Jersey. She is a member of American Academy of Orofacial Pain and American Board of Orofacial Pain.

She does not know any ayurvedic practitioner. I will have to find one myself.

Regards,
Amit.

Amit,

Are you assuming that this specialist will not know of someone because she studied in the US or did you ask if she knows of an ayurvedic practitioner and she said no? It is very possible due to her ethnicity that she would know of someone. Or perhaps she has family members living in India who would know of someone. The reason I think this way is because of the fact that she made the suggestion to your brother to seek this type of care. So she is most likely suggesting it to other patients as well.

Bryanna

Hi Amitsa, several years ago I also had suffered nerve damage when I had a tooth extraction. (Its a long story, I won't get into it, but I had an infected root canal, and then a huge infection, when the tooth was pulled I believe the surgeon hit the nerve as he was trying to scrape out the infection. The pain was unbearable. It took a long time- months to finally go away. It does appear that your brother suffered some type of nerve damage. I did do research on vitamins, I believe I was also taking magnesium at the time, and I also had acupuncture. I was scared of having this done, but surprisingly it helped significantly. I believe that my pain would have probably healed on its own but I feel that acupuncture sped up the healing process. Every case is different, but you may want to join a facial pain on-line support group- there are several. You will get information and ideas from the members. I cannot say your brother will heal, as many people do not, but he can try to optimize his health or find ways to cope with his pain. Wishing him all the best!

Vowel Lady,

I just searched the internet and found many magnesium supplements in different forms - oxide,citrate,bisglycinate,orotate.

Which one is best ?

How are NOW Magnesium supplements from USA ? They are available in India.

http://www.nowfoods.com/Supplements/


Regards,
Amit.

Cleo,

No, nerve damage is not a disease per say, it's an affliction. The body handles every negative affliction as an insult or an assault whether it be physical, mental, emotional... or due to infection, trauma or injury.

Our body's have a multitude of both passive and active defense mechanisms that are intended to work synergistically with each other. During an attack or an affliction, when the body is healthy and nurtured, the mechanisms are able to work harmoniously to mend, cure, and fix most problems. Even if intervention is needed to repair or remove an affliction from the body, a healthy body will always heal more favorably than an unhealthy body. Drugs, stress, obesity, poor nutrition, depression, etc. all cause the body to become unwell and UN-nurtured which causes the defense mechanisms to struggle to find harmony resulting in chronic problems.

The body's natural defense mechanisms are not rocket science, they are an integral part of our human anatomy. Ayurveda practices, ayur meaning "life" and veda meaning "knowledge" is all about taking in the good to keep the mind, body and spirit connected and in harmony.

Regarding the FDA... people need to be aware of the intentions of this organization as it is probably not wise to "assume" that they have the peoples best interest in mind...
Just one example: Did you know that the FDA promotes the usage of amalgam fillings in dentistry?

Bryanna

Mercury amalgam fillings are extremely toxic. Mercury is a known proven neuro toxin and to have them in your mouth is lethal particularly if you have multiple fillings.

Multiple Sclerosis ,Neuralgia ,Rheumatoid arthritis and a host of other neurological disorders have been linked to amalgam fillings. There is no known cure for such deadly disorders.

It has been banned in Scandinavian countries Norway,Denmark and Sweden. It is a part of UN treaty to phase down on Mercury fillings.

Still it is used in USA. The NHS in UK also continues with it.
Indian dental orgs continue to follow USA and UK blindly.

-Amit.

Just like the FDA...The American Dental Association also promotes amalgam as safe and effective treatment. People should be more concerned about the toxic effects of formaldehyde used in root canals. which is listed on FDA and ADA as toxic. 100 TIMES worse than amalgam or IGC "accident".

Cleo and Bryanna,


Not just the formaldehyde ,the root canal procedure itself is faulty.

I have had serious problems with root canals. I have written about them in my previous posts. I have had periapical abscess in both the root canals I have had in the past. I have no words to describe the horrendous pain on the left side of my face due to the abscess in both the cases. Antibiotics are NOT THE SOLUTION.


Most people whom I spoke with told me 'My root canal does not pain.It is fine with me.You may have had a problem '. They are foolish. There is nothing like a 'SUCCESSFUL ROOT CANAL' for the simple reason that 'ALL ROOT CANALS ARE INFECTED' . If you extract a root canaled tooth of a person who has no pain and send it to the laboratory,you will find all sorts of lethal bacteria,virus,even fungi inside it. So how is it successful ?

All dental pioneers like Weston Price, George Meinig,Hal Huggins and also Robert Kulacz (I suppose Bryanna worked with him if I am not wrong) have time and again warned about the serious and life threatening diseases root canals can cause. Root canals have serious debilitating effects on your entire body leading to chronic diseases. ADA knows all this.

Foolish people say root canals are a succesful procedure.Root canals are being promoted and retained because they are LUCRATIVE for the dentists. Irrespective of whether RC is done under a microscope or naked eye,irrespective of whether you disinfect ,irrigate using EDTA or sodium hypochlorite or anything a 1000 times,no matter how hard you try

RC is always a failure because a RC IS ALWAYS INFECTED.

Cleo,

The ADA has a financial investment in the manufacture, marketing and distribution of amalgam filling material so of course they are going to promote it.

Formaldehyde is a huge toxic concern as it is not only used in dentistry but it is found in various places such as food, vaccines and the environment. Mercury is just as huge of a concern and for all of the same reasons.

http://emedicine.medscape.com/article/1175560-overview
http://www.epa.gov/mercury/effects.htm

Bryanna

Bryanna, I don't see how a non profit organization made up of voluntary members can have any kind of ownership in a material at all especially without something like a patent.

Amit, It is considered malpractice for any dentist to extract an asymptomatic root canaled tooth. You never mentioned the condition of your brothers extracted tooth?

Cleo,

The ADA is a private protection organization. It controls, in various ways, over 70% of the dentist population. People who are not privy to the internal workings of such an organization are uninformed about their involvement in various financial affairs.

If you are interested.... click on this link and scroll down to page 15, which is 182 of the actual legal document.

http://engagedscholarship.csuohio.ed...85&context=jlh

Amit's brother had an infected NON root canaled tooth. The tooth had deep decay underneath a broken filling. When the dentist removed the decay, the pulp was exposed. His options were to do a root canal or extract the tooth. As I have explained previously, tooth decay is a bacterial infection. Deep tooth decay will negatively affect not just the nerves inside of the tooth, but also the dental nerves that it is connected to outside of the tooth including the alveolar nerves and beyond.

Most dentists do not show the patient their extracted infected tooth. Why? Because it's ugly, it has a pungent odor and it can be alarming. Most people would have no clue what they were looking at anyway. So what would be the purpose of doing that unless someone specifically asked to see it?

Bryanna




QUOTE=Cleo;1174134]Bryanna, I don't see how a non profit organization made up of voluntary members can have any kind of ownership in a material at all especially without something like a patent.

Amit, It is considered malpractice for any dentist to extract an asymptomatic root canaled tooth. You never mentioned the condition of your brothers extracted tooth?[/QUOTE]

Bryanna,

I have one question though it is not related to dentistry directly.

My brother did see a nutritionist . She has advised Herbalife products in addition to exercise to lose weight.

My brother was talking of some Shakes and protein powder.

My question is - Is Herbalife safe ? Do you have any idea ? It is a US company.

Regards,
Amit.

Cleo,

I agree it is malpractice to extract an asymptomatic root canaled tooth. What I meant to say is if you were to extract an asymptomatic RC tooth and send to a lab,you would find it infected always.

This experiment has been done before by Weston Price over a century ago and by Hal Huggins some years before. In Weston Price's case ,I suppose somewhere around 97% were found infected. In Hal Huggin's case,all of them were infected - All of them. The teeth contained bacteria,virus and even fungi. If this is the case,how come root canal is a valid procedure ?

Some people develop abscess very early may be within a few months or say 2-3 years .As per Price,this is a good sign and not a bad indication. He said if an abscess develops too early,it is an indication that the body has launched a huge fight .He found the abscess to be sterile .It was supposed to be body's way of isolating the source of the infection (the RC tooth ).

Is it correct to carry these microbes in ur mouth and that too in a place where the blood supply has been removed and immune system does not reach ? Thats why in my opinion, it is a faulty procedure.


Regards,
Amit.

Amit,

First I want to ask you..... how is your brother doing? Has the pain subsided?

The Herbalife company has an impressive board of advisers. However, I am not a fan of Herbalife products because their ingredients are derived from synthetic sources rather than whole foods, they add lots of fillers which diminish whatever little purity content there is in them and they add fructose and other sugars to make their products sweet and addictive. Also, the majority of their products are soy based. Ninety nine percent of soy is genetically modified and highly contaminated with pesticides. So no, I would not personally recommend these products for anyone who is trying to get healthy.

Someone well informed about nutrition would not likely recommend products like Herbalife because they know the difference between poor and superior quality. They also appreciate the importance of consuming fresh whole food sources (preferably organic and non gmo) over processed products like Herbalife.

What exactly is this persons nutrition back ground? Is she a Registered Dietician? Many RD's, those who have not sought specific education is actual nutrition, are conventional minded and often promote processed foods. Or is her business just a herbalife distributor with no formal education in nutrition?

Bryanna

Hi Bryanna,

My brother's Vitamin D levels are low. His reading is 20 ng /ml which is insufficient.

Sufficient levels are 30-100. Doctor has advised him 60000 IU once a week for 6 weeks. Above 100 is toxic level which is dangerous because it is a fat soluble vitamin.

His magnesium levels are also low.

He always says that his pain is subsiding surely but slowly.
Vitamin B and C supplements help him.

About the nutritionist, She is actually a Herbalife distributor I suppose (claims to be a nutritionist).

They only market Herbalife products for weight loss.

In India, Herbalife has a huge market ,particularly for those who want to lose weight after all other methods like gym and cardio workouts have failed to show any results.

Amit.

Vowel Lady,

My brother saw his neurologist again whom he had seen before. He is a famous person here ,educated in the US and England. He said nerve regeneration is one of the MOST DIFFICULT things to happen EVEN in healthy individuals. It is next to impossible if the nerve is damaged beyond repair.He said the body does try to regenerate but not successfully always or sometimes partially.

He said nerve has two parts - one outer covering called the myelin sheath and inner one called axon. He said myelin damage is easier to regenerate but if there is internal axonal damage, regeneration is almost impossible in most cases. Even medical science does not know the reason why.

As you said,he also added if the pain is unbearable,he may have to take medications to lessen the pain which can be decided only by trying different meds. He said there have been cases where nerve damage has taken as many as 30 years to correct and repair. In some cases the nerve pain has even persisted for a lifeime.