I need some input, mouth pain
 

My wife is suffering from mouth pain in an area where she had a root canal done years ago, the pain is severe. She has been to a dentist and an endodontics? they cannot find a problem, every thing appears to be normal, although they did prescribe an anti-biotic and pain reliever.

They now want her to see a neurologist? Normal procedure? any one have any clues? The comment made was nerve damage or possible stress? Would this mean a mri needs to be done?

root canaled teeth often hurt
 

Hi SLeeper,

So sorry to hear your wife is having a toothache. Typically, all root canaled teeth will eventually show signs of infection. In your wifes case, her tooth may also be fractured. Something to think about....... If the dentist didn't think there was anything wrong with her tooth, why did he prescribe antibiotics? They frequently do this because they cannot identify any clinical or radiographic pathology, but they know something is brewing. The antibiotic may subside the symptoms temporarily, but the infection in a the tooth will not be cured and it will flare up again.

I see countless patients with your wifes symptoms........ she may have some form of neuralgia beginning, but there is a good possibility that it is caused by that root canaled tooth or a different infected tooth in that area. Frequently an infection spreads from one tooth to another or one area of the mouth to another. Unfortunately, the infection is usually silent until the inflammation starts to put pressure on the periodontal ligaments......that's when the tooth or area starts to hurt.

When there is an infection in a tooth and it has proliferated into the bone surrounding the tooth, which typically happens to root canaled teeth, the painful area will mimic facial neuralgia. Radiographs are just 2 dimensional pictures so they are only helpful to a point. A dental panoramic film shows a different angle of the upper and lower jaws on the same film and this type of xray can be more diagnostic than a routine periapical or bitewing xray.

She could have an CT Scan or MRI done, but it would have to be specific for dental anatomy showing various slices of the jawbone to be able to pick up any abnormality.

Generally, the only solution that cures the pain completely is removal of the infected (root canaled) tooth along with the periodontal ligament that holds the tooth in the jawbone. It has been my professional experience that the earlier the offending tooth is removed the more successful the outcome.

Please let us know how she is doing.

Bryanna

Thanks for the info Bryanna! She had x-rays taken, I will have to ask her if they were Panoramic, I know our dentist does have that equipment.

I also wondered, if nothing found why antibiotics? Neither one she saw was able to see a problem. LOL she is a little nervous that they think she is crazy, they mentioned nerves or stress.

As a person that had some difficulty getting a dx for my PPMS I am used to some lame dx`es. We will search until the proper cause is found.

She has to see or PCP Thursday and I imagine he will refer her to a neuro. Although she has some discomfort the Motrin seems to be controlling it.

Thanks for your thoughts on it!

Thanks for that explanation Bryanna!

I was having pain upper back right where the three teeth are root canaled and has a bridge.

Sure enough one has an infection and now I have to go for a re-root canal. Dentist is sending me to specialist

He also said that he thought a couple other root canals might have some decay and wants to clean it up before it gets bad.

Who'd a thought that a root canal could go bad :p

Re root canal ...... :-(
 

Hi Shelley,

You may not like what I'm about to say........ but in all fairness to you and everyone else who is reading this....... it's your right to be informed before you move ahead with re treating a root canaled tooth.

So WAIT before you give consent to go ahead and let them re root canal any tooth, please do some thorough research on the subject.

I know the last thing you want to do is lose your teeth, but please educate yourself on the risks associated with keeping infected teeth in your mouth verses extracting them.

ALL root canaled teeth are infected, period. There is no way to sterilze a tooth because the <millions> of curvy microscopic canals that contain necrotic nerve material cannot be accessed by any form of instrumentation, laser, medicaments ... nothing. The only canals that are <somewhat> debrided are the large canals that are <visual> by the eye or on a radiograph. Even these large canals are often missed because they can run parallel to other canals and cannot be picked up on an xray. During the debridment of the large accessible canals, the nerve material that is not removed is pressed into these microscopic canals causing even more inflammation. This is one, of several, reasons why people often have post operative pain immediately following the root canal procedure. It is the inflammation within these tiny canals called dentin tubules that is causing the pain. Some other things that frequently happen during a root canal procedure are...... the root (apex) of the tooth gets perforated thus pushing infected material or filling material into the bone, a file or reemer can be pushed through the side of a root into the bone, and a tooth can become fractured from all the instrumentation. Many times, these things go unnoticed until the patients complaining of post operative pain gets annoying (seriously!!) or if they are noticed at the time of the procedure, attempts are made to <patch> them up.

The immune system has a marvelous way of lessening symptoms of chronic inflammation which is exactly what happens after a root canal is done. However sooner or later, the immune system gets busy with something else and then these other areas of infection, in this case root canaled teeth, start to show signs of <failure>.

Root canals do not fail, your body does not reject them, they are a flawed procedure right from the get go! It makes no difference if the procedure is done by a specialist (endodontist) or a general dentist........ there is no way to access the dentin tubules in any tooth, in any person no matter what is done.

Every person has the right to choose what treatment is in their best interest. Perhaps the only way to know what that is, is to be well informed of the risks associated with your treatment choices.

Sometimes picture tells a thousand words.....
http://crobm.iadrjournals.org/cgi/co...ll/13/2/171/F1

The light gray areas with the darker gray lines surrounding the large canal is the dentin tubules. Too many to count!

Again, I know this is not fun stuff to read or think about. But my intention is to bring forth the truth of the matter so everyone has the opportunity to choose what is right for them. One could also choose to ignore it, that's ok with me too ~'.'~

If you would like to discuss this further or just tell us your thoughts.... we'd like to hear from you!

Bryanna

She is not crazy.. she has legitimate pain in her face
 

Hi Sleeper,

Your wife is among millions of people who have the exact same symptoms and have been told they have no <real> problem! Many times it is a tooth problem and the cause is the chronic infection in the tooth that has spread to the surrounding bone irritating the nerve, etc.

Conventional dentists/specialists, will treat this with an antbiotic and pain meds once, twice, maybe even three times. Then suggest a retreatment of the root canal, which will do nothing ...... then an apicoectomy which is a painful surgical procedure that again does nothing to cure the infected tooth. However, the apico does add more inflammation and additional irritation to the already inflammed area.

Motrin seems to subside the pain because it is an anti-inflammatory drug that works on reducing nerve inflammation. However, this is not a cure.

If at all possible, seek an opinion from a Biological dentist. Perhaps the IAOMT site could offer you some insight to finding one in your area.

Please let us know how she is doing!

Bryanna

Bryanna, an update. My wife saw our PCP today, walked out with 3 rx`es and an appointment with a neuro.

I also looked at your info on the type of dentist? Our previous dentist is listed on the link, had to leave him due to an insurance change. Still might send her there if we get double talk on the issue.

Thanks again! We will let you know what direction this leads.

Paul

I've had a few root canals done then caps. They are all gone now and I have a partial where they all were. The teeth with the big fillings are still there, it's ALL the caps that the teeth HAD to go. They All got infected or broke off or both. I got septic a few times from infections up inside the root and had to have them extracted and still was sick for at least a month afterwards. Mouth infections CAN kill you. I had a 27 year old nephew die from his bad teeth. But his were all rotted to the gumline and abcessed. That side of the family lived in the woods like Hillbillies and I don't think any of them Ever brushed their teeth.

I've had the kind of pain you are talking about and fooling around with exrays and antibiotics is just a waste of time, it HAS to come out in order for it to drain. I know it's hard to decide but you are far better off without it once it has gone south on you. Rotted teeth and roots don't heal they only get worse. :o Getting older is NO fun. :mad:

Many years ago, I had root canal surgery with postop symtoms similar to yours. My endodonist couldn't understand the continuing terrible pain. He wrote to the journals, etc., but received no help.

Years later, I ran into him and he told me he had finally found why I had so much trouble and that there was now help from my neurologist. My neuro gave me neurontin for peripheral neurapathy. It was supposed to help with pain but all it did was cause my eyes to blur, so I stopped taking it. After talking with the endodonist, I tried taking one pill when I had a bout with recurring jaw pain. Boom! The jaw pain stopped, I stopped the neurotin and didn't take it until next time. Same results.

You might ask your neurologist about neurontin or something similar. You might have developed PN with all the insults to your nerves during surgery.

Good luck in dealing with this. Antibiotics did me no good, either.

Jon

Thanks for the info, problem is they can`t seem to locate or determine if the problem is actually from a tooth. She saw our PCP yesterday and Trigeminal Neuralgia was mentioned as a possibility.

I looked it up on the section of the board here and there is a link with a quiz for diagnosis, according to it she might have it. She sees a neurologist Monday, I have seen him and I am comfortable with his abilities with MS so we will see what he has to say.

My wifes teeth are in good shape, I checked before I bought her. LOL

I had 2 root canals a long time ago.BOTH gave me problems about a year later.Since i was so young{18},i was told...We need to consult with your parents about this..Before we take them out.I said hey,my parents don't feel my pain.TAKE THEM OUT!!!LOL
I would NEVER have another root canal done after that.
I tried to take good care of my teeth.
Guess i just didn't have a good start.
In other words.I certainly don't have them all anymore.But thankfully,i don't have pain anymore either!!!
All the best to your wife..and to anyone else here suffering with tooth pain.:hug:

Benefits of seeing a dentist in your insurance plan
 

Hi Paul,

Just some FYI.......... Thirty years I'm in dentistry....... I have never been able to justify leaving the practice of one dentist and going to a another dentist because they particiapted in insurance. Dentistry is expensive and sometimes it means taking out a loan or budgeting our money differently for awhile to get through some of it. It is also disheartening to have dental insurance and not be able to use it! But what are you really trading off??

Most patients switch because they feel it's less expensive. Can I tell you the truth?? It may look that way in the numbers, but in the long run, it can actually end up costing you more. You will only get what you pay for. Keep in mind, I am the one who works on the other side of the patient, so I know what goes on.......... no one wants to work for less money, no one will give you quality care for less money, and no one will seek additional education if they are only going to practice insurance guided care.

There are reasons why a dentist chooses not to participate in HMO type dental plans offered today and it's not because they will earn more money if they don't participate. It's because they don't want the dental treatment to be governed by the insurance policy because they know the limitations of the insurance and they know the lack of patient compliance if the suggested treatment is not paid by the patients insurance.

I share this information with you and others to help you become as equally informed as those of us who are in the profession. I know how expensive dental care can be but I also know why it is so expensive. A good dentist is a well trained tooth carpenter and an artist. Working on teeth is incredibly tedious and every aspect of the work has to be done precisely. The overhead in running this type of business is huge! The state of the art practices which are usually the most educated hire experienced/credentialed staff; use outstanding dental labs to fabricate their crowns, bridges, etc; perform all of the necessary steps to provide proper sterilization and never cut corners; purchase quality hi tech equipment to help get the job done faster and easier for the patient; and they often times have extra niceties for the patients comfort. That's just a glimpse into the subject.

We see and talk to numerous patients every day who thought they were getting their monies worth by seeing an insurance dentist. I wish I could tell you that these patients were taken care of properly, but most of the time, they weren't. To me, it is incredilby disheartening and something really needs to be done to change it!

So Paul go with your gut instinct and if you feel you are getting the run around and all your wife is getting are prescription meds, please search for an answer elsewhere. The longer this condition goes on, the harder it is to remedy it.

Please continue to keep us updated!

Bryanna

Bryanna I understand what you are saying. My wife and I went to her neurologist appointment today, she is suspected of having some sort of neuralgia.

After hearing her describe what is going on to the neurologist I also wonder if the pain is caused by a tooth problem.

She is going to have a MRI of her head and a follow up visit to discuss the results.

A dentist, an endo and now a neuro don`t seem to think it is a tooth related issue.

A dental problem sounds better than Trigeminal Neuralgia though.

Not surprised about the difficulty in the dx
 

Hi Paul,

Your wife probably does have some form of neuralgia. But where is it coming from? What is the origin of it?

If I had a penny every time I heard a patient say....... my <conventional> dentist, my endodontist, my ENT dr and the neurologist don't think my facial pain is tooth or dental related..... I would be a millionaire!

Of course I can't say her neuralgia is absolutely caused by an infection, but it wouldn't surprise me if it was. There are so many things that could cause neuralgia and it could be a combination of things going on. But there still has to be an <origin> to have started the whole thing. Right?

Here is a website with some good info about various causes of facial pain:
http://www.drshankland.com/root_canal.html

How is your wife feeling at this point? Is she on medication?

Bryanna




>

Hi Bryanna, better at this point but still some issues, the pain isn`t localized, and even a cool breeze can trigger it. Not a constant pain like before and to varying degrees and locations, but confined to the left side of her face.

She will get her MRI and depending on what is said or found will probably return to our original dentist for a second opinion on if it is a dental issue. No history of neurological issues in her family, but that means jack? None in mine either and I wound up with MS.

To many medications in to short of a time frame to decide what help the pain, antibiotics, steroids, pain pills. Tough to make a call and say which one helped.

Steroids and antibiotics are done now (today) so we are monitoring the situation for changes.

Thanks, Paul.

Well, I'm still plodding along here with 2 capped teeth that have to come out. The decay is up under the gumline eating away at the roots. Parts of them have been drillled out and filled but he couldn't get at it all since it was too far up there so he told me over 2 years ago this was going to be the end result. They will be coming out next week some time. I have had to scramble to come up with the cash to do this from many sources. My Crap Ins. doesn't cover extractions, only at certain oral surgeons or dentists either too far away or with a 2 month wait and I can't or don't want either. Waiting on capped teeth to be extracted is torture. You get SICK and you have excruciating pain in the meantime.

BUT I wanted to say this. That sometimes I too have had what felt like a toothache where there was NO TOOTH. It is a nerve thing originating in the jaw, I believe. Sometimes aggravated by something we are doing. Holding your head in a strained postition for extended periods. Or some kind of physical work you do on occassion and sometimes just stress, clenching your jaw if you are ****** off or worried about something for too long. I find that a long, hot shower hitting right on the jaw and relaxing it by dropping open your mouth, doing neck rolls to pop your verterae back where they should be, helps alot too. { I'm doing some right now as I type ;) } Gentle massage of the sides of your face and neck AND Naps. Yea, sometimes just taking a nap helps relax everything.

See I want you to see the path the nerve takes from the cervical spine to the the face. Especially from the base of your neck where tension concentrates. You can see how IF there is a problem back there it can radiate to the face and FEEL like a toothache. I have had this happen frequently and Thank GOD for the internet so I can SEE and understand what's going on. I hope this helps you. It helped me to understand so I can stop doing what I am doing to cause this. Sometimes though it takes a while for things to settle down. Nerves are funny little things that once get excitied take time to relax. Moist heat, stretches, massage and relaxation DO help me.

NOW if off for a nice, Long hot shower to relax my neck. :D ;) :hug:

WIIX - I totally agree with you. I have peripheral neuropathy which I believe may have been initiated by the root canals I had years ago. Anyone reading this thread this far should bone up on PN. Look at that "picture" of WIIX! PN literally plays havoc with your electrical system (nerves) and causes false messages to be sent anywhere in your body.

The intense pain where there is no tooth - and I had this one for years - is a false message sent from the central nervous system (the brain) out to the peripheral nervous system (everywhere else in the body). To me, it's like a messed up electrical system with sparks flying here and there all the time.

Some parts of my body are numb and feel no pain. You have to be careful of these because you can't feel a cut, stab, burn, etc. Your peripheral nerves are carrying back a false message of 'no pain' to the brain. You can really do damage if you don't constantly check these things when you have PN.

Good luck in solving your very real problems!

Jon

Thanks jon for confirming what I said. I was hoping Sleeper would have seen it by now but maybe he just hasn't been in here yet.

I USED to have PN, but it was caused by drinking too much alcohol. I haven't had any now in over 15 years and everything is back to normal now. I do get a twinge once in a while under my big toe nails but warming up my feet and gentle massage with a nice lotion always makes it go away.

I too have an occassional WIERD kind of thing happen. I will get TWO very separate sharp nerve twinges in different parts of my body at the exact same time. I think it's nerve thing again. Just lasts for a second or two but it's sort of funny. One might be in my shoulder and the other in my foot OR one might be on my back and the other in my leg. No obvious association with the two but just wierd. I am wondering if anyone else ever gets these strange little occurances too.

WiiX - Those twinges are what I think of as the sparks flying in your body's electrical system. It's a symptom of PN. Sometimes it's a few pins sticking in you a little shockingly! Other times it's a big hot knife stabbing one or more places. Doesn't last long, but it certainly gets your attention when it happens, doesn't it?

The PN section probably has answers to your questions. I just haven't gotten there yet. My teeth are demanding my attention right now.

Jon

Yea, mine too. :o

Bryanna, update time, after a couple of pain free weeks we think we have the problem pinned down. Now her mouth(gum) is swollen by the root canal tooth, go figure? She had an mri prior to the swelling, no answer on that yet, but back to the dentist, LOL he now thinks it`s the tooth, and back to the endontist today maybe.

It just figures I would get better info off the internet than from office visits, the way it worked for me too with my MS.

Thanks!

tooth infection
 

Hey there!

Based on the information that you have been posting and on my professional experience........ I have no doubt that your wife's root canaled tooth is showing signs of infection. Keep in mind that ALL root canaled teeth will have some degree of <chronic> infection because there is no way to remove all of the infectious <microscopic> bacteria from the inside of the tooth. This bacteria proliferates over time and because the mouth is so vascular the infection/inflammation can spread elsewhere. It is NOT unusual for people to have <remote> pain, inflammation or irritation in other parts of the face, head, body and even major organs caused by the infected tooth.

Please do your research on root canals before you have the endodontist retreat this tooth. The majority of what you will read says root canals "cure" an infected tooth. Keep in mind that the word "cure" simply means "retain", NOT heal or make well. The other option she may be offered is called an Apicoectomy. This is a surgical procedure where they go into the bone above the tooth and amputate the end of the root called the Apex. Bascially it is the same <cleaning out> procedure as a conventional root canal accept they enter the tooth from the end of the root instead of the biting surface. The surgical opening is then filled up with a MERCURY filling. This procedure is very painful and expensive and it does nothing more than the typical root canal because the bacteria that is causing the infection is that microscopic material that is in the dentin tubules which are not accessible. No doubt there will be pus and other visible infection, but removing that stuff is only the tip of the iceberg!

I am SO glad that you came here to this site and asked for help for your wife! If nothing else, I feel you are armed with some information to pursue the path that is in your wife's best interest. Please don't be hesitant to question the endodontist about what you have learned here. If you are seeking a CURE for her problem, then make sure that he understands that very clearly.

Please keep us posted on how she's doing!

Bryanna

Update:

I had 2 teeth removed last week. Two, left front and one next to it. Now, I stll do have that "THING" on the rear left side of my neck, a cyst, which I mentioned before. The two teeth I had removed WERE infected and they were capped. The pain I got from them shot up my cheek and into my eye and forehead like a jolt of electricity. NOW, that IS all gone BUT when I clean out this "THING" on my neck. I mean press on it to get out the accumulated blood and fluid, which I have to do everyday or the Pain is unbearable, THEN I get referred pain along both upper and lower jaws just like a toothache. But there are either NO teeth there or no cavities. So my theory was correct. ;)

Root Canal Infection?
 

Hi~ I googled root canal infection and came across this site. Obviously I'm having some pain from my root canal-ed tooth. I wasn't too sure what happened, it isn't too painful, but it just feels kinda uncomfortable (spasms, tremors), so I was thinking if it gets infected again... I never really knew root canaled tooth could get infected again until I saw this page. I'm not sure what to do, cuz frm what I've just read, I don't think there's a solution to it. It happened last week, and but it got better and stopped. Then it came again yesteday! Is is something that would stop when ur immune system gets better? Would the infection go away itself? Is keeping your mouth extra clean help eliminate the infection? What should I do now? Any help would be appreciated!!!! Thanks a lot!!

It's been over a month now since I had the 2 front teeth OUT. All the pain on that side of my face and head is gone. It took a while for things to settle down though. :o I have also been feeling a whole lot better physically. Infected roots CAN make you sick all over.

infected teeth
 

Hi mich,

Root canal therapy is done when a tooth becomes infected as a means of trying to "retain" the tooth in the mouth. The only other option is extraction and replacement. What becomes misleading is when the word "cure" is used instead of "retain". There is no current procedure or medicament that can "cure" an infected tooth because the infectious bacteria multiply before the tooth shows any signs or symptoms as it enters the tiny microscopic canals. These millions (literally!!) of canals are not accessible so they cannot be cleaned out. The bacteria proliferates and tries to find a way out as if to let off some of the pressure inside the tooth. This is when the tooth starts to hurt or a swelling develops. To retreat the tooth with another root canal does nothing to "cure" the infection inside of these tiny canals. The bacteria remains trapped inside and the tooth remains infected.

Keeping your mouth extra clean will have no positive affect on an infected tooth because the infection is inside of the tooth.

The choice is yours as to retreat it with another root canal or have it extracted. The retreatment may temporarily reduce some of the inflammation, but it could aggravate it too. Either way, the tooth will remain infected and it will flare up again sooner or later.

I know this is not good news..... I really wish there was a better answer!!

Please let us know how you are doing.

Bryanna

OOOOHHH to go back to the days when Everything was brand new. :o