Upcoming dental work
 

I went in for a routine cleaning and check-up yesterday. All I kept thinking was, "Please, no cavities on the upper left side." Anywhere else would have been better. Well, as my luck would have it, I have one cavity. Want to guess where?

While one week of Neurotin has already made a difference, I do still feel some aches and pains, so I know the TN is still active. I still have to double my dose, then triple it, but I can't do those increases during the week because I have kids to shuttle to and from school.

Anyway, I'm afraid that the numbing shot could trigger a bad episode, whereas, I've had only mild pain so far. I'm holding off on the filling until I see my neuro. Are my fears valid? If so, is there something my neuro can do to protect me?

Bluemom

I have to have a few numbing shot just to have my teeth cleaned lucky I have a pretty good dentist who has knowledge of T.N.
in case you have yet you should look up top in the stickies.there is a vast amount of info in each of those threads... for now this might help ya ....
please let us know how things go :grouphug:
PEACE
BMW

----This is from the tips for new comers thread up top -----


Tips When Having Dental Work
This is directly copied from the TNA website

TNA Tips for Keeping Dental work as painless as possible:

Go to the dentist when you’re not hurting. Make sure your dentist knows you have TN so he or she will be flexible to schedule you appointments (maybe even on short notice) during periods when your pain goes into remission. This will also help the dental staff to understand in case you have to cancel in case TN pain flares up right before an appointment.

Be well medicated. If you don’t have remissions or must have dental work done during an active pain cycle, consult your doctor so you’re on an optimal dose of medicine. To prevent a breakthrough, your dentist may want to increase the dose of any TN medications you are taking for a day or so before and after the procedure. Also try to schedule your appointment during the time of day when you’re least likely to get pain or when your medication is at peak effectiveness (usually about one hour after taking a dose). Several hours before the procedure, take a pain-killing medication such as codeine. Take it again after the procedure. The goal is to have at least five hours after the procedure during which you’re pain free.

Topical anesthetics. Most dental patients need numbing compounds mainly for tooth repairs, crown work, extractions and the like. However, even teeth-cleaning and exams may bring on pain for facial pain patients. Topical sprays or gels can be used to temporarily numb the gums.
Touch the sensitive area last. If there’s a trigger zone that usually sets off the pain, ask the dentist or hygienist to examine and clean everything else first.

Switch local anesthetics. If you need treatment, discuss with your dentist the type of anesthetic to be used. Ask your dentist to use bupivicaine without epinephrine for the local anesthetic. Bupivicaine is long-acting, so you’re less likely to need multiple injections, which might increase the risk of pain. You may want to ask in advance, because the average dentist doesn’t keep this particular drug in stock.
Epinephrine is a vasoconstrictor; it’s sometimes added to local anesthetics to prolong their numbing effect. Epinephrine can trigger nerve pain.
Consider the injection point. Ask the dentist if possible to inject the local anesthetic at a site as far as possible from known, active TN trigger points.

A knockout. If all else fails and you absolutely need dental work, discuss the possibility of a general anesthetic (either IV or inhaled) to put you to sleep while the work is being done. This type of anesthesia can reduce emotional trauma.

Thanks, Burntmarshmellow! So, if I understand correctly, , if I can keep the nerve from acting up during treatment and for roughly 5 hours after, I should be okay?

:Thanx:

bluemom

yes for the most part but this is never a sure thing each of us are different but I think you will be fine. we will be sending pain free thoughts and waiting to hear how things go.
:hug:

dear blue mom,

I am so sorry for your tooth problem on top of TN. I had 4 root canals on 3 teeth before getting diagnosed with TN, which is very common. I had 2 mvd to correct my TN, last one in April 2010. my Tn pain has always been in v2 running along left upper teeth and up my nose to my eye. that is why I thought it has to be teeth.
in early June my teeth started to bother me where I had the root canals. I was scared to death it was TN, but I also had a bad smell when I flossed there so bak to a new dentist I went. I went to one that knew TN. I actually had an abcess because one of my crowns had a bad fit and had caused an abcess. I had the root canal done and have a new temporary crown on. after my procedure, my pain still continues some. I talked to my neurosurgeon and he said that most definitely, the dental work can cause my trigeminal to go back off the deep end. it will take longer to have it calm down because it is used to going off the deep end. I had a compression that was finally fixed with my MVD. I do not think that my TN is back from the compression, but it still has not totally calmed down. My TN no longer responds to any of the anti seizure drugs so I am waiting.
I would have the work done, but I would talk to near or dentist about having a narcotic for possible pain. I am also curious why they have not put you on tegretol or trileptol instead of neurotin. they usually better control the pain. neurotic does help some people, but my neurosurgeon has told me it is the least effective of the drugs and caused me the most side effects.
try not to stress or panic because I have found this can cause me to be worse. I think because it just makes me not be able to handle the pain as well. I will be sending you good thoughts and let us know how it goes.

Easygoing

Hi, easygoing. Thank you for your response. My neuro's first choice for treatment was Carbatrol. He prefers the brand name rather than the generic. I wanted a generic drug as the cost to me is $53 less. So, his second choice was the generic of Neurontin, which is actually what I am taking. He was willing to do that because my pain is mild and he felt the side effects would be less. If the pain continues, I will have to switch to Carbatrol.

As for the dental work, using a narcotic did cross my mind, but from what I've read they do not ease TN pain. Are you saying that you have experienced otherwise?

I am so sorry for all of those dental problems you've had to deal with. Dental work is stressful enough without the added anxiety of TN troubles. I was lucky that my TN pain is clearly is my check, so I never sought unnecessary treatments.

I hope your pain settles soon. Sending gentle cyber hugs your way. :hug:

bluemon