Is my tooth causing trigeminal neuralgia?

[Wishmelucknow]

I have been having facial pain going on 18 months and amitriptyline has really calmed it down a lot. I had breakthrough pain this week and finally a tooth X-ray confirmed I have infection in the root probably from a cracked tooth as I can’t chew on that side (X-ray last year couldn’t see anything wrong). Dentist says it has to come out. I’d love to think this will help end my facial pain - but equally I’m scared it’ll make it much worse! Anyone had similar experience? The thought of even getting my tooth out scares me!

I had "atypical facial pain" on and off for years before the cracked tooth was finally diagnosed and sorted out. I hardly ever get it now. Hope yours behaves the same!

I had trigeminal neuralgia for about 6 months until it was tracked down to a wisdom tooth. It was the worst pain in the world, but gabapentin helped.

I had the wisdom tooth out and all pain immediately ceased. Get the tooth out!

I had a hairline crack in a tooth and which the dentist couldn’t see until he removed the filling. And bloody awful facial pain. He removed the tooth and the pain went!

Same

Once the tooth was extracted, no pain!

Tooth extracted today. That awful numbness and dribbly feel. A crack right through so fingers crossed I can ditch the amitriptyline once all has settled down but just at the start of healing process! Asked for extra numbness and a half.

@Wishmelucknow Was it a molar tooth and was it seen in 2 d x Ray

Exactly the same. Had the most horrendous pains a few years back, and I was convinced it was TN. Gabapentin helped, but it was remorseless. Went to the dentist who realised a lower tooth was pretty much cracked in half, removed it, and I've had no issues since.

I've had a couple of extractions over the years, and though it wouldn't be top of my list for a dun day put , it's honestly not that bad!

It was a molar -
bottom right. Tooth out and pain has gone thankfully

@Wishmelucknow excellent why can’t all dentists see hair line cracks I know x rays don’t show them which is a pain but surely dentist are trained to know

Dental pain and TN have different causes. I would have been delighted to find a dental cause of atypical facial pain tbh as they are almost always treatable whereas TN can require neurosurgery to change the shape of the nerve channels.

@Deedoo you’ve posted a lot about teeth recently. Cracks simply aren’t always visible, I failed to diagnose one in my own husband because I simply could not get a good enough history from him, he couldn’t tell me which tooth was painful or what caused the pain. By the time we worked it out, he needed an extraction.

If people were that simple, medicine would already have been taken over by AI.

Whatever symptoms and worries you have, I hope they are sorted soon.

The X-ray can only see the outside of the tooth. It was only when an X-ray taken 1.5 years later they could see a darkened area at the root indicating infection (trust me I had pain, could hardly open my jaw at times, had facial swelling etc). My last dentist (who retired now) said he could only tell if he started drilling and looking under the filling to see if there were any cracks but that “could cause the TGN to get worse - didn’t fancy that when I’d only just got the pain under control.

@silverdogblue that's really interesting. The pain I was getting before I had my tooth out was horrific..it was without warning and suddenly the worst pain (3 children included!) I had ever experienced.
It shot up through my face into my head and genuinely made me scream every time.
What would have caused that? If you don't mind explaining

The pain still goes up and down the trigeminal nerve, it’s just not trigeminal neuralgia. That’s a specific diagnosis. Pain in the trigeminal nerve (which provides sensory innervation to the teeth) ≠ trigeminal neuralgia.

Pain in the head and neck often refers (on the same side, not across the midline), it’s an area with lots of nerves and blood vessels with complex pathways. Plain old common or garden toothache is still a thing I’m afraid @Tortiemiaw, yes it’s the same nerve, no it’s not the same disease process.

My other point, I have left the profession now thankfully but young dentists unfortunately don’t see the volume of patients in training that we did when I was a student. This isn’t their fault but it means sometimes their diagnostic skills are lacking (and they don’t like doing extractions). Unless their first practice really works hard to Mitigate this, cracked cusps go into the “atypical facial pain” box when they probably shouldn’t.

Thank you!!

Hello what were your face symptoms as I’m going through the same x