Trigelminal Neuralgia? Dental?

[StayingHere]

In February I had dental work done on my two front teeth (veneers) long story but it was to cover some pretty ugly black gaps and twisted teeth and chips from prior gum disease and an accident. After this, one of the teeth would not settle so I ended up having root canal in the tooth. It hasn't made a lot of difference and still causes pain. I also have sensitivity in the other tooth. I am back and forth with an endodontist who isn't convinced of where the problem lies and is holding back on treatment- I'm about to have the tooth re-treated and the one next to it done in desperation to get relief. I'm pretty much fantasising about having them taken out and replaced with implants as I can't face the discomfort any more. In the meantime, my cheek on one side constantly aches, and my eye on the same side feels a kind of raw feeling. Before I go and sink my savings on root canals I'm starting to wonder if maybe I have a nerve problem. Does anyone suffer from TN and does this sound like it could be it? Or is TN way worse? My face doesn't hurt to touch, just constant discomfort in the cheek and round the eye plus the constant teeth problems.

I'm 35 if that makes a difference.
I would be so happy if it's just the teeth but I can forsee a situation where I have all the treatment and the pain remains. I've read a few threads and it seems people's pain is much more intense than mine though - I am just constantly irritated and sore. 5 years ago I actually had shingles in my mouth (on the other side) which was agony and miserable so I wonder if I"m a bit prone to nerve issues.

I've just had root canal retreatment but now the anaesthetic is wearing off I can feel much the same stabbing sensation and general discomfort. I don't know what to do if it doesnt settle; pursue root canal in the neighbor tooth or try and get a neurology appt.

It's not trigeminal neuralgia no. And it's not a 'Nerve pain'
Sounds Dental in origin.
Other contenders would be Sinus and TMJ pain or referred pain from another tooth. If you're seeing a private endodontist you're in the best hands. If neither of you are convinced it's Dental origin you can get referred to your local Restorative department for an expert opinion but they won't do treatment and waiting lists atm are long. You could do both- referral just to make sure but continue with what you're doing in the meantime while you wait. (Up to a year probably).

Thank you Frazzle76 - I am overseas on insurance so getting appointments with specialists isnt a problem. I just dont want to waste my time and money.
Why do you feel like TN is incorrect? My main complaint is pain in the tooth area even when I talk, and pain in my cheek on the same side. Not having much luck with the root canal on this side which is why i am starting to wonder if the problem is elsewhere.

The endodontist mentioned referred pain from the next door tooth and I think its his next Avenue. It just seems so hard to understand how the right incisor can cause my already root cancelled left incisor to feel such discomfort so frequently.

TN is a sharp pain that comes in waves. Is that how yours is presenting?

TN can be a gnawing aching icy pain too.

Did you have pain relief from it under the anaesthetic from the dentist? When my tn was diagnosed they thought it was dental and I had a tooth removed. It still have me trouble so they number the area to redo a filling..I was in AGONY while being numb at the same time as my pain wasnt caused by my teeth.

Also, do you get relief by taking paracetamol or ibuprofen or cocodamol? If you do you can rule out nerve pains it isnt helped by those.

@DrMadelineMaxwell it's a sharp pain around my tooth that lasts a few seconds and comes and goes. It is also dull and achy, the dull achyness is also felt in my cheek.
I can't get any relief from it via Otc painkillers, but I couldnt feel anything under the dental anaesthetic.
I am not suffering too badly at night, ie i can sleep, but it's a daytime issue.
I do acknowledge that my next door tooth is a bit sensitive/sore but I'm scared to go and have that root canal too only to continue to feel discomfort.
I am not sure what avenue to pursue.

I have TN but rarely got the shocks ..mine first presented as a deep burning pain.. but it was along one of the facial nerves and stopped absolutely dead centre at the end of the nerve branch. It was unrelenting.
I had two teeth removed unnecessarily before getting the correct diagnosis and being put on medication (Pregabalin as Carbzmazopine made me throw up although it worked)

In your case I would want to try a nerve pain medication (Carb is the gold standard.. don't accept Amitriptyline..it's shit) before messing further with your teeth... if it's not nerve pain, that won't help and you'll know it's not TN... if it works.. probably TN!

Thanks StillMedusa did you feel pain in a tooth/teeth?

Have they checked you for extra roots? I have extra roots and so spent 18mo in agony after a root canal filling. Took a psychiatrist to say I wasn't mad before they looked with a microscope and found it.

Hawkmoth I have had it all checked, it's a front tooth so only has one canal but I has a cone beam scan anyway. He said there was a void in the original filling (not done by him) which is why we have gone again. He has very fancy equipment. I can already feel the familiar pain though, I guess it isnt this tooth but dont know if it's the neighbouring tooth or non dental. I'm going a bit demented with it!

I'm starting to get anxious and frightened that pain is the rest of my life.

Yes..hence the removal ( :( ) of two teeth .. both the dentist and myself were convinced there HAD to be some unseen problem with them for the pain to be so bad. Of course the teeth were removed and the pain continued... it was only then by sheer luck I went to my GP in desperation and she had just come back from a conference on nerve paid.. started me on meds and sent me to a specialist who confirmed it was TN. The dentist felt awful about it, but really it wasn't her fault. I did get the shock pains too..but not frequently..mostly a burning constant pain. I'm a pretty pragmatic person but I remember feeling like I could not go on if this was forver.

I've been on meds for over 7 years now.. if I come off them completely it comes back, and now and again it flares and I up the meds pronto. I avoid dental work as much as possible.. an implant for the missing teeth is not an option because of the risk. (I do have a tiny denture but even that tends to set it off so as they aren't visible unless I'm grinning I tend not to bother)

I would see your GP..beg for carbamazapine because you think it may be TN , and take it from there.

Thank you StillMedusa. I am going to visit the GP and ask for referral to the pain specialist (you get a referral to a specialist for everything here). I am also a cheerful enough person on the whole but starting to feel pretty desperate. Once you started on meds did you get better quite soon?

Yes! I was put on an enormous dose at first.. the max allowed and was completely spaced out for a week or two until I adjusted but the relief was fast.. in a couple of days I was feeling SO much better!

I think you need to go in with the 'THIS is what I think it might be' attitude..don't get fobbed off. It would be great if you are wrong but the meds have to be the right ones!

If the pain stops with the anesthetic its not TN and its not classic symptoms of TN.

If the pain goes when the teeth are numbed its most likely dental tbh. You had what you've already said is a poor root filling, and you have a tooth which has known problems next to it. Plus both are veneered which means they are at more risk of problems, and you talk about an accident and gum disease. All in all it sounds like these teeth have a lot of problems. However it also sounds like possible TMJ or maybe sinus problems, possible concurrently with tooth ache.Its very difficult to say without examining you but its doesn't sound like TN

Thanks DishedUp. I agree they are shitty teeth, but I hoped that the retreated root filling would be an end to the sharp/stabby pain felt in the tooth. I realise as there isnt any filling in there it can't be that tooth, so I am just wondering why I can feel pain there specifically. It's so hard to live with.

The thing that makes me feel like it could be TN is that when I talk (I teach) a get quick sensation from my tooth up to my cheek. It's not excruciating but it is very irritating and hard to ignore.
I spoke to my dentist today who still suspects the other tooth, but acknowledged that tooth pain doesn't normally cross the midline.

Tooth pain can cross the midline though, and it could be muscular if its painful when you talk. Or even just this tooth needs time to settle because it had a poor root filling previously. If you are localising it to a tooth its likely to be tooth. Especially as it went when the tooth was numb

I'm not saying 100% its not TN. But its not classic of TN

Thanks DishedUp appreciate your help. He thinks my cheek discomfort is probably muscular from tension/worry. I am about to move countries as well as this. He said they could look into a muscle relaxant if it doesnt pass.
Thing is I do feel discomfort in the next door tooth, it's a bit sore a lot of the time. But I perceive the sharp pain in the root filled tooth. He wants to give more time to see how things feel in a few days. I know I need to be patient it's pretty hard though!

@StillMedusa, when you felt pain in your tooth did you also feel in your cheek or anywhere else? Or just in your teeth?

I had pain that I thought was my teeth. It was in my lower jaw and particularly spiked if I got water on my tooth when brushing my teeth, though I couldnt pin it down to one tooth. My dentist agreed and I opted for removal rather than root canal as it was tooth that had cracked badly many years earlier.
Pain carried on. So she then refilled the neighbouring tooth.
Pain carried on, even through the anaesthetic of the filling appointment.

My pain is usually in my tooth area on the lower jaw but can flash up my cheek. And can be in my tongue, tucked under my jaw or in the jaw joint. If I exercise, despite my meds keeping my pain 95% down I get an icy numb feeling in my cheek.

It's miserable sometimes but bearable most of the time.

@DrMadelineMaxwell do you find it needs a trigger? Or is it spontaneous?
I find that I get a spontaneous electric shock in my root treated tooth, as well as icy pain in my cheek. Also irritated by talking, and the area feels uncomfortable most of the time.
Because the pain started after dental work I was leaning towards a dental origin, but now I I've had the root canal redone and still in discomfort I'm starting to rethink. I feel pretty certain where the pain is located which makes me worry I'm not looking at referred pain.