HealingWell
Search Close Search
☰

DENTAL NERVE DAMAGE

Support Forums
>
Chronic Pain
✚ New Topic locked
1 23 4
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 12/1/2012 4:12 PM (GMT -5)
2y4t, Good to hear your bro's M-i-L ia finally pain free.   Certainly sounds feasible, I guess if a crack can be invisible to scans and xrays, it's certainly worth us checking out.   Cheers.

Just how did they find the crack btw?

Post Edited (Mackster) : 12/1/2012 2:28:49 PM (GMT-7)

Posted 12/1/2012 6:13 PM (GMT -5)
I'm not sure, my understanding is it didn't show up on xrays and looked like the normal curve of the tooth where it butts into the other tooth. I'm wondering if they have some kind of UV dye that they could put on there to check, that would make cracks show up. I'll my brother how they found it. I am really not on speaking terms with his M-I-L right now (long story). I'll get back to you when I find out.
Posted 12/2/2012 8:25 AM (GMT -5)
Much appreciated 2y4t.
Posted 12/3/2012 10:24 PM (GMT -5)
C'mon guys, there just has to be more people on this forum with chronic dental pain.
Posted 12/4/2012 4:45 AM (GMT -5)
Unfortunately narcotics do not have much effect on nerve pain. As Snowbunny had asked, have they tried any of the meds used to treat nerve pain such Gabapetin, its the generic for Neurotin, Cymbalta, Lyrica, or Amitriptiline? I am also thinking we had someone on here that was taking Nortriptiline for nerve pain with some success. Its a matter of finding which one of these meds will work for the patient. I just cannot fathom what your wife is going thru.

I sure hope she can get some help......Susie
Posted 12/4/2012 5:12 AM (GMT -5)
Hi Mackster, just wanted to let you know; my brother got back to me on FB this afternoon. He said they found the crack using a UV light. He said that it was apparently almost impossible to see, it was a "vertical fracture" in between the teeth that didn't go all the way up to the top of the tooth, but went deep into the root. It was not visible on any Xrays. He didn't say how they repaired it, but apparently it's fixed and the pain is pretty much gone now.
Posted 12/4/2012 6:11 PM (GMT -5)
Straydog, yeah she's tried  all the stuff you mentioned to no avail.  They just turn her into a zombie.

2y4t,  spoke to the pain management specialist about UV and he said the waiting list for a (non-emergency) CT scan in this area could be several weeks.  (Canada, the land of free universal health care wink )  However he did say that her neighboring tooth where all the pain is centred can be opened up to gain the same result.   There is a 40+ year old filling in it.   He has referred her to an endontist/dentist practice where we can at least find out.  Unfortunately, even in Canada, dentistry ain't free after 18(without private insurance).

Posted 12/4/2012 10:53 PM (GMT -5)
Hi mackster, not a ct scan, a ultraviolet light. Though I'm sure a ct scan would probably be very beneficial for diagnosis. I don't know how it looks on teeth, but I know that a uv light on metal makes cracks show up that were otherwise invisible to the naked eye. Another thing I've heard is to take an eye dropper and put one drop of ice cold water on a suspicious tooth, without getting any on the other teeth, if there's a problem with the tooth, the one drop of water would send her to the roof. Never tried it, but it seems like a sound idea.
Posted 12/5/2012 12:50 PM (GMT -5)
Hi Mackster, just popping in to say I feel bad for your wife. Dental pain omg no ideas how to help but as a fellow Canadian I know financially a root canal can set a person back a couple thousand, I have a few of those. I hope they figure this out quickly as mentioned by others this is a tough pain to treat.
Posted 12/5/2012 10:28 PM (GMT -5)
Grandmaroses, thanks for your sentiments.  I'll gladly pay thousands to rid my wife of her pain.
Posted 12/6/2012 10:36 PM (GMT -5)
Have any of the over the counter topical anesthetics helped? I know they may be short term, but when that's all you got, that's all you got. May also help a dentist in discovering the cause.

I'm beginning to think, after reading the other responses here, and like I said, having had multiple dental issues of my own, that this may be related to the tooth next to the suspicious one. The front 2-4 top teeth get nerves from both sides of the jaw, and the sinus areas. So there's 3 places for the pain to be transmitting from, and the pathways can sometimes get crossed up, if I'm remembering my anatomy correctly.

I hope this can get resolved. I've not noticed in the comments if a local injection was used right in close to the tooth itself to try to stop it at the source, instead of at the root (not the tooth, but the nerve, like at the back of the mouth). If a local injection at the site of the pain will stop it, that's diagnostic in itself, and the dentist can start with either doing a root canal on the neighboring tooth, or pulling the offending teeth/tooth and installing a bridge. If it does not, then there is something going on further back in the "wiring".
Posted 12/7/2012 2:23 PM (GMT -5)
Thanks LivingColor,  she's booked in to a dental/endontist father/daughter practice for Dec 17.

Meanwhile she's been put on Fentanyl which is delivered via a transdermal patch that lasts 3 days at a time.  The dosage is slow release at 12mcg/h.   Two days in and still no relief.

If anyone is familiar with this drug, your comments would be helpful, it's an opioid analgesic but may come under a different brand name in the US.

Posted 12/7/2012 4:44 PM (GMT -5)
Mackster I know dealing with our pain is rough at times and we start relying on our spouses even more but when they get sick it is so much worse.
My hubby was in an industrial accident over 20 years ago, he has had half of his face rebuilt. His face hurts and his teeth OMG his nerve damage is so bad and the worst part is there is nothing I can do to help him.
He gave up after far too many doctors and drugs, he is very stubborn and there are days when he is in extreme agony and others he says are easier and as we know chronic pain has its own way with each of us.
I have read here about fentanyl and recently have heard about it on the news, that's a strong pain reliever. I hope they soon figure out the problem and are able to fix it.
Posted 12/7/2012 4:58 PM (GMT -5)
Hi Mackster,

I'm very sorry about all that your wife is dealing with.... and appreciate the efforts you are doing to help her. I've been following this thread, but didn't have any real input until your fentanyl question.

There are several of us that have been on fentanyl patches here. Fentanyl *can* be an excellent pain reliever.... but for some - it's hard to keep the patches on; get the dose correct; it *can* have side effects (ranging from nausea to respiratory issues) and so forth. But, as I said, it works great for many.

The 12mcg patch, though, is the lowest patch made. Do you mind me asking you what strength morphine she is transitioning over from (I think that's what I read she was on). It can take a few days to build up in the system.... however, it is a low strength of fentanyl... so, again, just wondering if she's transitioning from something else.

I hate to say this... but having dealt w/ many pain issues over the years... I'm w/ Susie in that I don't know if narcotic meds are necessarily going to treat this pain. And it sounds like she's having lots of side effects from these medications. Is that correct?

I'm sorry if you already answered this.... but when my family has had a bad case of strep throat - we've been prescribed a liquid lidocaine solution. We've used it at times for treating tooth pain as well... it basically just numbs the entire area. It wears off after awhile.... but it might be another approach to treating this pain. It might be worth a call to the doctor... (Just now thought of that or I would have mentioned that earlier!)

I wish you guys the best of luck in finding *something* to help w/ the pain - and, ultimately, finding the solution to the whole issue.

Take care --Tina
Posted 12/7/2012 5:06 PM (GMT -5)
Just looked at our bottle - and it's called Xylocaine Viscous 2 % solution (I'm in the US, though).
Posted 12/13/2012 3:28 PM (GMT -5)
Tina, thanks for your invaluable input.   As you stated, the 3-day 12mcg Fentanyl patch is indeed a small dose.  After one week it has been decided to double the dose (2 patches-24mcg until a new scrip comes through).  She applied them this morning so I guess we may not notice much difference until tomorrow?  

I apologize that I didn't recognize that you are a forum moderator and I appreciate you taking an interest in my wife's plight.   Insofar as 'weaning off' or transitioning from her existing pain meds, she asked the pain doc about this and he indicated for her to continue with her current regimen until 'further notice'.  I can only surmise that they want to see how she responds before tapering down. 

To keep you apprised as to just what thes other meds are, they are: 1]oxycocet (percoset) 5mg --2 tabs 4x per day.  2]  statex (morphine sulfate) 5mg --2 tabs at bedtime.  3] lorazapam 1mg --2 tabs at bedtime.   *4]  Lyrica (pregabalin) 25mg --2 tabs at bedtime.           * She has just started adding the Lyrica for the past five nights under the advice of the pain doc and has found it helps her get more uninterrupted sleep.  (which make her mornings easier to bear)

To me, it seems like quite a scary cocktail, but I will defer to your superior knowledge Tina, on the dosage of these meds.

This coming Monday Dec. 17, we have an appointment (referred by the pain doc) at a dental/endontal father/daughter specialist practice in the next town.   I am cautiously optimistic that the answer to this dilemma may be found there.

Posted 12/13/2012 4:04 PM (GMT -5)
Hi Mackster....

Thanks for the update. I'm glad to hear that your wife has an appointment on Monday -- and I hope it leads to the answer to what's going on.

Re: her meds -- I hope that the increase in the patch might give her better pain control. If it doesn't.... considering that she is on fentanyl, percocet and morphine - that would probably lead me to believe that opiates aren't going to be the answer to her pain (but I'm not a doctor - just an experienced patient). That being said, I do hope the additional fentanyl dose will give her better pain control.

I know these meds seem scary.... and they definitely are strong medications.... but the dosages on all the meds are pretty low. The best way that I would monitor things is what side effects she is having.... like sedation, memory loss, nausea/vomiting - and, of course, more serious things like breathing issues and so forth.

All that said - it's ultimately the best thing to get to the bottom of what's going on.... and I know you are both desperate to do this! So, I hope that this Monday appointment leads to answers.... and that this ultimately leads to solving her pain issues. Please update us when you can...

--Tina
Posted 12/13/2012 5:41 PM (GMT -5)
Hey Mackster...

I just wanted to mention that she is on a very low dosage of the Lyrica....I was a bit confused as your last post says she just started this but I was reading your first one at the beginning of the thread back on 11-21 and you were saying she had just started the medication then a few days prior...

The only reason I bring this up is because I was looking to see if the Dr. was starting her low but had moved up her dosages by now as the "regular" starting dose can be 50mg, 3 times a day and can go all the way up to 300mg a day...So...only being on 50mg once a day is so small it may not be doing a thing and it's only being taken at night.

As Tina mentioned....if all the different opiates aren't working as you said then I would be looking more into the nerve pain medications (like the Lyrica) to get on the therapeutic amount to see if it starts putting a dent in things as it certainly sounds like it is nerve pain from all the descriptions...


 

It's a bit odd that the PM Dr. didn't want to wean her down on any of the previous medications/opiates but just add more...So if I read it right she is now on 3 long acting opiates as she had recently been put on the Nucynta by this PM, and is also on Morphine Sulfate ER, and now the Fentanyl patches....as well as the Percocet....I'm not sure why she would want to be on them all as you had written they haven't done a thing to help.


I would also just be very careful about all these that are nighttime dosages of the opiates mixed with the double dosing of the Benzo Lorazepam..and then you say the Lyrica also makes her sleep....that would be my personal concern loading up at night instead of spreading out all the medications in 24 hours...

Please watch out for things as Tina mentioned like breathing difficulties or extreme fatigue...

She should be able to just call the PM and ask about the Lyrica as it isn't a controlled substance to need an appt. to tirate up the dosage if he chooses.

Keep us posted..

Post Edited (Snowbunny21) : 12/13/2012 5:29:29 PM (GMT-7)

Posted 12/13/2012 10:40 PM (GMT -5)
Snowbunny, I think she prefers to 'load up at bedtime' as opposed to spreading it all out 24 hours is mainly to prevent her from being in a zombie-like trance during the day.

For some reason the lorazapam worries me, but is it any worse than the opiates?

And is 2mg considered a high dose?

Post Edited (Mackster) : 12/13/2012 8:46:35 PM (GMT-7)

Posted 12/14/2012 1:59 AM (GMT -5)
Hey Mackster...

It really comes down to how a person tolerates things... and if there are any side effects. I think that is what Snowbunny and I are saying.

For instance, I do occasionally use lorazepam for my anxiety... 1 or 2 mg and this is combined with all my other meds. That being said, I've got the tolerance issues of two full grown men... so, for me, it has no side effects.

That being said, lorazepam mixed with opiates and other meds that can cause sedation can cause major issues for some people.... including respiration suppression, etc. For instance, my husband occasionally takes short acting pain meds (prescribed by his doc) for his arthritis issues... and there is no way I would feel comfortable with him using those meds and 2mg of lorazepam. So, it really comes down to a person's individual tolerance, etc.

I also share Snowbunny's concern of her having three different narcotics on board.... even though some PMs can dose things that way... that is definitely not the norm.

Point of it all.... I think we are just concerned for your wife's safety... I hope you understand. I would really keep an eye on her and make sure she can still be roused awake at night... is breathing comfortably and so forth. If there are any doubts, I would definitely give a call to the PM doc.

....Tina
Posted 12/14/2012 10:40 AM (GMT -5)
Tina did a good job of explaining my view:)

I just wanted to add that most of us who are on medications do not feel drugged up or like a zombie during the day with our medications.....I don't feel any different except a bit of pain relief.

Most PMs choose to have their patients spread out medications over the 24 hours so that there is even pain relief throughout the day so that it's not all loaded up while someone is sleeping.

And as mentioned...others are on the Lorazepam so in itself it's not a concern at all....Neither are any of the meds your wife is on unto themselves....We are just concerned about the cumulative effect of taking them all at the same time before going to bed when respiration is lower and you can't observe her to see how she is doing.

Lorazepam is usually prescribed as an anti-anxiety med to be taken as needed....So that is why I was brought up the unusual prescription to be taken the full amount of 2 pills at night, every night....

And I guess I am just curious as you have written in a few posts that she isn't getting any relief from the opiates....then why stay on so many?

Obviously we are all different and some of us here are on some pretty heavy duty medications but it's also after 10, 15, even more years in pain management to get to this level...

My concern for your wife is that they don't even know what is wrong but just keep adding medication after medication without removing the ones that don't work...

Hopefully you can contact the PM today about at least raising the dosage on the Lyrica so that you all can see whether a nerve pain medication will help her...

Again....I am certainly not a Dr....just another pain patient that is expressing thoughts/concerns based on what we read for you to be able to speak with her Dr. or find a better Dr. who isn't just going to keep throwing medications at her but find out what is truly going on.....
Posted 12/14/2012 10:57 AM (GMT -5)
Good job on explaining, Snowbunny... and my apologies as I try not to speak for others on here (I know you don't care, but I do try hard not to do that). But thanks for explaining things in a way that I couldn't last night on the iPad (too hard to type!).

Take care all, Tina
Posted 12/14/2012 10:59 AM (GMT -5)
LOL..No worries at all Tina....I really appreciate any of my peeps stepping in to help if it takes me a bit of time to come back and explain myself...so thanks:)

I hope that Mackster realizes we all do have his wife's best interest at heart and we are all trying to brainstorm things that may be able to help her figure out what is going on and lessen the pain...
Posted 12/17/2012 8:56 PM (GMT -5)
UPDATE:   Went to the oral surgery specialists today and the prognosis was less than positive.

I have to say that the doc was very honest and I was impressed with her whole demeanour.

She did a thorough hot/cold sensitivety exam (and xray) on the teeth of whole upper mandible and concluded that the chronic pain emanates from a neuropathic nature rather than an inflammatory one.    Translated, this means that it would be doubtful that root canal surgery would be a prudent thing to do.   In fact, judging by her reluctance to even consider it, she added that it might be risking further damage to the nerves.   I asked about UV technology to determine any occult pulpal 'damage' and she said that her tests pretty well rule that out.

She (the doc) said she will discuss it further with the PM doc and the neurologist and get back to us in the new year.

Not the result we wanted I'm afraid.  So for the time being it looks like we are under the care of the PM doc who will of course, be dispensing from his long list of narcotic/opioid medications.

Hey, who knows, there just might be one that actually can give her some relief.

The Fentanyl patches don't seem to be making any difference despite doubling the dose to 25 mgh.

I appreciate the input from all you guys and can only say--keep it coming,  there maybe someone with a similar problem that might just stumble into this thread with good news and give us hope.

Posted 12/17/2012 11:53 PM (GMT -5)
Hey Mackster,

Thanks for the update - and sorry the news was less than positive.

Did she have any recommendations in terms of managing the pain? Or is that what she was discussing w/ the PM doc?

I personally still don't think that narcotic medications are the answer. If one of the meds truly worked (the morphine, percocet, even fentanyl - which is the *strongest* opiod in some ways) - then I would say to keep searching for the right one... but given that nothing is working... I'd maybe start exploring other medications.

I googled neuropathic tooth pain meds.... and it seems that the meds to treat this generally come down to either nerve medications (neurontin, etc)... anesthetics (like the topical lidocaine that I previously mentioned)... tricyclics antidepressants.... etc. Were you able to ask about getting the topical lidocaine a try? Or maybe some lidocaine injections to see if that even helps?

Just my late night thoughts :) Keep us updated on how she is.... and like you said -- maybe someone else will stumble upon this and be able to give some firsthand input.

--Tina
✚ New Topic locked
1234