Could this mean infection? Very anxious.

[MountainMama]

I am just going to recap. I had a root canal on a front tooth with a wide canal and open apex almost 3 months ago.

It never stopped being tender and I started getting more pain around the tooth. Some pain was also in the roof of my mouth, close to the front, but not directly behind the tooth. I also had a feeling of a knot lodged right above the tooth, behind my nose.

All the x rays showed healing. The void from the abscess shrunk, and there was stippling. My dentist checked the tooth, and the tender feeling had decreased as of the week before Christmas, but the pain around the tooth was still there. She suggested it was possibly trigeminal neuralgia but wanted to rule out other options first.

She put me on antibiotics. After 3 days on antibiotics about 90 percent of the pain went away. The knot feeling behind my nose went away. My tooth was barely pressure sensitive. I have been off antibiotics for 3 days now, and today the knot feeling is back, as well as a dull ache around the tooth. It actually feels a little pain if I touch the back of the tooth where the root canal filling is.

Does that sound like there is still infection? If so, wouldn't it be on the outside if the antibiotics helped? If it didn't completely go away, does that mean it could be in the tooth itself? Would a cone beam scan help?

I am supposed to call my dentist tomorrow and tell her how I am feeling. My anxiety is pretty high, as tomorrow is her last day at the practice and I will have to continue with her colleague. I am also anxious about more treatment on this tooth. I had been doing well lately, but my anxiety is ratcheting up again. I haven't been sleeping well.

 

[lizjackchris]

Hi...I don't have much to add other than a lot of your experiences have been similar to mine. I had a front tooth RCT that never settled. Ended up pulling it and now have an implant. Not to say yours will go that way....but that is my experience. Since your dentist has been mentioning Trigeminal Neuralgia. have you ever taken lyrica or other anti-convulsant type medications? What about Elavil/antidepressant? Great for atypical/odontalgia. I am currently having my own dental pain right now with no clinical basis, not even a filling in the tooth. Currently on vacation and when I get home, will try Elavil again. As far as you feeling better on the antibiotic and now not so much could indicate an infection. I asked that in another thread and that seems to be the consensus. What has helped me through my dental nightmares has been to take an anti anxiety pill given by my doctor. Anxiety will exacerbate anything. I have also found elavil which has analgesic qualities to be helpful. I had the Cone Beam Scan two weeks ago on my most recent dental nightmare. Of course nothing was seen. Believe me. I am bewildered just as you are. An endo I saw 2 weeks ago mentioned how he sees x rays with people who have these enormous abscesses and no pain, they don't even know they have them and then people like us with nothing on any Xray or CT scan and are suffering. We're the ones hardest to help. Go to your regular doctor let them know what is going on and perhaps he can prescribe something to help alleviate anything that may be non-dental in nature. Good Luck....

 

[MountainMama]

Hi...I don't have much to add other than a lot of your experiences have been similar to mine. I had a front tooth RCT that never settled. Ended up pulling it and now have an implant. Not to say yours will go that way....but that is my experience. Since your dentist has been mentioning Trigeminal Neuralgia. have you ever taken lyrica or other anti-convulsant type medications? What about Elavil/antidepressant? Great for atypical/odontalgia. I am currently having my own dental pain right now with no clinical basis, not even a filling in the tooth. Currently on vacation and when I get home, will try Elavil again. As far as you feeling better on the antibiotic and now not so much could indicate an infection. I asked that in another thread and that seems to be the consensus. What has helped me through my dental nightmares has been to take an anti anxiety pill given by my doctor. Anxiety will exacerbate anything. I have also found elavil which has analgesic qualities to be helpful. I had the Cone Beam Scan two weeks ago on my most recent dental nightmare. Of course nothing was seen. Believe me. I am bewildered just as you are. An endo I saw 2 weeks ago mentioned how he sees x rays with people who have these enormous abscesses and no pain, they don't even know they have them and then people like us with nothing on any Xray or CT scan and are suffering. We're the ones hardest to help. Go to your regular doctor let them know what is going on and perhaps he can prescribe something to help alleviate anything that may be non-dental in nature. Good Luck....

Thanks. Yes it is very frustrating. I have already had one root canal on a molar fail for no discernable reason, so another one would be very disheartening. I have had two molars extracted since October, one the failed root canal, and one that was believed to have a fracture in the root (which it didn't). That is why my dentist is mentioning trigeminal neuralgia, but she is hesitant to jump to that diagnosis without ruling out other options. I would rather not take the medication if I don't have to, as I seem to react oddly with a lot of medications.

If the cone beam shows nothing, then I will see my doctor about trigeminal neuralgia.

 

[Judythecat]

I have atypical odontalgia and a side diagnosis of burning mouth syndrome. I was diagnosed after an MRI and full head x-rays. I was offered the medication mentioned above, but declined because of side effects. My pain shifts around, so I am constantly back and forth to the dentist, who assures me all my teeth are fine. It is extremely tiresome, so you have my sympathies. (Mine actually started with a front tooth too, which has never, ever had any treatment.)

 

[MountainMama]

I have atypical odontalgia and a side diagnosis of burning mouth syndrome. I was diagnosed after an MRI and full head x-rays. I was offered the medication mentioned above, but declined because of side effects. My pain shifts around, so I am constantly back and forth to the dentist, who assures me all my teeth are fine. It is extremely tiresome, so you have my sympathies. (Mine actually started with a front tooth too, which has never, ever had any treatment.)

I am scared of the side effects as well. I seem to always get the side effects from medications, even the seemingly innocuous ones. I developed an ulcer after taking less than the maximum dosage of ibuprofen daily while going through all my dental work. I was given a steroid pack for a back injury and developed tingly/numb legs and arms, and narcotics make me faint, as they drop my blood pressure. I have had other various reactions to medication but luckily have been fairly healthy through the years and haven't ever really needed meds much.

After all this dental work, I don't know that I can afford the testing done to diagnose trigeminal neuralgia anyway. Our medical insurance is better than dental, but I still have a $3000 deductible. Yikes!

 

[lizjackchris]

I am scared of the side effects as well. I seem to always get the side effects from medications, even the seemingly innocuous ones. I developed an ulcer after taking less than the maximum dosage of ibuprofen daily while going through all my dental work. I was given a steroid pack for a back injury and developed tingly/numb legs and arms, and narcotics make me faint, as they drop my blood pressure. I have had other various reactions to medication but luckily have been fairly healthy through the years and haven't ever really needed meds much.

After all this dental work, I don't know that I can afford the testing done to diagnose trigeminal neuralgia anyway. Our medical insurance is better than dental, but I still have a $3000 deductible. Yikes!

I can understand your concerns regarding the side effects of medications but I strongly encourage you to try medications such as lyrica or elavil if your doctor deems them appropriate to help. Pulling a front toorh is not the same as having one or two molars pulled. I have had molars pulled and I have lost my front tooth. You pull a molar and you can basically forget about it if you want. Losing your front tooth and going through the bone graft, implant, crown stages is just no walk in the park. It took me over 1.5 years from start to finish. I had a few issues along the way and ultimately things seemed to settle. I am 6 years in. I don't regret the decision as I was in terrible pain after my RCT that I only lasted 1 month not 3 months. At the time, I did not know of some of the medications out there for atypical dental pain/pain not of dental origin. I wonder if it would have made a difference. Just saying I would explore any and all options before pulling a front tooth. On a side note have you tried relaxation, meditation or creative visualization type techniques. I say to my self... "3 dentists say there is nothing wrong with the tooth, the tooth is healing, the tooth will feel better......the mind can play tricks on us especially when we are used to things going bad/wrong dentally......you expect the front tooth to fail, because the other two molars did. We expect a bad outcome as just "par for the course". Believe me I have had so many dental failures, I just expect things to go wrong. But we have to believe sometimes things will heal and go right. I hope this sorts itself out.

 

[MountainMama]

I can understand your concerns regarding the side effects of medications but I strongly encourage you to try medications such as lyrica or elavil if your doctor deems them appropriate to help. Pulling a front toorh is not the same as having one or two molars pulled. I have had molars pulled and I have lost my front tooth. You pull a molar and you can basically forget about it if you want. Losing your front tooth and going through the bone graft, implant, crown stages is just no walk in the park. It took me over 1.5 years from start to finish. I had a few issues along the way and ultimately things seemed to settle. I am 6 years in. I don't regret the decision as I was in terrible pain after my RCT that I only lasted 1 month not 3 months. At the time, I did not know of some of the medications out there for atypical dental pain/pain not of dental origin. I wonder if it would have made a difference. Just saying I would explore any and all options before pulling a front tooth. On a side note have you tried relaxation, meditation or creative visualization type techniques. I say to my self... "3 dentists say there is nothing wrong with the tooth, the tooth is healing, the tooth will feel better......the mind can play tricks on us especially when we are used to things going bad/wrong dentally......you expect the front tooth to fail, because the other two molars did. We expect a bad outcome as just "par for the course". Believe me I have had so many dental failures, I just expect things to go wrong. But we have to believe sometimes things will heal and go right. I hope this sorts itself out.

Thank you for sharing your experience, and for the suggestion. I would prefer not to have to pull the front tooth if I can avoid it. Antibiotics never helped the failed molar root canal, so obviously something is different with this one.

I am planning on getting an implant on the bottom molar, because it is really impacting my chewing ability. I already had my wisdom teeth out, and a set of premolars for orthodontia. I am not looking forward to the process.