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Crown issues — atypical facial pain?

  • Thread starter Thread starter Sarah77
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Sarah77

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I had a crown placed September 29 on my lower back molar. Just a tooth that had large filling and we put a crown on in case that tooth would eventually crack. Post and core build up, too. Dentist said that the filling wasn’t too close to the pulp chamber and expected no problems.

The tooth has been generally achey ever since. Not to pressure on the sides. Not to wiggling. Not too sensitive to cold but a bit heightened. But just a dull constant ache. I’ve been to the Endodontics and the dentist multiple times— nothing shows up on x rays or the cbct scan. But the last week I have been getting a sharp pain when I chew hard foods (tooth is not in contact as it has been adjusted). I am also getting these random, unprovoked sharp stabbing pains in the tooth that feel like a needle is being pushed down into it. Sometimes I can recreate that feeling by pushing down on the tooth. When that feeling occurs it is achey for hours with a higher pitched ache if that makes sense and then returns to the same constant dull ache. Other times when I push down on it hard there is no ache IN the tooth whatever and it just continues to be dull and achey.

A little history — ALL of my crowns and root canals have hurt afterwards— still do. They ache unprovoked and they really ache when I do provoke them. The neurologist has determined it is atypical facial pain and has me on gabapebtin. It is his belief that none of my teeth actually needed root canal and it is neuralgia.

I am rather used to the constant ache feeling but this sharp shooting pain (provoked and unprovoked) is really scary and new. Also the sharp pain on biting hard food is new and unlike the other teeth pain.

Could that be the neuralgia? Or a cracked tooth? Do cracked teeth hurt In that type of way all on their own? This sharp needle like pain?

Tylenol, ibuprofen, aleve, etc don’t touch or change the pain at all.

Just so so tired of crowns then pain, then root canal and still pain. It doesn’t make sense that literally every crowned tooth follows this path.
 
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Could that be the neuralgia? Or a cracked tooth? Do cracked teeth hurt In that type of way all on their own? This sharp needle like pain?
Yes. Also yes. Also yes. Also yes :-(
Trigeminal neuralgia is not commonly associated with multiple trigger points, so moving from upper to lower and left to right would be very unusual, if that's what's been happening.

Neuralgia can normally be controlled by Tegretol. has that been tried?

Occasionally you can get a bit of relief by giving a block injection with a long lasting local such as Bupivacaine, this can sort of "reset" the pain receptors and give a bit of longer term relief, the local itself will last for a good 12 hours. Your dentist would need to order some in specially for you, it's not one we use routinely.

Sorry, really not much more help I can offer you.
 
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