Neuralgia flareup or can multiple teeth have suddenly gone bust?

[Judythecat]

I am partly writing this so I can see how ridiculous it sounds.

I suffer from atypical facial pain, diagnosed by Max-fac. It has been pretty “quiet” for the last wee while. This week my top front-ish teeth have been really bad. The pain is mainly in the gum (not like the tooth’s cuff, higher up) and right up in my nose. It BURNS. I had a checkup five weeks ago, all fine, and gums “smashing”. It’s not likely that multiple teeth have gone bad, simultaneously, in a month, is it? None of the teeth have ever had decay, but the very front one does have a small white filling because of over-brushing/erosion.

My next checkup is the end of January. I know my dentist would slot me in before if need be, but I don’t want to be a pest or waste her time.

Sorry if this post sounds unhinged, I just get so scared and worried, and I think I had kind of forgotten how horribly painful it is. In a way it would be better to have a dental issue, get treatment, all done, thanks and goodbye.

 

[Gordon]

Sounds much more likely to be a flare up from your AFP, given the multiple stressors around at this time of year I'd be almost more surprised if you didn't get a flare

 

[Judythecat]

Sounds much more likely to be a flare up from your AFP, given the multiple stressors around at this time of year I'd be almost more surprised if you didn't get a flare

Thank you for always being kind and answering my stupid questions.

Here is a thing I should remember. I took some ibuprofen in the morning for period pain, and it didn’t make any difference to my mouth. In the evening I had a couple of glasses of wine, and my mouth was quiet. Today - thankfully - it’s a bit less active. I doubled up my B12 last night, maybe that helped?

 

[Gordon]

I would have been very surprised if the ibuprofen did anything, it works on the brain to inhibit a molecule that's involved in the pain pathway, so it wouldn't work on a direct nerve pain like this.

B12 would take a while to be absorbed and get into your system so on balance I'd say the chilling with the wine was the answer... but as a Scotsman I would say that wouldn't I? Slainthe Beatha

 

[Judythecat]

I would have been very surprised if the ibuprofen did anything, it works on the brain to inhibit a molecule that's involved in the pain pathway, so it wouldn't work on a direct nerve pain like this.

B12 would take a while to be absorbed and get into your system so on balance I'd say the chilling with the wine was the answer... but as a Scotsman I would say that wouldn't I? Slainthe Beatha

As a fellow Scot I have to agree! However the pain was so bad today I rang the surgery, and my dentist has a cancellation on Wednesday so can see me then. Needless to say, within an hour of making the call, the pain was much more manageable and back to its “normal” level. I feel awful if I am just wasting the dentist’s time, but equally scared there is some big infection brewing that will knock me off my feet as soon as they shut for Christmas. This is a miserable condition!

 

[comfortdentist]

Have you considered an injection of botox into your nasopalatine foramen? Botox can provide reduction of pain for three+ months when the pain is in the area that you described.

 

[Enarete]

I feel awful if I am just wasting the dentist’s time, but equally scared there is some big infection brewing that will knock me off my feet as soon as they shut for Christmas. This is a miserable condition!

You are NEVER wasting the dentist's time, Judy. Maybe it was the reassurance of having an appointment that allowed your pain to ease a bit and if so then calling your practice was the right thing.

 

[Judythecat]

Have you considered an injection of botox into your nasopalatine foramen? Botox can provide reduction of pain for three+ months when the pain is in the area that you described.

Neither the consultant at the hospital or my own dentist has suggested this, but I will ask when I go in tomorrow. Thank you for suggesting it.

 

[Judythecat]

You are NEVER wasting the dentist's time, Judy. Maybe it was the reassurance of having an appointment that allowed your pain to ease a bit and if so then calling your practice was the right thing.

Thank you for being so kind. The receptionist was so nice, and right away said of course they would slot me in. It’s funny, I am not scared of the dentist, or having treatment (although obviously hope I don’t need any!) but I have a terrible fear of being a pest!

 

[Gordon]

Actually, Comfortdentist has got me thinking... I had a patient with severe neuralgia who couldn't take the neuralgia meds at all, so we gave her a shot of very long acting local anaesthetic (bupivacaine) in the general area of the trigger point.

While it didn't cure her neuralgia, it seemed to "reset" things for a good 4-5 days, so she could get some food in her and a decent few nights sleep. She also found it took a few days for the neuralgia to come back in full intensity.

Your dentist could perhaps order a bottle of it in for you and give it a try? You can't use a standard dental syringe for it, but a 1ml medical syringe did the job... pharmacies can order some of it.

 

[comfortdentist]

In the USA bupivacaine is available in dental carpules.

 

[Judythecat]

Actually, Comfortdentist has got me thinking... I had a patient with severe neuralgia who couldn't take the neuralgia meds at all, so we gave her a shot of very long acting local anaesthetic (bupivacaine) in the general area of the trigger point.

While it didn't cure her neuralgia, it seemed to "reset" things for a good 4-5 days, so she could get some food in her and a decent few nights sleep. She also found it took a few days for the neuralgia to come back in full intensity.

Your dentist could perhaps order a bottle of it in for you and give it a try? You can't use a standard dental syringe for it, but a 1ml medical syringe did the job... pharmacies can order some of it.

That sounds interesting as a desperate times measure. I am not medicated, so think I would need to try that route first - I really don’t fancy the side effects of the drugs I was offered, and am usually able to maintain the pain at about 3/10. This last week has been 9/10.

The good news is my dentist checked every tooth in my mouth, and my gums, and everything is okay. Gums were “perfect”, and no mobility, even though my teeth feel like they are flapping about inside my head.

I didn’t get a chance to ask about Botox because she was running quite late (three nurses off sick, so all a bit manic!) and I didn’t want to hold anyone up when they had kindly slotted me in. My next checkup is the end of January so I will definitely ask then.

Thank you and @comfortdentist for your kind and helpful replies. I am so lucky to have such a fantastic dentist in real life, but it is also so, so useful to get some reassurance online too. ?