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Dentistry/Severe Complications and Nerve Pain after Apicoectomy


QUESTION: Dear Dr. Teig, I have spent the past three years of my life literally living in misery after an apicoectomy. In the summer 2009 I had a root canal and then an Apicoectomy on tooth number 7(top right side of mounth). After the root canal there was a lingering infection in my face above the tooth behind my nose on the right side that is why the apicoectomy was performed. Immediately aterwards I experienced complications including severe pain, facial swelling to the point where my right eye was swollen shut. I was put on antibiotics on two different occasions to relieve the swelling. For months afterwards I constantly complained to the endodontist about the pain and he said it would take up to a year to heal. After sometime he then told me the pain was being caused by tooth number 8 and went on to root canal that one as well. That offered no help to the pain I as going through. The pain got worse and was constant nerve pain throughout the right side of my face. I started getting everyday pain in my cheek, behind my right eye, in all my upper right teeth. It felt like constant sinus pressure and pain. I also started getting the horrible headaches on the right side as well. I literally feel like someone has a voodoo doll of me and they are poking my right side of my face constantly. Even the air entering my right side nostril running through my sinus canal causes severe nerve pain in the area where the surgery was performed. So tooth number 7, tooth number 8, my cheek, behind my right eye, the headaches all come and go at different times. This has taken the joy out of my life. I have seen ENT doctors, Neurologists, Every dental specialist there is.My Otolaryngologisttold me the sinuses are fine it has to 100% has to be nerve related. Everyone gives me a different opinion but no one has given me any relief. I have heard take out the teeth, I have heard take all the top teeth out and get dentures. I have herd get the all on4 procedure for the top and take out all the teeth. I have been on Nerve medication called Gabapentin where I couldn't even function. I have been on pain killers, anti-depressents. I was told to get experimental nerve blocks on my spine that would help the nerve pain in my face. Bottom line is I am miserable. I am 41 years old with 6 kids and want joy back in my life. I have expressed my concerns to the Endodontist Dr. Bryan Berteaux in Katy, TX over the past few years but he takes no interest in my issues and doesn't seem to be concerned. What can I do for relief? I mean this when i say I would give my right arm to be pain free.

ANSWER: Bryan -  Of course, without examining you I cannot be completely sure.  Long term pain masks other problems.  You don't say if any of the doctors has given you a novocaine injection.  Often the novocaine can make the pain go away, then it shows that it is neurological in origin.  It sounds like the doctors have not eliminated at least once possible cause, before they have moved on to other possible causes.  You should have a board certified oral and maxillofacial surgeon evaluate you.  I suggest that one of the first things to do is to see if a novocaine injection in the area eliminates the pain.  If it does, then nerve injury is a good chance.  Any doctor needs to eliminate one possible cause at a time.  Just by elimination alone, the cause will remain.  I know it takes a little time and patience by you and the doctor, but it is the appropriate way to be sure of the cause of the pain.  

If the novocaine gets rid of the pain and nothing else works, the surgeon can inject the nerve where it exits the bone and actually kill the nerve.  I know that sounds terrible, but it eliminates the pain.  So you should see a board certified oral and maxillofacial surgeon to help come up with the cause.

---------- FOLLOW-UP ----------

QUESTION: Can you suggest anyone in the Houston Metro area?

Thank you,


Bryan -  I am not personally familiar with oral and maxillofacial surgeons in Houston area who are proficient in this treatment.  I am going to give you names of a few board certified oral and maxillofacial surgeons there who should be able to help you.

1) Dr. Mark Wong -  (713) 500-4311

2) Dr. Paul Metz - (713) 464-2833

3) Dr. Michael Sitters - (281) 440-1180

I wish you well and hope one the above can help you.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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