Dentistry/Upper Palate Chronic Pain
Long story short, I have had upper palate oral pain for over 5 years. I had extraction of my upper teeth six months before the pain started. I have tried everything. It seems to be a shooting, electrical pain that appeared to act like TN, so after all the Neurologist's medications for TN, I went to Oregon Health Science Center and was assessed by a Neurosurgeon. I had a MRI, which ruled out TN. After that, I was seen by an Oral Maxillary Surgeon, who said I am one of the rare people who can not wear dentures and he doesn't have any ideas as the anatomy from all the films look normal. The pain has caused me to be under a pain management program and since it is nerve pain, all the narcotics only allow me to tolerate the upper palate pain. I am unable to chew, talk, or anything to due with the mouth, which is basically everything and has ruined my quality of life. My husband of 42 years is affected, as well, because I lay on the couch most times and cry. I have tried heat, cold, and nothing helps. We have asked the Oral Maxillary Surgeon to think out of the box and possibly find some type of injectable medication or anything, such as botox, to numb the nerves in the upper palate so I can tolerate life. Do you know of anything or any studies, or research injectable medications that would numb or destroy the nerves,, or even if I had to have ongoing injections to control the pain? We are at the end of our possibilities of hope. I am a 61 year old woman, a RN, and not being able to wear dentures makes it very difficult to be out in public. Thank you for any help or research you can do.
Debbie - I am so sorry to hear about the overwhelming palatal pain you have endured for the last 5 years. Unfortunately, I have seem patients who have experienced similar pains, some in the same area and others in different areas. I have used, a number of times, a simple injectible medication for areas with overwhelming pain and the injections have eliminated the pain, but the trade off is permanent numbness. I am a little surprised that the doctor you have seen have not suggested the following. Simply, injection of dehydrated alcohol into the two greater palatine nerve canals. These canals are located in the palate, usually between the 1st and 2nd molars on the plate on each side. These injections will usually provide permanent numbness of the palate and all the areas that the nerves provide innervation and sensations. Will this work? The first thing that should be done, just to test if the alcohol will work, is for the oral and maxillofacial surgeon to injection local anesthesia into each palatal canal. If the numbing with the local anesthetic works, then the alcohol, if done properly will also work.
The above will provide permanent numbness, but also no pain. If you have additional questions, feel free to contact me again.