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Dentistry/Strange problem with severe pain



I have had a strange dental problem with teeth numbers 5, 6, and 18 for about the last 5 years. These teeth are causing severe and at time blinding pain with changes in air pressure. All teeth have had root canals that were delayed for a varity of reasons and when the root canals were performed, the roots were necrotic/half dried out. The pain in teeth 5 and 6 were initially diagnosed as trigeminal neuralgia, however I have none of the symptoms of trigeminal, other than the pain being in the general area of the trigeminal nerve. This pain, (5 and 6) would spread in a line, #5 going up my face, through the eye socket and into the scalp. #6 would go from the tooth along my cheek and into the back of my head. I finally convinced my dentist to extract #6 and that line of pain stopped after the extraction. #18 doesn't bother me that badly, it seems to just go down into my jawbone and not spread out.

I have seen several dentist as well as a neurologist who have not been able to figure out what is going on.

Do you have any suggestions to what I should look at next? I really would like to avoid having #5 pulled, but the pain is getting to be too much.

Thank you for your time


Teeth Numbers
Teeth Numbers  
Hi Bill,

I am sorry you have been having so much trouble with your teeth.

How did you know specifically which teeth numbers are hurting you?  Most patients don't know that sort of thing.  And you specifically knew the path of pain from each tooth, to somewhere else in your head.  I also had to google a numbers teeth photo (see attached), as a reminder of which teeth you are referring to.

Having possible nerve damage in your mouth is sort of like trying to figure out where the electrical problem is in your car. Very tricky and even excellent doctors or dentists can have differing opinions on what it is.

See if you can find a dentist who is also a Board Certified MD.....It should be noted, that most dentists have the word "Doctor" in front of their name, but that does not necessarily mean they have the "MD" designation.  You mentioned that your root canals were delayed for a variety of reasons....what were those reasons?  Depending on the problem, it is usually a good idea to address those issues expediently.

Well anyway, like I said, see if you can find a dentist or Board Certified Oral Facial Maxillary Surgeon with an MD.  Of course there are many good dentists out there without the MD designation....but in your case, we are also talking about possible nerve damage.

Next, you have already done the right thing by visiting a neurologist.  I would get a second opinion from a Neurologist.  If the Doctor decides he wants you to get an MRI, ask him specific questions about that.  Not all MRI's of the head are the same.

Other than that, I would proceed in a very conservative manner. Tinkering with your bodies nerves or "electrical system" is a complicated endeavor and positive results are difficult to achieve.  Maybe get that neurology second opinion before pulling tooth #5.

Let me know what happens.  I am curious to know what you are going to learn going forward.

Best regards,
Twitter:  @JonPatientPOV  


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Jonathan at PatientBabble


My area of expertise from the patients point of view would be TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my bite problem. I am not a doctor, but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. ////// I come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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