Tuesday, January 21, 2014

Don't go to the dentist's office alone

My lingual nerve injury has faded somewhat and things have settled - I'm living "the new normal". My pain that is far less than ever since my injury. But I have a new dental situation that may stir everything again. Sitting eating lunch the other day I felt something pop out in my mouth - it was the crown from a very old (15 yrs-ish) root canal - the left molar, #14.

Apparently, the crown that dislodged was a "temporary" crown, was only intended to last a few weeks, but it's been there since I had the root canal re-treated a few years ago. Yes, I said years. I'm not proud of it, but there you go.

When I was reeling in pain following my lingual nerve injury, no one could figure out why, and they figured it was a failed root canal. When the re-treatment of the root canal didn't completely resolve the pain, they determined I ALSO needed a new root canal in the tooth next to it. I was like an injured deer in the woods, wide-eyed and naive, doing whatever they told me to do. I would have done ANYTHING to make the pain stop, and I imagine you feel the same way right now.

Were either of those procedures really needed? Who knows. Maybe all the pain was just from the LNI. )

Why did I never replace the temp crown? I can only guess that
A. I was so traumatized by all the work I had done on my mouth in 2010-2012 that I decided to postpone further dental work because I remember the doctors telling me to "give it a rest - let things settle" (only things never did settle, completely) and,
B. that crown simply got lost in the shuffle, after learning I urgently needed crowns on 2 other cracked teeth, in addition to the nerve injury I was still trying to nurse...there was just so much going on, that it was never done. I thought it was done, but it was not.

So now, bacteria has been able to creep in underneath all this time, so the already-dead and discolored tooth is now decayed to the point that the tooth is kind of falling apart.

I'm painting a really pretty picture here, aren't I? Trust me, I'm as grossed out as you are.

How could this happen? Well, anyone going through the life-altering distraction of a new lingual nerve injury knows that you aren't exactly on top of your game, and there may be details that, well, slip by. This all occurred at a time I was going out of my mind trying to trace the case of my ongoing pain and getting no answers, seeing doctors all over town, getting two very expensive root canals on the same side of my injury which only exacerbated the situation and, in hindsight, may not have even been necessary.

The crown falling off last week was actually fortunate; I wish it happened sooner. Had that not happened, I would not have realized I needed to do something about that tooth- remove it - and that possibly some of the continuing pain in my face/tooth/gum is caused by an infection there.

The dental assistant when I went in for the loose crown last week scolded me, saying "That's what you get - you can't let these things lie, Jane". I quickly rebutted that this was not intentional, and their office never called to remind me the work hadn't been completed. Their response is "we inform our patients when we see it, and it is up to you to remember".

You could say "What a crappy dentist!" and tell me to find another one, but this new dentist works in the same office as my orofacial pain specialist. Now that the pain is controlled, and I can think straight (well, straighter), I wonder what else "slipped by" over "the lost years" since being injured on 12/31/09.

If you are lucky enough to have someone you can bring with you to the dentist's office, do it. They'll be thinking much more clearly than you are. I'm not married, and my kids were still young then. Now I discuss my situation with them and they are a great sounding board. Back then, it was overwhelming, and not fair to put it all on them. I'm the parent, I'm the one who's supposed to be strong.

So now tooth #14 is dead and needs to come out, it's not healthy to keep it in my mouth. In fact, there is a school of thought that says root canals, trying to "save" teeth in general, are completely unnecessary. I can see how cosmetically they'd be desirable on front teeth, but should root canals in back teeth be performed at all?
They cost well over $1000+ in my area and only last 10 years max (the dentists never inform you of this, you assume it's fixed forever), root canals weaken the tooth making cracks more likely, so need to be covered with a crown which also costs an additional $1000 or so. We pour thousands of dollars into a tooth which is unhealthy, leave it in your mouth, and need to remove it some years later, anyway. The alternative is tooth extraction. Holistic practitioners advocate tooth removal and no root canals. I did not even know this was an option back when they were done!

This week I'm walking around with just a little brown nub in the spot where my molar used to live. I'm scheduled for oral surgery next week to extract what's left of the tooth. A few months from now, I'll have a permanent implant/ fake tooth put in that spot. It will cost a small fortune, even with dental insurance (insurance doesn't cover everything, and they may consider this cosmetic, but actually the tooth is being replaced to keep others from shifting out of alignment into the gap).

Knowing what I do now, I wonder why patients are never fully informed of their options, and always have to learn the hard way. If not for the Internet, I would not know any of this. Which is exactly why I'm blogging this today - because you may find yourself in a similar situation (or may have already in the past).

Going to the dentist has started feeling a bit like going to a used car lot. You wonder if you've been scammed, no matter how honest and fair they seem.

What else is there that the dental profession isn't telling us?


  1. from debilitating burning tongue pain for a year and a half... to 99 percent healed i used auricular acupuncture at 5 sessions I'm still dumbfounded i can't believe it .!..im going to link his Facebook page ..for anyone who's desperately needs help . https://www.facebook.com/asiantherapeutics?ref=br_tf

  2. Hi Jane,

    I'm sorry about your tooth :( Implants are terribly expensive and the procedure seems rather invasive. Is it absolutely necessary, given your history of nerve damage? Is the implant to be placed on the same side as where your LNI occurred?

    When my injury happened in 2010, my cracked tooth first went through a root canal, followed by an extraction when the pain didn't dissipate. The dentist too, thought it was a failed root canal. After the extraction, the dentist suggested I get an implant. I never did. As you know very well, I was dealing with the terrible pain of nerve damage, and to have an implant placed in the very spot where the damage occurred! It was a big NO for me. I figured I would wait a few months, and when (at that time, I was so sure the pain was temporary) the pain was gone, I would get the implant. Well, the pain lessened over time but never went away, and I never got the implant done. I'm terrified if I do, the injections and procedure would start up everything again! I do not think I could go through what I went through four years ago all over again.

    So, before you get that implant Jane, is it absolutely necessary for you? Would you consider just leaving a gap in your teeth? My mother had two teeth extracted, one at top, another bottom, thirty years ago. Implants were not invented then so when teeth were extracted, that's it. The rest of her teeth have been fine since then, with some gum recession and the occasional cavity which were filled up.

    I think implants are a great way to go for people with no nerve damage. But for those who are still suffering pain, I'm not too sure. And like you said, dentists don't tell us everything.

    All the best Jane, I look forward to your next update,


    1. M. - thank you so much for writing- I too am concerned about the necessity of an implant for a rear molar, but was told by my dentist I MUST have one or the other teeth would shift. But at the oral surgeon's office yesterday, they said I could choose to have an implant, a bridge, or nothing at all. The problem tooth is not only on the side of the injury, it is exactly the spot where I feel pressure all the time, 24x7,part of the "cone of death" on the left side of my face that still won't allow me to lie on my left side, rest my chin on my hands, etc. I mentioned to the surgeon that I'd hoped removing this tooth might actually relieve some of that pain vs. setting things off again, but he said it's not possible this tooth was causing any pain, it's got to be from the nerve injury.

      Even though the burning tongue has subsided a great deal, and the ear and throat pain are now only noticeable (more than a "3" pain) maybe once a week, that pain in the cheek/gum/tooth continues, which is a mystery yet to be solved.

      Thanks again for sharing your story, you may have saved me a lot of pain and money!! Best to your mother. JF

  3. were getting older ,and implants still have complications ,,,i suggest a bridge or eat softer yummies

  4. hi im new to this ,and want to post as well as read.

  5. Jane, Please do not fall for the teeth shifting. I had a failed implant! That is when the horror began...the left side like you...all your same pains. I begged them to take it out after 8 weeks of burning! It took 50% so 5 dentists later they said it was good. Day of extraction the CTSCAN showed black...bone loss. I suffered for almost 17 months and took the chance to get it out. Burning happened from implant back to where the novacaine needle went in. I recently put my guard down and got some bio stimulation that was supposed to help but made things worse! I cannot even believe it. My story began in April 2011. I wish the story would end and I could have the answer for all of us. I know I am not crazy or a baby! I too have tried the some of the same meds as you. Not enough research yet on the implants either. Good luck on what you decide. I know you will be careful. We do not have much choice sometimes. Thank God I am tough to begin with...but it is getting very hard. Let us know what you have decided to do.

  6. Found your blog. So much to read. 9 months ago went to dentist and four days later I woke up with a tight mouth and discomfort eating. I have the first two months recorded. Underside of tongue sore. Sometimes food just burned or hurt. It started feeling better and seemed around Thanksgiving it was resolving. Although plain water still tasted metallic. Food saltier. After New Year it come back. Bad winter. Always thirsty. March brought relief but after giving a presentation Thursdays night, talking for 90 minutes ... woke up Friday again in discomfort . Figure it was stress but hasn't resolved yet. Sigh .....

  7. As I think about the past 9 months I realize how much my joy of eating ad changed. Some days when I feel remission I do enjoy food; but it doesn't taste the same. Even now I can taste saltiness in my bottom gums behind the bottom front teeth seeping. Oil pulling with coconut oil and oregano essential oil helps some ....

  8. Based largely on advice here, I have opted not to replace the tooth, so have lived with the empty hole in my mouth where my molar used to live for a couple of months. It feels WEIRD, and makes it hard (more like impossible) to chew anything on the left side. But I'd rather have a gaping hole in my mouth than take the chance of agitating an already painful situation on the left side.

    Thanks again for your support and advice, and God bless! JF

  9. I am afraid now but have a dental appt Sept 2nd to replace #19 filling. RATS! Now I am freaking out because of this article! So let me guess, just don't go to the dentist anymore? Then I would HAVE to get a root canal! :(

  10. I have had extensive dental work performed over the coarse of the last two years. Have had 3 root canals as well as 3 implants placed. All successful. Recently having my molars crowned I felt a shock when I was getting injected. Very odd feeling. Since then (two weeks ago) my tongue has been numb as well as a feeling of soar throat. No real pain just discomfort. Reason for my posting truly is to say teeth in fact do and will shift if there isnt something in place to stop them from doing so. I am a proven patient of this. Should have been four implants going in however my molar shifted enough to only fit three in the place. It is not a big deal however it is a true fact. As far as implants go... not as painful or as disturbing as people beleive. Disconcerting yes but that is most definitely to be expected. Hoping this give people hope as well as some guidance. Wish you all the best.

  11. I am a 58 year-old female. My pain story goes back to 4/2010 and happened for no reason; just came out of the blue. I was in so much pain that reaching for a pen caused pain flashes along with excruitiating facial cramping. Talking and stress made the pain much worse; Crying and B12 shots helped. Since, I have visited approximately 60 speciaists; 400+ medical/dental visits and spent over $60K! No one could give me a diagnosis that made sense; a lot of ccontradictions. After going around and around with specialists, in 2/2013 a dentist recommended mouth restoration. The orthotic used prior (3-4 months) to the restoration proved that maloclusion was the problem as the fog lifted, horrid pain was gone; the only problem was slight sensitivity in the front upper teeth. The dentist said that the sensitivity would not worsen with the restoration as those teeth would be sealed. Then, 14 teeth were reconstructed on 6/2013 (#22-27; #5-12). Note that nothing was wrong with the teeth, except worn enamel) nor gums, the teeth were just in the wrong place which caused malocculsion. The morning after the restoration the 4 front upper (#7-10) and lower teeth (#23-26) burned like acid was being poured on them. When temps were removed, #26 was broken and the dentist performed emergency root canal; that tooth turned black at the root and hurts when touched/percussion, but doesn't react to hot/cold. The burning pain in those teeth (7-10; 23-26) hasn't stopped (been 20 months); pain worsens after I talk, eat or any percussion and they also reacts to hot and cold, except#26, which had the root canal. I have been drinking meal replacements for breakfast and lunch with soft food for dinner. I am unable to bite into anything using those front teeth. Forget anything chewy or crunchy and forget kissing, talking and laughing. After dinner (chewing with back teeth) the burning pain in the front teeth goes through the roof. I am unable to tolerate pain meds and currently taking Neurontin which does help alleviate the pain. Recently went through two rounds of the medrol pack which alleviated the pain altogether for two days. Since the restoration, I have visited 8 dentist specialists (DMDs, Prothedontist, Periodontist, prosthdontist, neuromuscular dentist, endodontists), , and all have said they never have seen nor heard of a case like mine and there is absolutley no reason for the teeth to burn. My gums are perfect, the margins on the crowns are perfect, no infection, no inflammation. One DMD diagnosed BMS, but I have no symptoms; no dry mouth, no sores, no mouth burning, and the recommend klonapin didn't help the burning pain. I have also had multiple visits to allergist/NAET, chiropractors, and massage specialists to no avail. I nenowned neuromuscular dentist thought possibly ligament sprain and malocculsion could be the problem. He recommened another orthotic ($5K) along with medrol pack; it hasn't helped the burning teeth. My bloodwork is impeccable; no vitamin deficiencies noted; perfect blood pressure. Note that novaccaine injection makes the burning pain immediately go away; the dentists and others say "interesting", but will not tell my why. I am seriously considering extracting those teeth, but have been told I would be hard pressed to find someone to pull them due to my good oral health. Could lingual nerve damage be the cause? Any other diagnosis or treatment recommendation?