Been prescribed medication for trigeminal neuralgia


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Have had dental problems on and off for 6 months ! Had an extraction in January and since then had problems ! Dentist had done all they can and has referred me to a specialist dental hospital in Leeds . The waiting list is between 16-18 weeks! The pain seems to be getting worse. Today they have prescribed me Carbamazepine as this is the only option left that they can do for me. Will the place they have referred me to be able to do more for me if these tablets do not work as I’m panicking now thinking I’m going to have to live with this pain for the rest of my life and quite frankly it’s starting to make me depressed !
I’ve had x rays done and went to the hospital for an x ray and 2 dentists can see no problems with the tooth . Thanks in advance
 
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Dr M

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Good day

Carbamazepine is often prescribed for neuralgias. If the tooth that was extracted was a difficult extraction or a surgical extraction, there is a chance that the nerve could have been damaged during the procedure, or even during the administration of the local anaesthetic.
The pain that you are experiencing now-is it related to another specific tooth or just a generalized dull, burning or tingling pain?
I have had cases where the nerve did get an injury, and then I also prescribed Carbamazepine in order to help with the " nerve pain" , but in most cases what is needed is time. A nerve injury, if not permanent, can sometimes take months or even a year to heal fully again, as the fibres regenerate.
 
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The extraction was a simple one and there were no problem. It’s a dull pain but gets sharper every now and again. I can feel it on the back tooth , the extraction site (the one in front ) and the tooth in front of that one .
 
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Had tooth pain in October/ November last year went to dentist had a failed root canal so they took the tooth out . I’m a slow healer my dentist says as the extraction sites have always healed slowly. A few weeks after there was pain that I told them was my back tooth. Had numerous appointments to alter my bite. Paid for a mouth guard for sleeping . Things improved for a few days then this pain kept coming back. Had x rays in the dentist and was sent to the hospital and none of the dentists could see anything wrong on the x rays lve Exhausted all options with the dentist . I’m on a referral waiting list but it’s looking like 16-18 weeks. Dentist has prescribed me a dose of 100mg carbamazepine to take once a day and she will review . I’ve just taken my first tablet
 

Dr M

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It might also be that one of the other teeth might have a crack and then a CBCT scan might be the only way to possibly see it, since conventional x-rays won't reveal a crack in all instances. Have you been taking any anti-inflammatory medication?
It is possible that an occlusal adjustment might have been needed, but if there was no real relief, further investigation might be needed? Have you been referred to a specialist of any kind?
 
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Yes I’ve been referred to a dental hospital in Leeds. I’ve had one of the scans that move around your head is that a CBCT scan. I will attach the photo
 

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Dr M

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The x-ray you attached is a panoramic x-ray which is still only a 2 dimensional image. A CBCT scan is a 3 dimensional view of the area
 
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I was prescribed carbamazepine and took for 14 days and there was no change in pain , actually it’s got worse ! Dentist told me to stop taking and made me an appointment to do further investigations on Wednesday . Still getting worse but feels like it’s spreading . My neck hurts and the extraction site in front of the painful one and the 2 teeth in front of that one too. Also my upper jaw feels painful sometimes too. I haven’t had a normal dentist x ray since just before they did the extraction on the other tooth in January so I’m hoping they will find something on this updated x ray on Wednesday .
 
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Hi sorry to hear your traumas, I wanted to post a reply on unfortunately we can’t help with an answer but my husband has been and still is suffering something similar. Been in pain since around June time eventually gained access to dentist and now has seen various ones plus a private CT scan done various xrays but none of the dentists can establish what is causing the pain. It is the same chronic every day with occassions where it increases. He got referred to a dental hospital and has seen root canal specialist today to rule out issues with a previous one but again nothing showing. The guy is suggesting now not dental pain and has referred him back to the original person he saw to look at pain blockers and check what else it could be.

We have tried gum shields antibiotics allsorts but nothing has worked if anything made it worse.

Just thought it may be worth replying to say not alone and also to see if anyone may suggest anything to sort us both out strangely enough we are from similar areas if you mentioned Leeds we were referred to the Sheffield one.
 

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