Looking for some helpful suggestions

[worried76374]

31 year old female, otherwise healthy, history of panic disorder

6 months ago, severe pinching clawing sensation in right side of head, one day later, severe shooting pains in lower right teeth

1 week later, shooting pains spread to lower LEFT teeth, days later, pain spreads to upper teeth BOTH sides. Massive headaches lasting up to an hour. Strange crawling and tingling sensations all over my face. These subside over two weeks or so.

MRI normal, no vessels touching either nerve. Thin slice MRI done at Mass General. Neuro says not TN. Went to a neurosurgeon for a 2nd opinion, he says not TN.

Present day: Pain still in teeth, changes sides and locations. Mild pain, aching to sometimes shooting.

Currently taking Lyrica 150 mg/day
Nortryptiline 75 mg at bedtime

Went to cranio facial pain specialist who looked at me like a deer in headlights. Spent 3 hours in the chair. Lots of poking, prodding, back molars on both sides VERY sensitive to cold testing. I almost screamed. The pain is  not normally that bad. He gave me 3 dx's: traumatic trigeminal neuralgia. I asked "Where's the trauma? Why is it bilateral?" Then he said, "No, I mean you have Pulpalgia" But I have normal xrays! Then he says "You  might need a root canal, let's wait a month and see what happens." He gave me a shot of Marcaine in the lower right nerve which stopped the pain on that side but not in the upper right, left or lower left. I think it is criminal to let dentists claim they are facial pain experts with hardly any knowledge of the human brain!

I learned from the facial pain specialist that my nightguard had shifted my bite, so I am only biting down on one back tooth. I stopped wearing the nightguard and my bite seems to be getting better.

My family dentist cleared me of any teeth problems. I did experience serious emotional stress (crazy plane ride) before the sudden headache and eventual tooth pain.

Nobody can explain what is happening to me. What could have caused the sudden onset of teeth pain and have it spread to the other side? My whole set of teeth is one big symphony of throbs and pains.

My face also hurts on the left apple of my cheek and my forehead and scalp burns every few days.

PLEASE give me thoughts on what you think is happening to me. I had a life before this, a really nice one, and I'd like to resume it.

I had a dental cleaning two weeks prior, but my neuro and dentist said that would not cause this pain.

What do you think?

Thanks!

[ggreg]

Well, I am fairly certain it is the wearing of the night guard that caused this whole series of events.  Those things can shift, which yours did, or break down, and cause you to grind down unevenly, resulting in all sorts of wierd tooth pain.  The plane ride before all this happened also points to this, becuz you were nervous, so your teeth probably unconsciously gripped down mighty hard during that time of stress, and that's when tooth-on-tooth set the nerves on fire in your mouth.  I know, you have it on both sides, but when you goof up a tooth on one side, it can cause you to change your bite on the other side, and set up a bunch of discomfort over there, too.

Unless not wearing the night guard is a HUGE problem, I agree with the facial specialist, don't wear it no more... or you could get a new one if it's a big deal.  I might also mention that assuming your wisdom teeth have come in, at your age of 30 sometimes those can cause pain.  You can always have them pulled if you continue to have some sort of problem in the back of your mouth.  I remember one of mine started bothering me something fierce, and I demanded they take 'em all out, and talk about relief!  They can come in sideways or push against its neighbor, and this hurts.  

Also, ordinary gum disease (despite the dentist giving you an okay) will cause your mouth to swell and hurt in different places, especially in the back teeth.  Get a flashlight and magnifying glasses, and have a look-see in your mouth in the back.  See if your cheeks are swollen and show bite marks on them, or if your gums are red around the back teeth.  

If they are red or swollen, good oral hygiene can help clear that up.  Get you a Waterpik thing, great for keeping stuck food out of there.  One more thing, next time you feel that awful shooting pain, crush up some cloves or get clove oil, and put some on the molars that hurt, and keep it there for about five minutes, and the pain will leave you for a couple hours.  But I do think initially, after a couple more weeks of no more mouth guard, like they told you to do away with, you might notice the pain goes away.  If not, then the other ideas I mentioned may be at work.  Anyhow, I think it's a tooth deal, not a neurological deal.  In fact, if it keeps bothering you, try a new dentist perhaps.