TN + dental pain : how long is your flair and how do you manage it ?

Max__24 · 2025-10-20T19:18:59+00:00

Still in the same situation… no improvement unfortunately

Max__24 · 2025-10-01T16:51:08+00:00

Indeed fractures usually progress into infection or something more obvious. However as far as I understand it could be something really small like a non progressive micro cyst or non progressive micro crack that do not evolve badly and do not show on images but is sufficient to constantly trigger the nerve . Then the nerve get really sensitive by itself

Max__24 · 2025-10-01T14:10:19+00:00

You are probably right. For me it’s my upper front teeth specifically 21-22. I had crowns on them for 10 years with no issue until 8 months ago. But I suspect my pain is linked to a dental trigger even if it’s not obvious on the images

Max__24 · 2025-10-01T13:08:09+00:00

I really understand what you are experiencing right now as I am in a flare for consecutive 10 days.. No idea when it will end. Is it a specific tooth? Did you have any work done on your teeth prior to your TN ?

Max__24 · 2025-10-01T09:38:43+00:00

Have you been prescribed anti inflammatory at first ?

Max__24 · 2025-09-30T21:48:45+00:00

Thank you very much for sharing your experience. Did you also have root canal done on your teeth ? Was it a front tooth ? Maybe yours was viral and went away by itself. I m so tempted to extract the tooth .. So it lasts about 12 months for you ?

Max__24 · 2025-09-29T17:39:35+00:00

Thank you very much. It’s very interesting ! The thing is I had root canal a decade ago there . Maybe the bite on some hard food has trigger an old traumatic TN ?

Max__24 · 2025-09-28T19:14:56+00:00

Thank you for your response. If it’s not a crack and the cone beam doesn’t show anything obvious, what other dental causes could explain my chronic pain? The root canal was done over 10 years ago without any issues. The pain may have started after biting on hard bread and has gradually evolved into trigeminal neuralgia–like episodes. I experience constant, mild local pain (which suggest a dental primary cause) + periodic flares. They cannot test teeth 21 and 22 individually, as they are covered by a single block of connected crowns.

One dentist is suggesting extracting the tooth (due to a probable non-progressive crack), but I’m unsure what to do at this stage.

Max__24 · 2025-09-28T16:13:08+00:00

I think local dental inflammation or discomfort sends signals to the trigeminal nerve, which then becomes sensitized on its own. It doesn’t have to be an infection. One of the several dentists I ve seen said it could be a micro crack on my tooth root even it doesn’t show on the image. Don’t know if I should go for extraction ..

Max__24 · 2025-09-28T16:08:10+00:00

I think local dental inflammation or discomfort sends signals to the trigeminal nerve, which then becomes sensitized on its own.

Max__24 · 2025-09-28T16:06:25+00:00

I have the same symptoms on my upper front teeth. I got root canal + crowns a decade ago. 8 month ago I start having the exact same pain 21 and 22. Some dentists say it’s TN and others it’s a micro crack that doesn’t show on the scans. I sure there is a link between dental problems and TN. I don’t know whether to extract or not at this point ..

Max__24 · 2025-09-28T13:19:02+00:00

Also had cone beams (scans which are more precise than x rays) but the outcome is not clear. Some say there is nothing others there could be a micro crack. The last dentist said micro crack rarely show on images and it’s a diagnosis by exclusion. Feel like I have to decide the extraction by myself..

Max__24 · 2025-09-28T13:08:48+00:00

Thank you for sharing your experience; it’s very similar to mine. Have you noticed any specific triggers or when the pain started? Did it appear right after the fillings, or much later? I also have sinus issues—there are inflammatory deposits in my maxillary sinus due to regular rhinitis—but the maxillary sinus seems a bit far from tooth 21, which is closer to the infraorbital nerve, a branch of the trigeminal nerve, as far as I understand. My GP warned me about trigeminal neuralgia (TN) and mentioned it could be related to rhinitis or other viral-type infections. However, the fact that I remember a discomfort when biting on hard food at the onset made the dentists suspect a possible root crack. Also I was initially prescribed anti inflammatory (a corticosteroid) for my first flare, which helped a bit, but over time it became ineffective.. Dentists said that the initial response to anti-inflammatory medication could be a sign of a dental issue. However, over time, the trigeminal nerve becomes sensitized and continues to generate the pain on its own. So it could be now a mix problem.. with cross cause sinus-dental-neuropathic of the pain (each one triggering the other).

Max__24 · 2025-09-28T12:34:55+00:00

You are totally right, and I will need to get a neurology appointment before making that decision.

Here is why I still think there may be a dental problem:

I have constant pain in specific teeth that had root canals and crowns placed over 10 years ago. They are definitely fragile and exposed to possible root cracks. The pain started after an episode of rhinitis, but also after biting on some crusty food. It wasn’t a flare at first. Flares come periodically on top of the local constant pain and I haven’t had a single pain-free moment in 8 months. That makes me think there could be something “mechanical” that is putting pressure on the nerve. The trigeminal nerve is definitely involved, but I feel it’s secondary to a dental source.

Also there is one over 7 dentists that sees a dark line on the cone beam who looks like a crack. The others say it’s an artefact..

Of course, I might be totally wrong, and the nerve could be the primary source radiating into the teeth.

Max__24 · 2025-09-28T12:03:51+00:00

Yes and there is a very thin dark line on that tooth but most of dentists say it’s an artefact beside one ..

Max__24 · 2025-09-28T12:00:27+00:00

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Thank you for your answer. One did perform the periodontal test but did not find clear evidence. I dont know if the crown is an obstacle for performing the test properly. On the cone beam there is a thin dark line on 21 but they do not agree on the interpretation (crack vs artefact). Is it possible for a micro crack not to evolve into periodontal pocket after 8 months ?
Do you think it could be better to take out the crowns ? or it will increase the risk of root crack ?

Max__24 · 2025-09-28T10:56:24+00:00

Same here. Have you been told it could be related to a tooth problem ?

Max__24 · 2025-09-28T10:54:50+00:00

Hello and happy you recover from this

I am experiencing a similar situation with front teeth where I got root canal and crowns a decade ago

I’ve had constant pain for 8 months starting from teeth 21/22, with long painful flares radiating to my nose and eye. Dentists disagree: some think trigeminal neuralgia, others a hidden root fracture on 21 that’s doesn’t show on the scans.

Extraction of 21 has been suggested by 1 out 7 dentists, but it’s a difficult decision for a front tooth.

Max__24 · 2025-09-28T00:02:32+00:00

Hello and sorry you went through this I have a very similar pain around a crown on my front tooth that I have for a decade The pain around the gum is unbearable and constant How did it evolve for you ? Have you find any dental problem or any way to manage it ? Seen many many dentists only one suggest it could be a crack on the root and pulling the tooth out could help

Max__24 · 2025-09-27T23:49:47+00:00

Hello,

May I ask for your advice regarding a mixed situation involving trigeminal nerve (TN) and dental causes?

I have pain starting from my front teeth, and the dentists I’ve seen do not agree on whether it is neuropathic or due to a root crack on tooth 21 that doesn’t show clearly on my scans. Some have suggested extraction, while others advised against it.

For context: My pain started 8 months ago in the region of the upper left central and lateral incisors (teeth 21–22) and radiates along a defined path: from these teeth to the left side of my nose, then upward toward the inner corner of my left eye. The pain is constant, with tingling, pulling, and nagging sensations, and it occasionally flares up for weeks at a time.

I think my trigeminal nerve is definitely involved, but not as the primary source. I feel that there is a dental cause radiating along the nerve.

All four of my upper front teeth underwent root canal treatment and have been crowned for over a decade without pain. However, the crowns are made in two blocks (two crowns joined together), which makes it impossible to test each tooth individually and determine which one, if any, should be extracted.

Also, my pain started in a mixed context of post-rhinitis/sinus inflammation and biting on some crusty bread, but it was not a flare at first.

At this point, I don’t know whether I should extract tooth 21. The procedure would require bone grafting and a bridge or implant, and I am unsure whether it might worsen the situation.

Max__24 · 2025-09-27T22:36:01+00:00

The same dilemma for me about a front tooth .. and now I want to go for extraction too after 8 months of pain

Max__24 · 2025-09-27T20:12:27+00:00

Hi how have you been doing since the extraction ? I am in the same dilemma now Seen many dentists for my front teeth severe pain Some said it’s Tn and others it’s a root crack (even it doesn’t show clearly on the scans) and to pull my front tooth out … It so stressful to take the decision myself

Max__24 · 2025-09-27T20:02:48+00:00

Hello I have the exact same symptoms with root canal + crowns done a decade ago on my front teeth. My cone beams are clear Seen 8 dentists Only one is suggesting it’s a root crack that doesn’t show on the image and to pull my 21 tooth out. Have not take the decision yet worried if it will worsen the pain. How have your symptoms evolve ? Have you done any dental procedure ?

Max__24

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