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Root Canals

Severe pain on gums pulled tooth/root canal



Back in Sept, 2006, had a tooth pulled (#30) after 3 root canals were done and still in pain, then was told that I need root canal done on #29 and #31 next to the tooth that was pulled, which I had done in April and June, 2007. Still have severe pains. Went to dentist, been on antibotics several times, went back for recheck of the root canals and was told they are fine. Had second opinion by endodotist, and was referred to Periodontist which he said everything including my gums were fine, no pockets, no gum disease. Then went to regular doctor and had CT Scan and MRI which were fine. She put me on Lyrica and it seemed to help.

My problem is that I am in (sometimes severe) pain constantly around the top of the gums and jaw around #29, pulled #30 and #31. The pain does not stop. I don`t know where else to go or what could be wrong. When the Peridontist touched my gums I was in great pains and he said that he never seen anything like it before. Cannot touch or chew on my right side. What could be causing this? Where else can I turn?


You may have developed what is known as atypical facial pain, an entity that refers to pain in the face that does not quite fit the criteria for trigeminal neuralgia. Atypical facial pain is often a "neuropathic" (or "nerve dysfunction") type of pain. That explains why the Lyrica (which works on neuropathic pain) helps.

It is not known why it occurs in some people. The Lyrica may be titrated up to effect and tramadol (aka Ultram) may help with breakthrough pain. If pain persists, you may benefit from seeing a pain medicine specialist.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University