I agree with your entire basis for the problems regarding root canals. I also agree with your statement below about lasting pain due to a chronic infection. This is precisely why it is such a grey area when it comes to TN. I personally would never have had a root canal had I known then what I know now.
Type 2 Trigeminal Neuralgia when presenting itself in the mandibular branch mimics tooth pain. It does not matter if the person does nothing, has a filling, root canal or an extraction. The pain will remain and most likely worsen.
There are two different things happening. So, when presented with this type of pain and there is no physical evidence of an infection I think that it is important to at least consider a problem with the nerve itself, separate from the teeth.
Many people that have TN have had one or more unnecessary root canal or extraction. Knowledge of this rare disease in the dental and medical fields is lacking.
You do important work on this website and I do not mean to undermine that in any way. I simply need to bring it into the conversation if I see red flags going up. You are aware of TN and how and when it can present itself in the dental chair. Maybe in these situations you can present it as well so that at least the patient is aware of it?
After all this is a website about Neurology. The trigeminal nerve serves a person's entire face. When presented with nerve pain Trigeminal Neuralgia or Neuropathy should at least be in the conversation. It takes some people many years to receive a proper diagnosis. If more people at least knew about its existence that would not be the case.
Here is some more info:
Originally Posted by Bryanna
I cannot say for certain but I would not be surprised if the main reason people continue to have TN <like> pain after an infected and/or root canaled tooth is removed is due to the chronic infection that has diseased and damaged the bone and beyond. The entire area that surrounds an infected tooth can be severely inflamed and very sick. The surgery to remove these teeth and bone has to be very extensive which could result in permanent or temporary nerve damage. It can also be very difficult to eradicate all of the diseased bone because bacteria hides in the nooks and crannies of the bone.
With that said, I cannot help but think that keeping an infected teeth and/or root canaled tooth while treating the TN pain would be counter productive. I think it is unfortunate that all too often people get caught between a rock and a hard place because at that point no matter what they decide to do they may continue to be in pain for the rest of their lives.
This is why I repetitively inform people to think twice about keeping an infected tooth... root canaled or not.