Trigeminal Neuropathy after Dental Work (amidst other things)

Hi All,

I am new here and would love to describe my situation and see if you have any thoughts. Even though I have been researching the heck out of this, this may be the first time I am sharing the full crazy story... it will be long, so if you make to the end, I will be so grateful! Here goes.

I am married with two grown sons. For the past ten years, I have been helping care for my mom who had dementia. I have been extremely close to my brilliant, loving, funny mom, so to watch her deteriorate for years was... well, you can imagine.

Even though I had a lot of anxiety and stress because of this, I thought I was coping fine, and was completely healthy physically.
Until one day in the summer of 2025 (14 months ago) I had to go to the ER with an extreme abdominal pain which turned out to be a large calcified fibroid. I was told by multiple surgeons I needed a hysterectomy, which I desperately wanted to avoid. I finally found a surgeon who was willing to remove just the fibroid itself and leave my uterus in place.

While waiting for the surgery, I developed a dental infection in a crowned tooth that previously had a history of many interventions. There was no pain, but I was told the tooth had to go. I wasn't sure how quickly I would recover after fibroid surgery and wanted to be done, so I had the tooth extracted the day before (!) surgery. (In hindsight this was stupid, but I didn't know any better).

I had the surgery, it went fine, but while I was recovering, the extraction site in my mouth continued to hurt for weeks. Oral surgeon kept telling to give it more time. In the meantime, at the same time I started having weird UTI-like sensations that I thought were caused by the fibroid surgery. The pelvic pain became really bad. I ended up in the ER again, where I was told I had pelvic congestions syndrome - the first I've heard of anything like that. On further examination and testing, it was found that I also had a vascular compression called Nutcracker Syndrome. This all unfolded over a couple of months after surgery. Now I had mouth nerve pain (it sort of fluctuated but was always there), and the crazy vascular pelvic pain.

Add to this many appointments with vascular specialists, testing, researching, freaking out, etc. I couldn't even figure out which one of my two issues was worse - and to be dealing with both at the same time was just crazy. I had a procedure scheduled called ovarian vein embolization. I was really scared about this as well, obviously, especially because from my research it looked like it didn't usually help too many people and actually often made people worse. I was just completely overwhelmed. Then, after about 2-3 months, the pelvic pain just randomly stopped. I canceled embolization.

However the mouth pain was still present - just always there, sometimes better sometimes worse. It would often go away and then come back. By this time I had read all about Atypical Odontalgia and Atypical TN, joined all the FB groups, read all the content, and was completely terrified. In the winter, I was finally seen by a renowned orofacial pain specialist who I am still seeing. He diagnosed a neuroma. I got a steroid injection and topical medication (was also taking Nortriptiline which I stopped a couple of months ago).

My mom passed away in February. My grief has not impacted the pattern of the pain in any way from what I can tell - it's just random.

So - this is the background. I have been told point blank that the neuroma means damaged nerve, and it is unknown whether it will ever resolve, but typically if it hasn't within a year, prognosis is bad. Now, over a year later (!), I still have this issue, and the fear and desperation I feel over this is off the charts. It has not reduced at all even though I have learned about Sarno and TMS months ago and have been trying to 'do the work'. I thought after repeated reminders to self that this is just my brain, things got a little better, but then it flared up again.

Despite trying to let go of the fear and preoccupation, I am thinking about this constantly and not able to change my mindset at all. However, I also have periods when the pain lessens to almost zero, or goes away completely for a few days - then I forget all about and feel euphoric that I 'beat it'. Them inevitably it returns and I am devastated again. I am so tired and demoralized by this endless cycle. I journal, try to meditate and talk to my brain all the time but it doesn't change anything.

I keep thinking of all the people with this that never get better and the horror I feel about my own future only grows. Apart from the Nortryptiline, I've tried every brain tool there is to try: hypnosis, 1 TMS doctor, 2 PRT therapists, a 10 day brain retraining at a clinic, even Scrambler. I have watched ALL the success stories from all the practitioners, read all the books, know all the players in this sphere. I am consuming endless amounts of TMS content, but there is no shift.

I am a successful, high achieving professional and in the past I have been able to achieve most of the life and career goals I set for myself, but here I am feeling powerless. Often I find myself thinking that I am doomed by the nerve damage and no amount of TMS work will make a dent here and I am just wasting time. Other times I feel a little more optimistic. Mostly I feel like some higher power (fate?) is screwing with me and punishing me for something, although I don't know what - I am generally a nice person who cares about others.

Again thank you to those who made it to the end of this novel. I'd love to hear your thoughts especially given how this nightmare began, what it means in terms of TMS, and whether I still have any hope of changing anything.
 
If the pain can go away for a second why can’t it go for a year, or longer? You’ve had days of being nearly pain free, what does that tell you? My biggest takeaway from your post is that you have unrealistic expectations, you expect recovery to be linear, for it to just steadily decrease and then be gone for good. That is not how TMS pain works. The fact that your pain behaves very typically for TMS should be encouraging, not discouraging. Your reaction to the symptoms are extremely significant, perhaps most significant. Especially in an area that we naturally guard and in an area that you had surgery in. You are teaching your brain that these symptoms aren’t accomplishing anything. Even if you had a neuroma, ultimately the brain is the thing creating the pain, the nerve is just transmitting the signal. You need to be more mindful of your reactions, if when the pain is gone your elated, thinking you beat it, and when it returns you depressed, thinking the worst of the future, cursing your present, you’re sending some really REALLY mixed signals. The brain doesn’t require perfection but it does ask for some measure of consistency. Those low moments are where you need to really be your advocate and friend.

How much faith do you have that what you’re dealing with is TMS?

I highly recommend getting into spirituality and developing a meditation practice centered around spirituality. Those thoughts of thinking some higher power is screwing with you are incredibly damaging, and holding back your recovery. The only thing screwing with us is us. We have free will. Whatever higher power is out there doesn’t want to see us miserable and in pain.

Give yourself some grace, you’ve been through a shit ton, and I am sorry for it.
 
If the pain can go away for a second why can’t it go for a year, or longer? You’ve had days of being nearly pain free, what does that tell you? My biggest takeaway from your post is that you have unrealistic expectations, you expect recovery to be linear, for it to just steadily decrease and then be gone for good. That is not how TMS pain works. The fact that your pain behaves very typically for TMS should be encouraging, not discouraging. Your reaction to the symptoms are extremely significant, perhaps most significant. Especially in an area that we naturally guard and in an area that you had surgery in. You are teaching your brain that these symptoms aren’t accomplishing anything. Even if you had a neuroma, ultimately the brain is the thing creating the pain, the nerve is just transmitting the signal. You need to be more mindful of your reactions, if when the pain is gone your elated, thinking you beat it, and when it returns you depressed, thinking the worst of the future, cursing your present, you’re sending some really REALLY mixed signals. The brain doesn’t require perfection but it does ask for some measure of consistency. Those low moments are where you need to really be your advocate and friend.

How much faith do you have that what you’re dealing with is TMS?

I highly recommend getting into spirituality and developing a meditation practice centered around spirituality. Those thoughts of thinking some higher power is screwing with you are incredibly damaging, and holding back your recovery. The only thing screwing with us is us. We have free will. Whatever higher power is out there doesn’t want to see us miserable and in pain.

Give yourself some grace, you’ve been through a shit ton, and I am sorry for it.
Thank you - really appreciate your thoughtful reply. I guess my main stumbling block comes from learning things such as 'ATN typically gets worse over time', 'CNS reorganizes chemically after a prolonged period of pain, etc etc'. Like, the mechanism of why this pain persists is so well understood and described scientifically that I often can't help but feel that to try to overcome it with meditation or journaling or reacting to sensations a certain way is just useless. I guess until I get over the skepticism, nothing is really going to change. But then again - maybe nothing CAN change. Arrgh - so frustrating.
 
Thank you - really appreciate your thoughtful reply. I guess my main stumbling block comes from learning things such as 'ATN typically gets worse over time', 'CNS reorganizes chemically after a prolonged period of pain, etc etc'. Like, the mechanism of why this pain persists is so well understood and described scientifically that I often can't help but feel that to try to overcome it with meditation or journaling or reacting to sensations a certain way is just useless. I guess until I get over the skepticism, nothing is really going to change. But then again - maybe nothing CAN change. Arrgh - so frustrating.
Truthfully it sounds like you aren’t on board with the TMS diagnosis, so as long as that’s the case then your progress is gonna be limited. It’s normal to have doubt and get down at the situation, obviously facial pain is uniquely disabling and distracting as it’s right next to where our thoughts are. But we need to accept that we do have some agency. I think you’re a bit lost in the fact that there may be a physical explanation for the pain, but the patterns of it going away for days at a time completely disprove that. Even if what you’re dealing with is physical, can you believe and have faith that your body and brain can recover when you get out of its way?
 
The only way to train your brain is by doing it right when the symptom is present. So each relapse is your greatest opportunity to remind it that these sensations are safe, that you are secure, and that you do not need them as false alarms.
When the pain comes, respond as neutrally as possible. Redirect your attention and set aside catastrophic thoughts, which work exactly like fear. Try to distract yourself, go and go for a walk. Those moments of crisis are precisely when your brain rewires itself. If you manage to do it well each time, that is when the patterns will change. Your symptom could come less and less, giving you wider gaps of time, or it could be milder, or last less.
The way it happens is unique to each person, but remember that this is like an exam: you don't have to get the highest grade or be perfect, but show your brain that you are perfectly fine and that you do not need this. And don't pressure yourself, remember that the process is not linear.
 
Truthfully it sounds like you aren’t on board with the TMS diagnosis, so as long as that’s the case then your progress is gonna be limited. It’s normal to have doubt and get down at the situation, obviously facial pain is uniquely disabling and distracting as it’s right next to where our thoughts are. But we need to accept that we do have some agency. I think you’re a bit lost in the fact that there may be a physical explanation for the pain, but the patterns of it going away for days at a time completely disprove that. Even if what you’re dealing with is physical, can you believe and have faith that your body and brain can recover when you get out of its way?
Thank you! Maybe I’m not fully on board yet. But on the other hand, to answer your question - yes, despite everything I still somehow believe I can recover. Not just hope but believe. Not even sure why… maybe out of self protection.
 
or goes away completely for a few days

As Rabscuttle said, if this is possible then I am curious as to how you think it can be caused by the neuroma? It's not as if the neuroma disappears for a few days and then comes back - very small periods of no pain could be incidental (like 5 minutes here and there when distracted), but a few days? I struggle to see how that makes sense from a structural perspective.

My other question is has this neuroma actually been confirmed via MRI? Usually, whenever there is a diagnosis involving "atypical" 99% of the time it's TMS as it essentially means they don't know what is causing it (and given TMS is the biggest knowledge gap for most professionals, that's often the answer).
 
the mechanism of why this pain persists is so well understood and described scientifically
Is this really true? I hate to cast aspersions on so-called medical knowledge (well, no, I don't) but historically, medical knowledge has proven to be inconsistent at best and dead wrong many many times over generations, and so many things are, in reality, still a mystery.

Based on what can be learned on any syndrome forum, this same statement could be made about fibromyalgia, CFS, MCS, IBS, migraines, and on and on. All of these and many more are identifiable conditions that are 1) diagnosable, 2)of unknown origin, and 3) ultimately untreatable beyond pain mitigation. They've all been given official names, but WE all know them as conditions which are ultimately treatable once they are recognized as a function of the faulty and primitive TMS brain mechanism.

The responses you've received are excellent. As you work on correcting your mindset, watch out for your tendency to engage in what I call YBS: "Yes, But... " Syndrome. This is a function of our primitive brain always trying to keep us in a negative mindset, because it thinks that's the only way we can stay alive. Our primitive brain cares only about survival, not about quality of life. Start there.

Final thought - in all the long list of treatments you've tried, psychotherapy was not included. PRT therapy does not count. You're going to have to take emotional risks and go much deeper than PRT is designed to go. It's possible to make yourself sick with unconscious stress and internal emotional conflict. I know what I'm talking about, but that's another story I've recounted elsewhere - suffice it to say that therapy has been very helpful.
 
Back
Top