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Old 07-15-2012, 03:53 PM   #1
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Anti-anxiety meds help tooth pain from malocclusion?

My wife has been sufering from some pretty bad tooth pain for the past few months. She has a bad bite, or malocclusion, and has had 6 bite adjustments from a prothodontist in the past month. However, this isn't working so far, and the pain only has gotten worse. The prothodontist wants to fix the bite first before looking into any crown or RCT to treat the tooth pain (all in back molars).

My wife is not doing well emotionally, she is very angry about the pain (blames dentists for causing it), and spends 99% of the day focusing on her teeth pain and bad bite.

Five days ago she got a prescription for the anti-anxiety med lorazepam and she's been taking a moderate dose of 1mg per day. This helps immensely with her depression and anger and surprisingly(?) it also helps a lot with the tooth pain, to the point where she says they pain is almost gone.

My question is, is it normal for this type of med to act as a painkiller, or is it possibly a sign that her tooth problems are causing so much distress that she is unable tell the pain apart from the distress? Seems to be a weird question, as she obviously knows if she is in pain or not, but any answers would be appreciated.

Re. the pain: it hurts her a lot to chew food or drink cold liquids. Even when she's not eating or drinking, she has a burning pain in a couple of teeth, and a lot of "pressue" in another tooth, as a result of her bite being off. She thinks her bite problems are caused by a filling she got 6 months ago, but I think it could also be related to her night time teeth grinding.

We live in Canada, and maybe one option is to see an oral surgeon, although we would to have the dentist refer us. Is there any value in seeing the oral surgeon to perhaps look into the pain issues? I don't think the prothodontist really seems to know what is causing the pain.

 
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Old 07-15-2012, 04:11 PM   #2
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Re: Anti-anxiety meds help tooth pain from malocclusion?

There are a surprising number of psychiatric meds that have been shown to help with pain, especially chronic pain. After all, pain is just a sensation, processed in the brain, and altering the levels of certain neurotransmitters can drastically reduce it.

At the same time, a person's emotional state can affect how painful something seems, that is, someone who is relaxed can tolerate pain better, with less emotional distress.

For now, I'd suggest she enjoy the relief however it comes.

 
Old 07-15-2012, 08:18 PM   #3
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Re: Anti-anxiety meds help tooth pain from malocclusion?

That kind of medicine does tend help with nerve pain.There are a few types of nerve damage/pain that can be as you're describing. Atypical Trigeminal Neuralgia or Type 2 Trigeminal Neuralgia. If you look them up, the diagnosis is really tough to get. You might want to read up on that.

Untreated pain can become chronic pain, so it's good she's getting some relief. I have a disease that causes chronic pain, and when I get frustrated because I'm in pain, the pain gets worse because I get worked up about being in pain.

It could be either/or, but I feel for your wife and I'm happy to see you are taking her pain/concerns very seriously. It's hard when those around you don't understand your pain.

 
Old 07-16-2012, 07:46 AM   #4
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Re: Anti-anxiety meds help tooth pain from malocclusion?

I admire you for being so supportive of your wife. I also have some anxiety drug that I take a couple of times a week. This is not a good long term answer though. I have had root canals and they are done quickly, no waiting while adjusting bite. I have seen a few prosthodontists and while general dentists recommend them for this, I have not had complete success with them. It is important to research bite problems and reviews of splints etc. First I would deal with the Endodontist to make sure there is no need for a root canal. I believe a patient knows when something is different and uncomfortable or painful and this is a difficult situation. It's great if you go with your wife and sort out the info and suggestions and see if the treatment makes sense to you. I wish you luck with this

 
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