Patient was referred for root canal treatments of the upper molars. There is a history of trauma. After the trauma she started to feel pain in her left upper molars, but also in her left lower molars, today she also has pain in her left upper front. When discussing the trauma event, the patient told me that she got a serious hit on the left side of the head around the area of the trigeminal ganglion. All involved teeth tested vital on cold, but do display spontaneous pain, especially when functioning. I am thinking this is probably a neurological problem, due to the trauma, with maybe trigeminal involvement. I decided to remove some old amalgams, to just rule out these teeth as the cause of the symptoms and referred the patient to a neurologist for the orofacial pain complaints. Root canal treatment will not solve the problem in my opinion.

Patient was referred for root canal treatments of the upper molars. There is a history of trauma. After the trauma she started to feel pain in her left upper molars, but also in her left lower molars, today she also has pain in her left upper front. When discussing the trauma event, the patient told me that she got a serious hit on the left side of the head around the area of the trigeminal ganglion. All involved teeth tested vital on cold, but do display spontaneous pain, especially when functioning. I am thinking this is probably a neurological problem, due to the trauma, with maybe trigeminal involvement. I decided to remove some old amalgams, to just rule out these teeth as the cause of the symptoms and referred the patient to a neurologist for the orofacial pain complaints. Root canal treatment will not solve the problem in my opinion. Agreed?