1: Ok, something started when you were 33; extreme pain subsequent to a filling. Said pain is or can be associated with TGN, Trigeminal neuralgia, damage to it or some kind of interference with it that constantly triggers facial pain.
2: During the years, you had 5 molar extractions. Maybe due to infection causing pain. Maybe due to pre-existing pain from the trigeminal nerve for a tooth having no infection. Basically a circumstance where you thought removing the tooth would remove the pain. Pain from a tooth infection affects a nerve in the tooth and that nerve connects to another one found in either maxilla or mandible depending on where the tooth is. In that circumstance, removal of tooth removes that type of nerve connection that signals pain. So, if removal of the teeth gave no pain relief, then some OTHER nerve could/would be the pain generator.
3: Bottom line is that after multiple extractions of teeth due to PAIN, there was no relief of that pain. Hence a suspicion of Trigeminal neuralgia.
4: Removal of molars = removal of bite force needed to preserve bone. The tooth bearing part of the bone; the aveolar process of the jaw/s resorbs. So, facial length is lost. The facial proportions change unfavorably because the soft tissue of the face loses support due to the lost teeth and bite imbalances that arise from using the 'left over' teeth to chew.
5: So, the aesthetic problems are due to loss of facial bone support from dental losses. There is also existing PAIN, chronic pain and the stress of that in addition.
6: Because of the aesthetic problems, you are going around to doctors who are known to 'fix' aesthetic problems whether they be maxfax or plastic surgeons in Europe or elsewhere. It doesn't matter who or where they are. What matters is that they would look at your medical history which includes chronic facial pain. If they had any reason to believe the surgery for aesthetics would not address the pain condition OR could make it WORSE, they wouldn't offer it.
7: Your primary focus is on aesthetic (loss). BUT since the focus on that is directly related to tooth loss in a circumstance where removing teeth didn't remove the pain that was felt to them after removal and also since the pain condition is STILL THERE, quite possibly due to Trigeminal nerve pain of some kind, you would need to shift your focus on types of possible source of the pain.
8: To the best of my knowledge, there are types of surgeries for TGN. So, you would need some kind of diagnosis that you had that. One surgery said to relieve that is microvascular decompression which is when a blood vessel is pressing down/irritating the nerve. There could be maxfax surgeons who do can address TGN or work in conjunction with others who do. So, that is for you to explore.
9: You are spinning your gears looking for surgeons; maxfax or plastics based on aesthetics alone. I mean that if you are going to consult with them, especially a maxfax, you would need to SHIFT the FOCUS of the consult to whether or not he/she had any leads on surgeons who could address the TGN and ALSO IF that would come FIRST to possibly allow for a future maxfax surgery. I mean that if they are not offering to do aesthetic surgery on you due to another condition (pain condition) where that could get worse with surgery, then you have to look for surgical possibilities to directly address the pain condition first.
10: Another possible option that probably doesn't include surgery is dental prosthetics, dentures, false teeth designed to elongate parts of face that got shorter due to tooth loss and also designed to construct a bite to help aesthetic facial support. Sometimes that sort of thing is marketed as a 'dental face lift'. So, you could look around for the types of dental pros who design dentures and ask if they can design something that could better support your face. I mean the FACT that you have MISSING teeth and the fact that they would know bone loss and lack of facial support resulted from that and also that they are in business of designing dentures would justify consults within venue of dental prosthetics (dentures).
Kavan,
Thank you for taking the time . You can also read what I wrote GJ.
I will add, I forgot to write , in 2008, before my pain started (in 2010) I got hit real heard in the left side of face (where two years later the pain started) , but for 2 years I felt nothing).
About Trigieminal Neuralgia - yes I totally now about that seen countless of docs about that.
There are two main Diafnoses . Trigeminal Neuralgia , and "Atypical facail pain"/Atypical Odontalgia/Trigeminal neuropathy .
They all from the same "family" but totally different, while the pain in all in unsufferable (really really, I can't describe anyone) . The difference is made by how the patient describe their symptoms (you can google it).
TN - is mostly caused by a vein pressuring the nerve (BTW I have that vein also) but not all viens pressuring the nerve will cause that pain - and here comes how the patient desctibe the pain. ALL oral experts, neurologists , neurosurgeons agree I have "ATypical facail pain" or "Trigeminal Neuropaty" . Which is NOT TRigeminal neuralgia.
It means the reason for pain is unknown, they stop looking . And treat the pain . Which is unsucesful in mine and many other cases . I also tried treatments for TN - which didn't do a thing.
So - most likely it's not TN - from all I've read (and I've read tons and been on tons of docs and ) it's not TN.
My pain is ON BOTH SIDES (complacated... one other side started years later . The symptoms were different, doctors insisted to say it's ALL "facial pain" I inisited , and after two years insisting they discovered I had oral antral fistula and MAJOR infection in sinus , that in 2020 I had to go surgery under general anesthesia to close the fistula (hole in jaw to the sinuses) and clean the sinuses. The operation failed. But since the sinus is clean ALL docs claim this ISNT the cause of pain on that side (it's the right side. NOT the side it all started , the left side).
The extraction of teeth cames much later after the pain , and the visual change happened almost right away , monthes after ... I saw it my friends saw it , people knew me saw it .. only doctors ingonre it - cause auestetic is not important vs health issues.
I am not suitable for the surgery for TN - belive me , I have tons of knowledge in this . Not only knowledge, I mean I'm seen so many docs....and again , not "just" doctors, neurosurgeons that that's their field.
I can go agianst their saying and do thing brain surgery , but that's kinda insane if all dr's say it isn't the cause of pain . Again they can be wrong. The surgery is called MVD by the way .
I do agree that some faciial changes are due to teeth extraction and mostly the change of closure of teeth .. I don't close on molars . In the past , my muscle was so active.. I had like this muscle that atheletes have in cheek... it looked like operation all the time. Now - I'm YEARS YEARS not operatining this muscle, surely not on the right side where I don't eat there . And face is like any muscle in body, if not active it will sag.
But it took them monthes to make me this closure of teeth that won't hurt , that any change is forbidden.
I feel kinda lost , cause when I'm in pain as right now - that's only what I care about . When the pain is less (not happens much ( auestetics bothers me a lot But as you said there are so many "BUT's" (doctors won't operate a person with facial pain etc etc) so so many things that indicates why it won't happen.
I do hope for myself I will find a way to break this cycle, for me it's my life. It's two fields here , the pain and the looks . Even if I would be healthy I'm not sure I'll have the courage to go for auesteic adventure - so not to mention when I'm in such pains.
By the way the "Atypical facial pain" issue or "Atypical odontalgia" thing (google about it ) it more interesting cause there - the reason for pain is unknwon. It can go from teeth ubbalanced, to ICR (idiopathic condylar resoeptions) to "tied toungues" - there are so many crazy and not so crazy theroeis , most of them hard to check out .Some I tried. Some friends of mine went to europe for experiment treatments to "balance" their teeth and got worse .. so it's hard to say .
To conclution :
I'll have to find a way to control the pain , without it - no surgery (auestetic) . In the future might be ... implant.. injections (hylaronic acid or I don't know. Maybe maybe jaw surgery , I doubt it ).
As for the pain in the Right side , I might send you some picture to show you something .
