My mom has been diagnosed with Dementia and Alzheimer's as of November 2015 and all the testing results per her neurologist say the damage to her brain showing she has been having non symptom strokes for some 50 years, lots of damage.

About 2.75 years ago she had a root canal and has repeatedly complained of pain with that tooth. The dentist who performed the procedure has x-rayed numerous times = no problem. A 6 hour stay at an ER Christmas morning shortly afterwards worth the same complaint showed no problems. She sees the dentist quarterly due to bad dental hygiene (normal for Dementia patients), new dentist at current facility doesn't find any issues with root canal area.

Almost 2 weeks ago she spent days between ER and hospital observation for the same complaint and same result = no problems. I visited her yesterday and her reactions to "the pain" is so extreme the staff are telling me about it plus my witness of her reactions, I am at a loss. Everything leads me to the Dementia is distorting and escalating her reaction. Any thoughts out there? Anyone else experience this? My mom's history is that her situation needs addressing and anyone else's similar situation she lowers its importance. I am the sole person overseeing her care, my brother shows empathy but that's about it, I want to do right by her but with Dr's saying nothing is wrong has me at a loss. I appreciate any thoughts...

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My husband (no dementia) complained about molar tooth ache for quite a while, and the dentist said he needed a root canal, so he did it. The pain didn’t go away completely and still would flair up occasionally. They performed a 2nd root canal on the same tooth. Same result. Intermittent flair ups, but the X-rays still didn’t show any problems. This issue had gone for a couple of years. So they decided to pull it and do an implant. When the dentist pulled it DH heard a loud whooshing noise, and the dentist and tech said “wow!” And actually called another tech into the room to witness this mess. Huge abscess under the tooth that never showed up on any X-ray. He decided to forget about the implant. I would suggest just pulling your moms tooth.
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Reply to rocketjcat
rocketjcat Oct 24, 2018
One other thought... the dentist may say that the needs that tooth to chew. Baloney. DH chews just fine without it, and Mom can chew without her entire bottom plate in, if I don’t notice it’s missing.
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How widely did the dentist x-ray, did s/he look beyond the actual teeth and root? Was this an upper tooth, could it be sinus pain? Perhaps you need a referral to an ENT specialist who can look beyond the mouth for a cause.

(edit)I've been doing a little bit of reading on line - it is possible that a problem with the root canal may not be obvious in an x-ray, if the pain is intractable I'd be inclined to look into redoing the root canal or even consider an extraction.
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Reply to cwillie
Judysai422 Oct 27, 2018
I had a root canal and co ti usd to have pain. My dentist said it takes a long while for the bone to regrow and that could be the issue. However, he looked beyond that upper tooth and found a lower one that was cracked. He repaired with new filling, and guess what ... the pain vanished.
Also my MIL has a nerve in her face that gives her constant pain. Keep exploring options although it is entirely possible she is obsessing on a phantom pain due to dementia or for attention.
Root canal doesn't mean the tooth was extracted. If the tooth is still in her mouth, the root can be cracked and yes - this can cause extreme pain.

I had an abscess and root canal was done. One year later I was back at the specialist who couldn't understand a new abscess on the same tooth. It was decided to extract the tooth and they discovered the root had cracked. This will NOT show up on an X-Ray, not even the circular kind that the specialist uses. Needless to say, the specialist was horrified and felt terrible that I was again in so much pain. He apologized profusely and explained how a cracked root doesn't necessarily show up on an X-Ray.

Tooth pain is totally debilitating and she might need an extraction. I had no more pain after the extraction, other than to my wallet, lol.
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Reply to RayLinStephens

How about trying a single 350mg Tylenol once per day but tell her it is an Rx from the dentist. First, at her age and other related issues one tylenol/day should not be harmful (in my very unprofessional opinion), and secondly, placebo effects are very real in many cases. And as a final thought, if there is some real pain wouldn’t a single tylenol be better than ignoring it?
I care for my wife with advanced ALZ and I wouldn’t hesitate to at least try this approach.
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Reply to BigjimM

Christmas nearly three years ago the pain is so bad she puts up with an ER visit of six hours.

Two weeks ago, it's bad enough to get herself taken to the ER and admitted for observation.

And in between? Did it settle down? If it "grumbles" without flaring up so badly, does anything help to relieve the pain?

What does strike me is that the dentist and doctor aren't saying there's nothing wrong, they're saying they can't find it. And it wouldn't be so unusual for a troublesome nerve to be very, very difficult to get to grips with. I certainly think you should try to hide (even if you can't quite drop) your suspicion that she's making this up for attention.

What is her main doctor suggesting now as a treatment strategy?
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Reply to Countrymouse

I had a root canal in the 1980s that hurt sporadically for decades. Finally determined with improvement of imaging techniques that the tooth had an extra root that was difficult to see. Second root canal, finally no pain. Take her to a different dentist with state-of-the-art imaging equipment (an endodontist, perhaps) and have them look. Other possibility is that they went through the tip of a root and there is inflammation or infection.
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Reply to lynina2

After several years of testing for physical causes of the pain (legs, arms, back, headaches, etc) all the specialists concluded without identifying physical causes it was fibromyalgia like related to the nervous system. My wife has the pain (very real to her) and we have tried about every thing but probably the most comforting so far are massages along with a placebo. Unfortunately there is little help for the dementia /Alzheimer’s sufferers which adds to the stress of the care givers (in my case my wife of 44 years). Even our gp of many years was being very truthful when he suggested we might try marijuana ( unfortunately we lived in a state where that was not possible but are now living foreign and am considering that approach although my wife has never smoked might have to try brownies, etc.) you might think about new treatments in states that niw allow medicinal marijuana
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Reply to lwatson66

I think rocketjcat and cwillie have a good point, to extract the tooth.
You don't say how old mom is but it sounds as if she has had D/A for a while. It may be best to be without the tooth. I am mid-age and don't have dementia, but I had a root canal several years ago and I can tell you that I have had "flair-ups" where the tooth is sensitive bordering painful--then returns to normal. It seems that D/A symptoms can include hyper-sensitivity, so these combined sensitivities may be the problem. If your mom can live without the tooth, you may consider that alternative. Just be sure the extraction is done by an oral surgeon. However, she may then miss the tooth.... Good luck with whatever you decide. So difficult to know the "right" thing to do.
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Reply to wakankasha

I agree, have the tooth pulled. I have a root canal right next to my sinus cavity. So I can have slight pain at times. I also had an infection that didn't show on an Xray.
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Reply to JoAnn29

Not possible to know if she is exaggerating or not, or attention seeking. Can you observe her when she is alone and does not know you are watching.

Is there an immediate reaction when someone comes into the room. Does she look as though she is in pain? Is she touching the area or screwing up her face, or very restless. Is she able to sleep. What happens when she eats?

I had the same experience with a tiny abscess under a tooth. Nothing showed up so nothing could be done. Finally another dentist did a root canal and sure enough there was pus. That all cleared up but for years I could press on my face over the area and it was still sore.

Have they done blood tests to see if she shows signs of infection.

An extraction is a good idea but if she needs anesthetic that is another risk.

I think I would ask the Dr if a course of a suitable antibiotic would help. That's always a good idea prior to what could be the extraction of an infected tooth.

Agree any extraction must be done by an oral surgeon. It is a simple matter but carries great risks. Also in a facility that has fully trained staff and life saving equipment, that is assuming she is not a DNA.

Is she getting adequate pain relief medication. A couple of Tylenol won't touch that kind of pain.

Take your time and observe her carefully before making any decisions.
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Reply to Veronica91
Wjared99 Oct 25, 2018
The facility called me about 8:30 this morning, my mom was crying, holding her face and said just to open her mouth hurt very bad, wasn't eating. She hasn't been eating much for the past couple of days but able to drink the Ensure supplments. Don't know if the pain is why she's not eating? Dr. called in a painkiller, I called the dentist. Dental assistant went out this afternoon and took xrays of tooth in question and surrounding area. They are talking about antibiotics once the dentist reviews latest xrays. Fingers crossed, thanks for sharing information. Much appreciated
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