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What could be the cause for abscessed molar when suffering from trigeminal neuralgia?

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Infectious Diseases Specialist
Practicing since : 2002
Answered : 871 Questions
This is complicated. I currently have an abscessed molar (upper right) for which I have been undergoing root canal treatment since last May 2013. I have been on Clindamycin for a week, with Flagyl added four days ago. This infection seems to have caused a sinus infection (right maxillary) and a flair up of trigeminal neuralgia (right side). I recently was retested for Lyme disease, for which I have been in remission for four years. My test results for Lyme are positive again. I feel really lousy - living on Advil (800 mg every 6 hours, plus Neurontin (300 mg) for pain. I know trigeminal neuralgia is a Lyme complication, since it affects the cranial nerves, and the trigeminal nerve is the 5th cranial nerve. I'm not sure how to proceed - perhaps my family doctor can add an antibiotic that will address the sinus infection and Lyme - doxycycline? (I'm allergic to penicillin.) I'm nervous about being on all these meds but need to get this under control before I end up in the hospital.
Posted Sun, 16 Feb 2014 in Infections
Answered by Dr. Roopa Hiremath 2 hours later
Brief Answer: Dental infection complications and Lymes disease Detailed Answer: Hi, Welcome to health care magic. I have gone through your query and I understand your concern regarding relapse of Lymes disease and trigeminal neuralgia flare up. Let me elaborate on your problems one by one. Dental caries is most commonly caused by streptococcus mutans which along with food debris and mouth bacteria eats away the dentine of the infected tooth and if left untreated, it can lead to dental abscess and then spread to nearby parts like the ear and sinuses. In your case, sinusitis may have been caused by spread of infection from the dental source and you have been rightly prescribed antibiotics like Clindamycin and Flagyl which are very effective against streptococci and anaerobic bacteria. This infection will resolve when the source of infection is treated. (dental infection) Trigeminal neuralgia flare up also may get resolved once the sinus infection and dental infection is controlled. Coming to Lymes disease, this disease can show a property of persistent infection which is characterized by arthritis, dermatitis and neuropathy. You might show positive for IgG antibodies for years after infection. If you are showing positive for IgM antibodies in significant titre, then you can get a prescription for a specific antibiotic from your treating doctor. I suggest you complete the course of antibiotics prescribed to you, get the dental infection treated successfully and then get appropriate treatment for Lymes. I hope I have cleared your doubts. Please let me know if I can assist you further. Thanks.
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