The New England Journal of Medicine
|To the Editor:
A 66-year-old woman with a two-year history of right-sided Trigeminal neuralgia (involving the second Trigeminal division) presented with severe exacerbation of her typical sharp pain after a root-canal procedure in a right upper incisor. The procedure had slightly repositioned a mercury-amalgam restoration, nudging it closer to the adjacent tooth, which bore a gold-alloy crown.
Thereafter, and until the mercury amalgam was replaced by a porcelain restoration, tomatoes or certain other acidic foods would produce intense jolts, described as being like those of an “electrical battery,” in the right palate, boosting the pain in the same division of the Trigeminal nerve to an excruciating level. Lightly touching the right cheek also triggered paroxysms of neuralgia, which subsequently resolved with use of gabapentin.
Adjacent dental amalgams that are composed of dissimilar metals in contact with saliva can :
William P. Cheshire, Jr., M.D.