Face and Mouth Pain
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| David Keith, is an Oral and Maxillofacial Surgeon at the Kenmore office. |
By David Keith, DMD
Pain in the face and mouth are very common complaints and result in many lost days of work and a great deal of suffering. Some of the more common causes are;
- Toothache
- Sinusitis
- Headache
- Temporomandibular disorders
- Ear infections
Your Primary Care Physician or Dentist will be able to make these diagnoses and initiate appropriate treatment. On occasion a referral to a Specialist might be necessary.
Sometimes the diagnosis is more complex. Here are some of the rarer causes of pain in the mouth and face:
Trigeminal Neuralgia
This is characterized by sharp, shooting, lancing pain in the face or mouth that is triggered by talking, chewing, tooth brushing, washing the face or applying make-up. It lasts a few seconds and then the patient is pain free for a variable period of time. After a few weeks or months the pain goes into remission only to recur sometime in the future. It is a very severe pain and frequently people 'stop in their tracks' or clutch their faces when the attack strikes them. Your Primary Care Physician will be able to help make the diagnosis, may order appropriate imaging studies and refer you to a Neurologist for further evaluation and treatment. You may also be referred to your Dentist to rule out a dental cause for the pain. The primary treatment is with medication. Sometimes neurosurgical treatments may be necessary.
Atypical Facial Pain
This is a constant deep throbbing ache in any part of the face, which is present all day long and fluctuates in intensity without apparent rhyme or reason. It may be associated with poor sleep habits, muscle pain, trauma to the face or dental or surgical treatment in the area. After a thorough work up to rule out disease in the area the treatment is with medication. Behavioral Medicine and Complementary Medicine techniques can all be helpful.
Atypical Odontalgia
Atypical Odontalgia (toothache) is thought to be a variety of atypical facial pain. The pain is experienced in the teeth, gums or jaw bone. Because it feels like a toothache people usually go to their dentist in the first instance. All potential causes of dental pain need to be dealt with. Sometimes a root canal treatment is performed and the pain may continue and sometimes increase, the tooth may be extracted and again the pain persists or increases. At this point the pain may move to the adjacent tooth and the cycle of treatment continues, sometimes it persists in the area where the tooth was extracted and then it is known as Phantom Tooth Pain. A thorough evaluation by an Oral and Maxillofacial Surgeon will be suggested. If a diagnosis of Atypical Odontalgia or Phantom Tooth Pain is made, it is necessary to recognize that this is not a dental problem and therefore further dental treatment will not eliminate the pain. Treatment with medication, Behavioral or Complementary techniques can help reduce the pain but not necessarily eliminate it altogether. Over time most of these pains resolve on their own.
Burning Mouth Syndrome
This is a very troublesome burning, stinging sensation in the tongue or mucous membranes of the mouth. It may be associated with dryness of the mouth and changes in the sense of taste. Sometimes this is brought on by chemotherapy or other medications and sometimes it arises spontaneously. Medical causes such as severe anemia or deficiency disease need to be ruled out. Treatment can range from taking frequent sips of cool water to medications and some specially formulated rinses.