THE MANAGEMENT OF ORAL AND FACIAL PAIN DISORDERS
Toothache and similar dental problems are readily diagnosed and respond to simple treatments and do not recur. Other pains may develop as a reaction to stress or without any obvious cause.
Facial Arthromyalgia (also called tempro mandibular joint dysfunction syndrome)
This is a dull ache with occasional severe attacks affecting the jaw joint and its associated muscles. You may experience clicking in the joint which extends into the head and down the neck. Ear symptoms such as a sense of fullness or buzzing and dizziness are also possible.
Atypical Facial Pain
This is usually a dull ache or throbbing pain affecting the checks, eyes, jaws and all non muscular parts of the face. It can affect both sides and be associated with some form of headache. The pain may come and go bit may be worse when you are tired or under stress.
Atypical Odontalgia
This is a pain or severe discomfort in the teeth or in a tooth socket after an extraction, in the absence of any usual dental cause. The pain is often made worse by dental treatment and can move from tooth to tooth.
Oral Hypaesthesia (burning mouth syndrome)
This is a group of problems which include a burning or altered sensation in the tongue or gums or a nasty taste. This is often relieved by chewing. You may notice a sense or increased or decreased saliva or unpleasant taste in the mouth. It may be difficult for you to wear dentures or tolerate new fillings, crowns or bridges, dispute many attempts to help you.
Phantom Bite Syndrome
This is an unpleasant awareness that your teeth do not meet comfortably. It does not respond to your dentist balancing the occlusion.
These problems often last long periods of time and will come and go, especially when you are under stress. The situations that particularly affect us are long term problems such as difficulties with our children, material strain, work, housing, being lonely, ill health in members the family or more upsetting events such as bereavement, divorce or moving house. It may surprise you to know that getting married, being promoted or having a baby are also events that put us under stress. Children may develop such pains as a result of parental disharmony or poor adaptation to school.
Other related problems such as tension headaches, neck ache, migraine, chronic low back pain, pelvic pain or painful periods, stomach pains (especially irritable bowel) and itchy skin are experienced by some patients. All of these problems suggest that widespread pains occur in certain individuals with susceptible body chemistry.
Treatment
In order to make a diagnosis, we need to take a full and detailed history and sometimes do blood tests and x-rays
It is important that you understand that the diagnosis of the pain does not mean that we think you are imagining the pain. The pain is real and arises in cramped muscles and dilated blood vessels.
We usually prescribe antidepressant medication for this pain, NOT because we think you are depressed but because we have shown that this medication helps prevent the pain in non depressed patients.
You will need to take the medication for some months to ensure relief. It is not addictive and has no severe side effects, although depending on the medication prescribed some patients may initially experience drowsiness, dry mouth or constipation.
If you have any queries please ask your dentist.
