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Tooth pain and other orofacial pain can be a symptom of various conditions and can provide cues about the underlying issue, alerts Dr Srishti Tody.
We often do not pay much attention to our teeth and most people do not realise the importance of these little structures.
Our teeth play an important role in daily life activities like eating, smiling and are also responsible for clear speech. However, tooth pain can be a real dampener on daily life and cause a lot of suffering.
Usually, one assumes a toothache is because of a cavity or decay in the tooth, but sometimes the tooth pain is telling you more.
Tooth pain and other orofacial pains can be a symptom of various conditions and can provide cues about the underlying issue.
While an orofacial pain expert would be best suited to diagnose your specific condition, here are few possible interpretations of tooth pain:
1. Tooth decay
This is the most obvious and common reason for tooth pain.
The tooth gets infected and causes a cavity and the symptoms include pain, swelling, tenderness, etc.
It is usually treated by dental filling or root canal therapy or extraction in severe cases.
2. Gum disease
Gums are the soft, skin-like tissues surrounding the teeth. Gums cover the bone which holds the teeth in place.
At times, the gums and even the bones can become infected and inflamed and this can also cause tooth pain.
These conditions are treated by cleaning the gums and bones non-surgically or surgically depending on the severity of disease.
3. Wisdom teeth
Very often wisdom teeth do not erupt completely in the mouth. They may be trapped partially or wholly in the gums or bone.
If food particles get caught in the pockets of tissue around the tooth it can become swollen and painful.
Sometimes wisdom teeth also exert pressure on the adjacent tooth or the nerve surrounding it. Usually, extraction of the offending wisdom tooth is sufficient to resolve the issue.
4. Muscles of the face and mouth
We have numerous muscles in/around our face and mouth. These muscles are used when we smile, talk, chew food, yawn, or move our mouth and face in any way.
These are some of the most used and overused muscles in the body because we indulge in these activities multiple times in a day.
Many people also clench or grind their jaws which also exerts these muscles.
Pain and tenderness from these muscles is very often referred into our teeth.
In many such cases the tooth or teeth have no disease themselves but are painful.
This is an example of non-tooth related orofacial pain.
Patients with these conditions should visit an orofacial pain specialist who can rule out teeth as the cause and can simultaneously treat the underlying root of pain in the muscle and manage the symptoms.
5. Jaw joint
The joint connecting the upper and lower jaws is commonly referred to as the TMJ (Temporomandibular Joint). This joint is used every time we move our mouths in any way.
Like any other joint in the body, it can develop joint related diseases like capsulitis, arthritis, etc.
These can all refer pain into our back teeth. And just like muscle related toothache the teeth themselves are 'normal'.
Such patients also need to visit an orofacial pain specialist to diagnose and manage their condition.
6. Nerves
There are multiple nerves inside and around our mouths and on our face.
At times, these nerves may get irritated due to injury from external trauma, nutritional deficiency, hormonal conditions, brain lesions, etc.
Nerve pain can be electric, burning or tingling and all of this may be felt in a tooth or teeth around the affected nerve.
Hence, nerve pain may present as tooth pain and needs to be correctly diagnosed and managed by an orofacial pain specialist.
7. Sinus
An inflamed or congested sinus due to allergies, cold, viral or bacterial infections can exert pressure on the upper teeth and make them painful.
This is commonly experienced by most people at some point in their life.
This is usually easy to diagnose because of overall symptoms.
Treatment by an ENT specialist of the underlying cause of sinusitis and decongesting the sinus usually resolves all symptoms.
8. Cardiac
In rare instances, cardiac pain may be referred to the jaw and could potentially cause tooth pain.
There may be other symptoms of cardiac distress which can help correctly diagnose the cause of pain.
Extensive work up and management by a cardiologist is essential in these cases.
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Feature Presentation: Ashish Narsale/Rediff.com