Facial pain is common among adults. Most facial pain is associated with headaches and intense pain related to a dental origin. Other fairly common causes of facial pain include nerve conditions, jaw issues and other infections.
In this column, I address the most common facial pain conditions.
Pain from a gum disease abscess appears as pain and swelling on one side of the face. Patients often cannot pinpoint them, although they can point to the side of the face where the pain comes from. A gum abscess occurs when a gum pocket becomes trapped with bacterial plaque or calculus and it cannot drain. There is increased temperature and the body releases enzymes and proteins to fight the infection. The result is pain, pus, swelling and bone loss. The underlying bone is destroyed and the tooth gets shaky. Treatment is usually antibiotics and/or drainage of the pus followed by prompt treatment by a periodontist or a dentist with experience in gum treatment. Abscesses can cause a throbbing pain that may radiate to the jaw, face and neck.
Pain from an abscess caused by a cavity-stricken or cracked tooth is also quite common. The pain is intense and associated with a radiating sensation. The nerve of the tooth is damaged by trauma or bacterial infection caused by a cavity. Both abscesses from gum disease and a cavity/trauma should be treated immediately by an experienced dentist. Antibiotics followed by a root canal and comprehensive treatment is the treatment of choice or an extraction.
Pain caused by trigeminal neuralgia is considered one of the worst pains known to mankind. It is caused by the fifth cranial nerve called the trigeminal nerve. The cause of this condition is unknown. The nerve becomes irritated and fires uncontrollably resulting in excruciating pain on one side of the face. This pain, because of its intensity, causes patients to do desperate things. Many patients convince dentists to extract teeth on the side of the pain only to discover that the pain remains. This is because the source of the pain is not a tooth. They often see another dentist and again more teeth are removed. It is not until a definite diagnosis is made will the patient learn that the source of the pain is the fifth cranial nerve. Because this nerve is directly associated with the face, it gives the impression that it is of dental origin. The pain tends to come on suddenly and ranges from a constant aching or burning sensation to a severe stabbing pain. Performing certain movements or actions, such as eating, brushing the teeth and applying makeup, can trigger a painful episode.
This unique pain is only managed when diagnosed by an experienced dentist or a medical doctor with experience in such conditions. Causes of trigeminal neuralgia can include:
• Compression or pressure on the trigeminal nerve.
• Nerve damage from past injuries or facial surgery.
• Underlying medical conditions.
Treatment for trigeminal neuralgia include:
• Avoiding the known triggers.
• Taking prescription medications, such as anticonvulsants (Tegretol or Neurontin) and muscle relaxants.
• Anti-depressants and Botox injections.
• Surgery, in rare cases.
Pain in the temporomandibular joint (TMJ) is associated with pain just in front of the ear. Symptoms of a TMJ disorder include:
• Jaw pain that may radiate to the face, head or neck.
• Stiffness in the jaw muscles.
• Difficulty opening and closing the mouth, which can include jaw locking.
• An uncomfortable clicking, popping or grinding when moving the jaw.
Treatments for TMJ disorders depend on the severity of a person’s symptoms, but can include:
• Taking over-the-counter and prescription pain relievers.
• Stress reduction techniques.
• Wearing a mouth splint or bite guard.
• Undergoing surgery to correct jaw alignment.
Constant facial pain can be disruptive to your quality of life. The key to successfully managing facial pain is a proper diagnosis. Because facial pain can be unusual in its presentation, it is important to see an experienced dentist or physician for an opinion. With proper diagnosis and prompt treatment, you can be relieved of pain, preserve your dentition and enjoy good dental health and wellness.
• Dr. Kendal V.O. Major is the founder and CEO of the Center for Specialized Dentistry, which is a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified fast braces provider. His practice is located at 89 Collins Avenue, New Providence. He can be contacted at (242) 325-5165 or firstname.lastname@example.org.