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What Jaw and Ear Pain Means After a Car Accident

When you are involved in a car accident, your body is subject to a large number of strong forces all at the same time. Even a minor accident at a slow speed of 30 mph can create literal tons of force on the body. While you may notice some injuries immediately, other unexpected symptoms may begin to appear over time. One area that may begin giving you trouble, even after seeking whiplash treatment, is the head and neck, including jaw pain and a variety of ear issues, like a ringing or difficulty hearing. Jaw and ear pain can both indicate more severe problems that require immediate attention, so it is important to understand what these symptoms mean and how they can be treated.

Why Your Jaw May Hurt After an Accident

The only part of your skull that is actually able to move is your jaw, also known as your mandible. While we associate our jaws with the chin, it is actually much larger. The hinge of the jaw begins at the cranium, right in front of your outer ear, allowing for complex movement that enables you to have a broad range of motion and exert a large amount of force when your jaw moves, like when you bite or chew.

Because of this versatility, the jaw muscles are actually somewhat fragile. Any stress to the jaw can cause a disruption to normal daily activities like eating, sleeping, or talking. If you have issues in the muscles or ligaments surrounding your jaw, this is known as TMJ disorder, named for the joint that connects your jaw to the rest of your skull. Symptoms of a TMJ disorder include pain at the site of the joint, tenderness in the jaw, difficulty with chewing, headaches, ear and facial pain, or a feeling that your jaw is “locked” and unable to move.

TMJ injuries often occur as a result of a heavy impact to the neck or skull area. It is a car accident injury that occurs when your head physically strikes something like a window, dashboard, or airbag. In these cases, your jaw is likely to be affected. Additionally, the sudden back and forth movement that may lead to you seek whiplash treatment can also lead to TMJ symptoms that need attention. A simple sprained joint or broken jaw bone may also indicate movement that can contribute to brain injuries.

Jaw disorders often do not resolve on their own, because the jaw is in constant use, even when you are lying still. Because of this and the relation of jaw injuries to traumatic brain injuries, any jaw pain should be seen by a doctor.

Why Your Ears May Ring After an Accident

Like your skull, the inner ear is a fragile and complex portion of your skull. It can be impacted by not only force and pressure, but changes in the air pressure or cabin shape. In a car accident, any debris that flies can cause a blow to the ear, or general conditions can cause pressure that damages your ear canal.

If your ear has been injured, it is common to experience trouble hearing or the feeling that your ear is “clogged” in some way, dizziness, pain, nausea, and a ringing in the ears. These can be common symptoms in the aftermath of an accident, and may even indicate whiplash. However, more severe symptoms like bleeding or fluid discharge need to be seen immediately as they can indicate a skull fracture or spinal injury.

The Importance of Having Ear and Jaw Pain Evaluated

All injuries that result from a car crash should be evaluated as soon as possible, and not all serious conditions will display signs immediately. Therefore, it is important to begin seeking treatment immediately so that you can identify any dangerous issues and begin your general or whiplash treatment early.

How long should you wait to go to the doctor after an accident? Well, jaw pain, ear pain, trouble with chewing or swallowing, ringing in the ears, headaches, or any similar conditions should be brought up to your medical provider as soon as you notice they are an issue to rule out any serious conditions.

If you are experiencing these problems or are in need of other services after a car accident, AICA Orthopedics offers a range of specialists and treatment plans. Whether you are seeking whiplash treatment, a full evaluation after an accident, or help with jaw and ear pain, AICA Orthopedics is prepared to help. We specialize in car accident victims, building personalized plans with a multidisciplinary approach to recovery.

Could the stress of the COVID pandemic be causing your jaw pain?

  1. Coronavirus
  2. Could the stress of the COVID pandemic be causing your jaw pain?

By uclahealth • December 11, 2020

People everywhere are feeling the stress of the pandemic, and many are feeling it in their jaws. According to a recent study, prevalence of facial and jaw pain increased by 12% since the COVID-19 pandemic began.

If you are noticing that your jaw feels sore or stiff, you may be grinding your teeth or clenching your jaw, which are common indicators of stress. These behaviors, also known as temporomandibular joint (TMJ) disorders, can cause pain both in your jaw joint and the muscles that support jaw movement.

The connection between stress and TMJ disorders

Stress tends to bring tension to your muscles, and the jaw is no exception. Anxious habits, like teeth clenching and grinding (known as bruxism), may appear during times of extreme stress. The force of these actions can place significant pressure on your TMJ (jaw joint), which connects your jawbone to your skull. This strain on the joint and nearby nerves can lead to facial aches and pains.

Symptoms associated with TMJ disorders may include:

  • Aching pain in and around your ear
  • Difficulty chewing or pain while chewing
  • Dull headaches
  • Jaw pain and tenderness
  • Limited range of motion when opening your mouth

Recognizing your jaw clenching and teeth grinding

If you are suffering from jaw pain, the first step in finding relief is identifying the source. Teeth grinding more commonly occurs during sleep. The most common sign of grinding is tooth wear, which may not be easy to spot on your own. But if you are grinding your teeth at night, you will likely wake up with pain including:

  • Sore jaw
  • Stiff neck
  • Pain mimicking an earache or headache

Jaw clenching tends to happen more often while you are awake and should be easy to spot. If you find yourself clenching your teeth throughout the day, take note of when it is occurring and what you are doing at the time. See if the clenching correlates to the pain you are feeling.

Tips for relieving a tight jaw

Reducing stress is the best way to minimize jaw clenching and teeth grinding. Until that happens, there are things you can try at home to help loosen your jaw and alleviate the pain. For relief from jaw pain, try:

  • Avoiding jaw overuse by eating soft foods, cutting food into small pieces and not chewing gum
  • Hot or cold compresses applied directly to the jaw muscles
  • Massage by opening your mouth and gently rubbing the muscles near your ears
  • Pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or over-the-counter options
  • Stretching that includes head and neck stretches as well as holding your mouth open wide to stretch the jaw joint

When to seek help for jaw pain

If your jaw or facial pain is steady and unrelenting, or your bed partner can hear you grinding your teeth at night, it may be time to contact your doctor or dentist.

Your primary care physician can determine whether your medications or an underlying illness are to blame for your habits. If the culprit is indeed stress and anxiety, your doctor can refer you to a mental health specialist.

Your dentist can provide a customized mouth guard to reduce the effects of these habits. If teeth grinding goes untreated for too long, it could lead to tooth and gum damage, tooth sensitivity and increasing TMJ pain.

If you are experiencing facial and jaw pain or need help managing stress, reach out to your primary care provider.



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How is Ringing in the Ear Related to Jaw and Neck Pain?︱IMPACT Physical Therapy

How is Ringing in the Ear Related to Jaw and Neck Pain?︱IMPACT Physical Therapy

If you regularly suffer from ringing in the ears, it’s likely you have tinnitus, a condition that affects up to 20% of people. Though they are very different symptoms, your stiff, sore neck may be related to your tinnitus, linked together by temporomandibular disorder or TMJ. We’re exploring how neck pain and ringing in ears are connected and what to do about your symptoms with this guide. 

Tinnitus and TMJ 

Temporomandibular disorder is a painful problem that affects your jaw muscles, joints, and facial nerves. These joints are located just in front of your ears and connect your jawbone to your skull. TMJ can make it hard to fully open one’s mouth and often includes a loud clicking or popping sound while eating. 

In addition to jaw pain, some of the most common side effects of TMJ issues include:

  • Sore, stiff neck
  • Tinnitus
  • Earaches 
  • Headaches 

So while your neck pain isn’t causing the ringing in your ears, they both may be side effects of TMJ problems. Some of the biggest reasons why a stiff neck and tinnitus are caused by TMJ include: 

  • Your chewing muscles are located very close to your ears and can affect your hearing 
  • Your head’s nerve supply is very closely connected 
  • One of your jaw ligaments in directly connected with a hearing bone found in the middle ear 

What to Do About Sore Neck and Tinnitus Issues 

If you are suffering from both a stiff neck and tinnitus, it’s more than likely you’ll need to address your TMJ to alleviate these painful symptoms. Depending on the severity of your TMJ disorder, there are several possible treatments, including: 

  • Introducing softer foods into your diet 
  • Wearing a bite guard or night guard while you sleep to prevent teeth grinding or jaw clenching
  • Surgery for the most extreme cases 

As you work through your TMJ issues, there are a few things you can do to help alleviate your neck pain and ringing in the ears.

  • For neck pain:slow, gentle neck exercises can help release tension and discomfort, as well as using a warm compress. Deeper massage or physical therapy may be necessary for more intense pain. 
  • For tinnitus: removing excess earwax buildup can help reduce tinnitus. For louder ringing, the use of hearing aids also helps dampen the sound. 

Treat Your Sore, Stiff Neck with IMPACT Physical Therapy 

Neck pain and ringing in ears are uncomfortable symptoms you shouldn’t have to live with. Physical therapy is an excellent treatment method for relieving stiff neck issues. Request an appointment to learn more and see how our expert team can help restore normal movement and comfort.

© Copyright 2021 IMPACT Physical Therapy. Site by LDM.

Is Your “Bad Bite” the Cause of Your Ear Ringing and Pain?

Do you suffer from tinnitus or constant ear pain? Have you been to your doctor for your pain and ringing but still haven’t found a solution?

The reason for this may be because the issue is not solely medical – it is also dental. You could be experiencing a condition called Temporomandibular disorder or TMJ Disorder for short. What can cause TMJ disorder? A malocclusion or a “bad bite.”

TMJ disorder is often hard to diagnose. It is quite common for TMJ sufferers to go to their dentist when they haven’t been able to get a proper diagnosis from their own physician.

How is it that a jaw joint issue can affect the ears?
And is there anything we can do to stop the ringing and the pain? 

TMJ Tinnitus: How a misaligned jaw can result in ear ringing and pain

Your tinnitus is possibly a symptom of a larger problem – namely, TMJ Disorder. But the reality is that even this disorder is a symptom.

The cause of TMJ issues is misalignment of the teeth. Misalignment puts the bones, muscles, joints, and tendons of the head and neck out of alignment as well.

 

Image Credit

 

This causes a lot of strain on the muscles, including those of the ear. The ear muscles – the tensor tympani and tensor levi palatine – react to facial muscle tension. The reason for this is because they are both connected to the trigeminal nerve.

The result: ear pain and ringing.

Jaw pain can contribute to problems throughout the body

If you thought TMJ disorder only affects the head and neck – think again.

It affects the entire body.

If you think about it, the way our body is connected from our head to our toes is a beautiful thing. It allows for harmony and fluidity of movement. But the slightest imbalance in your jaws can result in tinnitus, headaches, dizziness, nausea, and jaw pain.  

We Believe… Every Patient Deserves to Find Relief – What a TMJ Dentist Can Do For You

If you experience TMJ tinnitus, jaw pain, migraines, or clicking and popping of your jaw joint, you need to come to my office.

Without jaw joint and tinnitus treatment, your symptoms are likely to get worse down the road. As your symptoms progress, the ringing and ear pain can get more intense. What is now an occasional ear ringing and headache can easily turn into being in constant pain down the road.

It is vital to get the treatment you need to get relief from your symptoms of today, as well as the issues that could arise tomorrow.

One of the common causes of TMJ disorder and tinnitus is a misaligned bite. I have multiple ways of helping you find relief.

  • Orthodontics – This is the ultimate TMJ Disorder treatment. If your bite is to blame, we need to fix it. And that is what braces will help us to do.
  • TENS Machine – Tight muscles can be a major source of jaw pain. This is a gentle electronic stimulation of the jaw muscles that assists them in releasing and relaxing more fully.
  • Custom-Fit Orthotic – This device aligns the jaw so that it’s in a position that’s natural and comfortable. We use a K7 mapping tool to analyze your jaw, which helps us to properly design the orthotic.
  • Another solution for more severe TMJ pain is a full mouth reconstruction – where we rebuild and reshape the teeth to allow for a better bite, relieving the muscles and joints in the area.

I’ve worked with multiple patients who experience painful symptoms and continue to educate myself to help them. My goal is to always stay current with treatment techniques and technology. Doing so provides me with some amazing tools that help me provide symptom relief to my patients.

I’ve worked with multiple patients who experience painful symptoms and continue to educate myself to help them. My goal is to always stay current with treatment techniques and technology. Doing so provides me with some amazing tools that help me provide symptom relief to my patients.

 

Don’t Put Tinnitus Treatment Off Any Longer

You may think that ear ringing or occasional ear pain is just a simple annoyance. But that’s really not true – not if you look at your symptoms as part of a bigger concern that’s happening to your body…

TMJ patients with ringing in their ears often experience pain of one sort or another. They may have earaches, migraines, or shoulder tension. And none of that falls under the category of “simply annoying.”

These symptoms of TMJ disorder can affect your daily life. Even if you don’t have any painful symptoms now, that doesn’t mean you won’t get them in the future.

Save yourself a lot of pain and frustration by getting treatment from my Mount Prospect dentist office. We’ll create a TMJ treatment plan that will provide you with relief and prevent further damage down the road.

Do you think you might have TMJ Disorder? Here at the Meyer Dental Group we believe that TMJ sufferers should get a proper diagnosis from their a dentist. Book a TMJ consultation or fill out my free TMJ Pain Questionnaire. You’ll get a response with my recommendations for treatment and relief.

Dr. Tom Meyer DDS – TMJ Chicago dentist, dentist Mount Prospect

A Sore Throat, Earache and Jaw Pain Could be Tonsillitis or Strep Throat

If you’re experiencing earache and jaw pain along with your sore throat, there are a few possible causes that might be reason for concern.

These symptoms may indicate a case of tonsillitis or its closely related cousin, strep throat. Tonsillitis is a swelling of the tonsils and can be either bacterial or viral in nature. Strep throat is a bacterial infection of the tonsils which also leads to swelling.

Your tonsils are located at the back of your throat and the top of your mouth where they help filter out bacteria and prevent infections.

Sore Throat

When your tonsils encounter more bacteria than they can handle, they become overwhelmed and swell up. This swelling causes the soreness in your throat.

Jaw Pain

The swelling of your tonsils often extends up from your neck and throat, into your jaw, causing swollen lymph nodes and jaw pain.

Ear Pain

Also located in your throat is the eustachian tube, which drains away the fluid from your inner ear. When your tonsils become swollen, the eustachian tube can become blocked, causing fluid to be backed up in your inner ear. This fluid buildup leads to pain in your ear.

Other Symptoms

People suffering from tonsillitis often also experience a loss of voice, difficulty swallowing, fever, chills, and headaches. Strep throat victims can often experience painful swallowing, fever, headache, abdominal pain, body aches and loss of appetite.

What to do about a Sore Throat with Ear and Jaw Pain

If you’re experiencing the symptoms of either tonsillitis or strep throat, visit your local FastMed and have an examination performed by one of our medical professionals. We’ll check your tonsils for any swelling and can administer a strep test and throat swab. If tonsillitis or strep throat are detected, antibiotics are typically prescribed to fight off the infection.

People with recurring infections may require a tonsillectomy to remove the tonsils entirely.

In the meantime, get plenty of rest, drink cold water to help ease the pain in your throat and try gargling with salt water or using a throat lozenge. You can also take Tylenol or Ibuprofen to alleviate the pain and any fever you might have.

About FastMed

FastMed Urgent Care owns and operates over 100 clinics in North Carolina, Arizona and Texas that provide a broad range of acute/episodic and preventive healthcare services 365 days a year. FastMed also provides workers’ compensation and other occupational health services at all its clinics, and family and sports medicine services at select locations. FastMed has successfully treated more than six million patients and is the only independent urgent care operator in North Carolina, Arizona and Texas to be awarded The Joint Commission’s Gold Seal of Approval® for quality, safety and infection control in ambulatory healthcare. For more information about locations, services, hours of operation, insurance and prices, visit www.fastmed.com.

Jaw pain? It could be a Temporomandibular Joint Disorder (TMJD)

Experiencing facial pain, tightness, locking and clicking when opening and closing your mouth, head and neck aches and/or ringing in the ears? You could have a disorder of your temporomandibular joint (TMJD).

What is the temporomandibular joint?

The temporomandibular joint (TMJ) lies just in front of your ear, where your jaw bone connects to your skull and is the most used joint in your body. It allows us to talk, chew, yawn, swallow and sneeze.

To find your TMJ, place your fingers in front of each ear and open your mouth. You will feel an indentation beneath your fingers. Within this joint lies an articular disc that allows smooth and controlled movement of this complex joint.

What is Temporomandibular Joint Dysfunction?

Temporomandibular Joint Dysfunction or TMJD is any condition that causes pain and dysfunction in the jaw joint and the muscles that control jaw movement.

It affects approximately 40 per cent of the population, with the greatest incidence in adults aged 20 to 40. Almost every patient with TMJD will have contributing factors arising from the neck, and about one third of people suffering from neck pain and headaches have the TMJ as a contributor to this pain. It is often the ‘missing link’ in curing headaches. 

TMJD can often lead to clinical depression. Think about it… if you had pain smiling, eating, talking and laughing, you’d feel pretty down.

Signs and symptoms of TMJD

Dull, aching pain is the most common symptom associated with TMJ disorders. Pain is usually felt in the jaw, but can also be felt in the face, ear, and teeth and may also radiate to the neck or shoulders. It is often made worse by chewing. Other symptoms include:

  • Difficulty eating (especially chewy or hard foods) or your jaw hurts when you eat
  • Jaw clicking or popping
  • A grating sensation when chewing
  • An uncomfortable or uneven bite
  • Jaw locking
  • Decreased ability to open the mouth or jaw hurts when you open mouth eg. when you yawn
  • Headaches
  • Ringing in the ears or a ‘fullness’ of hearing
  • Deviation of the jaw on opening of the mouth

What causes disorders of the temporomandibular joint?

There are many potential causes of TMJ dysfunction. These include:

  • Trauma to the joint via a direct blow
  • By-product of dental intervention
  • Excessive joint stress from chewing gum, biting finger nails, yawning, grinding teeth or jaw clenching
  • Jaw abnormalities, missing teeth or poor bite (malocclusion)
  • Resting the head in the hand
  • TMJ arthritis
  • Dislocation of the disc
  • Postural abnormalities – this is the big one!
  • Whiplash injury
  • Lax ligaments
  • Stress

How is TMJ Dysfunction treated?

After an examination and ruling out other conditions, your physiotherapist will provide advice on habit and diet modification to help ease your pain. If necessary, a stabilisation splint (or bite guard) can be fitted by your dentist.

Massage, heat/ice, acupuncture and mobilisations of the joint will also be considered to ease symptoms.Your physiotherapist will provide exercises to correct your posture to reduce stress on the neck and facial muscles and teach you how to set up your workstation or office space. Strengthening exercises will be prescribed to re-train faulty jaw movement patterns. We can also refer you to a psychologist who can help you deal with any stress or anxiety issues.

While TMJD can’t be ‘cured’, symptoms can be managed effectively in the long-term. Think you might suffer from TMJD? Contact your nearest Back In Motion practice to book your Free Initial Assessment.

Author

Justin Mistry – Director and Physiotherapist – Back In Motion Bundall and Back In Motion Burleigh Waters 

Justin Mistry is Practice Director at Back In Motion Bundall and Back In Motion Burleigh Waters. He has undertaken specialised training to help patients who suffer from TMJD. He works closely with dentists, psychologists, GPs and facial surgeons to overcome this debilitating condition.

Peter R. Sutton, D.C.: Chiropractor

Did you know that approximately 80 percent of all people who have pain in their head have lost some of the normal curve of the upper spine in the neck area?  These people may experience daily headaches, neck pain, vertigo (dizziness), and even ringing in the ears which are all common symptoms of a temporomandibular joint (TMJ) disorder.  Most people would never suspect that the neck and jaw would be related, including many physicians and dentists, but they can directly affect each other causing discomfort or pain if they are out of balance.  The latest research is showing that a bad neck position and poor posture can be one of the main causes of a TMJ disorder, and unless it is properly addressed, patients will continue to suffer.  If you are someone who has either neck pain or jaw pain, or possibly both, it can be a “chicken or the egg” situation meaning which came first, the poor posture or the bad bite and jaw position.  In most cases, it doesn’t matter because once symptoms start to occur; both the neck and the jaw are affected and need to be taken into consideration to give the patients relief.

Head position can have a large effect on the entire body, especially in the jaw and neck.  In fact, if your head is positioned just slightly forward it is actually 10 times heavier than if it is properly aligned on top of your spine!  Therefore, anything that causes a change in head position and neck curvature can lead to discomfort and pain.

If you have a posture that places your head in a forward or downward position you can be at a risk for a TMJ disorder or cervicogenic (neck-related) headaches.  A cervicogenic headache is pain referred to the head from a source in the cervical spine.  However, these symptoms from the neck could actually have been caused by a bad bite in the first place.  What dental issues can cause a bad neck?

 

  • Clenching and grinding
  • Worn down teeth
  • Poor posture
  • Snoring or sleep apnea
  • Severe overbite
  • TMJ disorder

 

As shown in many studies, there is a very close relationship between the upper cervical spine and a person’s jaw posture.  People may experience neck discomfort or they may experience headaches, jaw pain, ear ringing or even vertigo.  The frustrating part for a patient is they are often unaware of the origin of these symptoms.  If you have had any symptoms with your head and neck throughout your life, you should consider being evaluated in order to determine if you have a neck or jaw posture misalignment.  Luckily, when properly identified, there are very predictable solutions to alleviate these pains.

Dr. Sutton is a board certified Chiropractor and the owner of Abundant Health Chiropractic 480-802-0797

Author

Peter R Sutton DC
Dr. Sutton is a practicing Chiropractor for the past 16 years in Chandler, AZ

90,000 Jaw hurts, pain in case of jaw fracture

When the jaw hurts, a person experiences severe discomfort, and with severe pain, he cannot lead a normal life. Despite this, many are still afraid to see a doctor or simply do not know which specialist to visit. Meanwhile, pain is an important signal in medicine, indicating that something has malfunctioned in the human body.Therefore, when the jaw hurts, you should also carefully consider this symptom and not postpone a visit to the doctor.

Jaw pain: causes and consequences

Pain in the jaw can be caused by many reasons, ranging from mechanical injuries to inflammation and cancer. What to do in each of the above cases?

Infectious processes in the jaw (osteomyelitis)

Osteomyelitis is a purulent-infectious disease of bone tissue.It can occur when there is a focus of inflammation in the mouth, ear, throat, and also as a complication of a fracture of the jaw. Distinguish between acute and chronic course of osteomyelitis. In acute inflammation, general symptoms characteristic of infectious diseases predominate: weakness, fever, headache. Pain sensitivity in the jaw can be both local and radiating to the temple, orbit and extending beyond the jaw. If the cause of the inflammation in the jaw is unknown, then you should first contact your dentist to exclude odontogenic osteomyelitis, since it is the most common type of disease.

Osteosarcoma

This is a malignant neoplasm that forms from bone tissue. It begins with muted pains, which intensify more and more, especially when palpating. For an accurate diagnosis of the disease, it is necessary to carry out X-ray diagnostics by a maxillofacial surgeon or dentist and then consult an oncologist.

Temporomandibular joint problems

The function of the jaw joint can be impaired due to trauma, malocclusion, inflammatory diseases of the jaw joint, and neurological problems with the muscles of the jaw.Since a common cause of joint disruption is muscle overstrain, in this case, not only the jaw hurts while talking and chewing, but pain can also occur in the face, neck, near the ear, and headaches can occur.

In the medical center “Garant” on the dysfunction of the jaw joint, you will be consulted and diagnosed by a maxillofacial surgeon.

Neuralgia

Neuralgia is a disorder that affects peripheral nerves that mainly run in narrow canals.The jaw can hurt with neuralgia of the ear node (acute pain from hot and cold, going from the temple to the teeth), the superior laryngeal nerve (pain in the hyoid bone), with cranial neuralgia (pain behind the ear and in the lower jaw). In these cases, you will need a consultation with a neurologist.

Carotidinia syndrome

In diseases of the carotid artery, migraine and temporal arteritis, carotidynia can occur, which is a long-term (up to several hours) pain syndrome that affects, in addition to the areas of the face and neck, the lower jaw.

Jaw fracture

This is perhaps one of the most obvious causes of severe jaw pain. The cause-and-effect relationship is a blow – a fracture of the jaw – pain is understandable to everyone. Among the first symptoms that indicate a fracture, and not a bruise, are: unbearable pain, difficulty opening the mouth, malocclusion, swelling, bruising. In this case, an immediate ambulance and maxillofacial surgery is required.

If you feel that your jaw hurts, do not delay seeking medical attention, as this symptom may be a sign of the onset of a dangerous illness.

You can also read the article “Surgical Dentistry”.

TMJ pain

Temporomandibular joint (TMJ) dysfunctions are one of the most common causes of facial pain, often incorrectly referred to as temporomandibular dysfunction. There are 2 main types of TMJ dysfunction: myogenic (the source of muscle pain) and arthrogenic (the source of pain is the TMJ).

Understanding TMJ dysfunction
This violation suggests the following symptoms:
– pain or discomfort in or around the ear, TMJ and / or muscles of the jaw, face, temporal region and neck on one or both sides.Pain can come on suddenly and grow, fluctuating in frequency and intensity, months and years.

Clicking mouth opening, crepitus, closing, restricting opening or deflection of the mandible during movement, difficulty chewing, and headache are also associated with TMJ.

Temporomandibular joint structure
The temporomandibular joint or temporomandibular joint is a freely rotating and sliding joint, coated with fibrous cartilage, soccer ball (condyle), fibrous lining (disc), bone lining cavity (fossa), ligaments, tendons, blood vessels and nerves.The disc functions as a moving shock absorber and stabilizer between the condyle and fossa. When the jaw opens, the condyle normally rotates first and then slides forward within the fossa with a disc between the condyle and fossa.

Chewing muscles
Muscles attach to the lower jaw, upper jaw, skull and neck. The chewing muscles open, close, extend, and move your jaw, allowing you to speak, chew, and swallow. Additional chewing muscles (muscles of the neck and shoulder girdle) stabilize the skull on the neck during chewing.

Myogenic TMJ dysfunction (muscle-related)
It usually occurs due to overwork, fatigue, or tension in the masticatory or accessory muscles, resulting in facial, headache, and sometimes neck pain.

Arthrogenic TMJ dysfunction (joint-related)
As a rule, it is the result of inflammation, degenerative changes in the hard and soft tissues in the joint. Capsulitis or synovitis (inflammation), disc displacement (also called internal injury) and degenerative arthritis are the most common causes of TMJ dysfunction

Causes of TMJ dysfunction
The exact causes of dysfunction have not yet been clarified.It is believed that the development of dysfunction is due to a combination of several severe factors, including trauma and joint disease.

Teeth clenching and grinding (bruxism), as well as muscle tension in the neck and head are not currently proven causes of TMJ dysfunction, but they can aggravate the course of the symptoms of this disease, and they must be taken into account in order to treat and manage patients with this pathology … It is important for people with this dysfunction to understand that the condition can be chronic and can be highly influenced by many factors, including emotional stability.Since there is no quick fix or emergency treatment for TMJ, the most successful and supported treatments are focused on self-monitoring and control of aggravating symptoms.

Factors associated with TMJ dysfunction
– Trauma: Direct trauma to the jaw is associated with the onset of dysfunctional symptoms. Direct trauma to the jaw can occur from a blow to the jaw, hyperextension (overextension) of the jaw, and in some cases, compression of the jaw. Prolonged or forceful dental procedures, intubation during general anesthesia and surgical procedures in the mouth, throat, and upper gastrointestinal tract (esophagus and stomach) can injure the TMJ.
– Inappropriate habits: Habits such as clenching your teeth, clenching your jaws, grinding your teeth (bruxism), biting your lips or nails, using chewing gum, and placing your jaw in abnormal positions are common. With regard to them, evidence of their involvement in the development of dysfunction has not been proven. Such habits are often associated with TMJ dysfunction and can contribute to the appearance of factors that translate into a chronic form and aggravate the existing symptoms of the pathology.
– Bite: Denture refers to the way the teeth fit together or “bite”. Historically, dentists have considered malocclusion as the main cause of TMJ dysfunction. Recent studies have shown that malocclusion usually does not lead to this group of diseases, with the exception of a few cases. Each situation must be considered individually in order for the doctor to be able to make a differential diagnosis of facial pain.
– Psychological factors: Many patients with TMJ dysfunction report that the onset of symptoms or worsening of the disease is accompanied by an increase in emotional stress and psychological imbalance, leading to depression or anxiety. Scientific research shows that many people with this dysfunction experience varying levels of depression and anxiety, and these levels are higher than those without this dysfunction. To date, it has not been established whether symptoms of depression or anxiety are present before the onset of TMJ dysfunction and then contribute to its formation, or whether chronic pain associated with this pathological condition leads to the formation of anxiety and depression.Many patients begin to clench and grind their teeth more and more intensely when they experience emotional stress, psychological imbalance, or pain.
– Temporomandibular joint diseases: Some types of arthritis can damage the TMJ, as well as other joints. It is common in osteoarthritis developing in an aging population. Many other diseases, such as Parkinson’s disease, myasthenia gravis, strokes, amyotrophic lateral sclerosis, can lead to excessive or uncontrolled movements of the masticatory muscles.
– Other factors: The use of drugs and certain prescribed medications can affect the central nervous system and muscles, and lead to TMJ dysfunction.

Diagnosis of TMJ dysfunction.
Diagnosis of this disease should be part of routine practice for general practitioners and dentists.

A short set of diagnostic procedures may include:
– Medical history: complaints of pain in the jaw area, headaches, neck pain, discomfort in the TMJ area, closing of the jaws, clenching of the teeth, damage to the jaws, head, neck, as well as a history of cases of TMJ dysfunction or treatment of facial pain.- Objective examination: may include measuring the opening of the jaws, combined movements, deviation of the jaws during opening, palpation (pressure exerted by fingers) of the joint, jaws, muscles of the head and neck to determine pain points and the presence of crepitus. It is also necessary to assess the gums, soft tissues of the mouth, teeth and make notes about the disease, the presence of tooth damage, as well as the symmetry of the jaw, face and head. If any abnormalities are found during the examination, a more detailed history should be collected and a more in-depth examination carried out.

Comprehensive assessment of TMJ dysfunction
Comprehensive assessment may include:
– Complete analysis of all symptoms related to TMJ, head, neck, medical history, dental history, life history, heredity, psychological history.
– Comprehensive objective examination of the face, cervical spine, masticatory muscles, head and neck, neurological structures, teeth, gums, hard and soft tissues of the oral cavity.
– Psychological history, including a short survey and testing.- Additional tests, including x-rays and imaging techniques, biopsies, blood tests, urine tests, neurological tests, diagnostic injections.

Treatment of TMJ dysfunction
Since there is no known cure for this pathology, the management of patients with symptoms of dysfunction is similar to the management of patients with other orthopedic or rheumatological disorders. The goals of management of this group of patients are: reduction of pain syndrome, adverse pressure and stress on the jaws, restoration of jaw functions, implementation of a well-planned management program to treat the physical, emotional and psychological aspects.Management options and treatment sequence for TMJ dysfunction are similar to other musculoskeletal disorders. As with many diseases of the musculoskeletal system, the signs and symptoms of TMJ can be temporary and resolve on their own without serious long-term consequences. For these reasons, it should be especially important to try to avoid aggressive and irreversible treatment options such as surgery, major dental surgeries or orthodontic treatment.Conservative management techniques include behavioral changes, physical activity, medications, jaw exercises, and orthopedic aids. All have been found to be safe and effective treatments for cases of TMJ dysfunction.

Most patients with this disease achieve long-term remission with conservative therapy. Scientific studies show that in more than 50% of these patients, only a few symptoms persist or they disappear completely.

Patient self-monitoring should include:
– Limited opening of the jaws (no more than 2 fingers wide).
– It is necessary to give the jaws a rest, avoiding prolonged chewing (chewing gum, bagels, tough meat).
– Avoiding teeth grinding and clenching by relaxing in the jaw area and keeping the upper and lower rows of teeth at a distance.
– Avoiding leaning or sleeping on the jaw.
– Avoidance of pushing movements with the tongue and chewing of non-food items (nails, pens, pencils, etc.), stress, pressure on the jaw.
– Use of cold, ice or damp warm compresses as directed by your doctor or therapist.
– Performing massage of the affected muscles.
– Performing gentle, restricted jaw exercises as prescribed by the attending physician.
– The use of drugs as directed by the attending physician.

Treatment options.
– Orthotics:
You may be offered an orthosis (or a retainer known as a “night watchman” or “bite guard”) that fits over the upper and lower rows of teeth. The retainer has many different purposes, and it can be worn either permanently or part of the time, it all depends on the appointment of the attending physician. In most cases, retainers are used to separate the rows of teeth, realign the joints of the jaw, and help the jaws to relax.The unique look and adjustment of the brace will depend on your condition, how it changes while wearing the brace, and the overall treatment plan.

Care of patients in the presence of stress.
One of the goals of TMJ dysfunction treatment is to define a therapy for daily stress. Your doctor may recommend several options for you to do this. These options include: method-biofeedback (biofeedback method), breathing for relaxation, image management, and sometimes, referring to a specialist.

Physiotherapy.
Physiotherapists are specially trained professionals who assist in the rehabilitation of all types of physical injuries. There are many treatment options that can help. These include: jaw exercises, posture training, ultrasound, electrical stimulation and mobilization. Your healthcare provider and physical therapist will work together to shape your treatment plan.

Bite correction
Sometimes it is necessary to improve the way your teeth fit together.This can be accomplished in a variety of ways. Orthodontics, usually with braces, will help you move your teeth so that they fit better together. In some cases, when the jaws themselves are not misaligned, they are corrected with combined treatment by an orthodontist and maxillofacial surgeon. This is called orthognathic surgery.

Correction of the bite occurs due to the intensive work of the dentist, with the installation of crowns, bridges, and, if necessary, implants.This is done to replace missing teeth or change the size and shape of the teeth so that they fit together and function more harmoniously with the jaws and muscles. Surgical treatment is sometimes performed to repair or reconstruct the jaw when conservative treatment fails to achieve a comfortable existence and good functioning. Surgical treatment is rarely necessary, but it can be performed to remove debris that may accumulate in the joint cavity, as well as to repair damaged tissue or even replace the entire jaw, such as changing other joints (knee, hip and shoulder).

Conclusions
Extensive research is underway to determine the safety and efficacy of treatment for TMJ dysfunction / orofacial pain. Many researchers and clinicians insist on reversible and conservative treatment of dysfunction. Even when the symptoms of this dysfunction persist for a long time, they are pronounced, many patients with this pathology do not need invasive treatment. Treatments designed to alter the bite or reposition of the jaws through orthodontic or dental reconstructive manipulations are usually unnecessary.And if they are used, then when absolutely necessary. If irreversible treatment is expected for TMJ dysfunction or orofacial pain, we recommend seeking additional authoritative opinion.

Trained dentists, physiotherapists, psychologists and clinicians are often the best source for correct diagnosis and follow-up of this patient population.

Exercises for the temporomandibular joint

90,000 Temporomandibular joint diseases: treatment in Moscow

The temporomandibular joints are one of the most mobile joints.

During one day, they open and close a person’s mouth many times. The joint consists of the temporal bone and articular process of the lower jaw, tendons and articular bag. Due to the rather heavy load, diseases of this joint are very common (according to statistics, in 40% of the population). A rather large load falls on the joint, not only due to regular chewing of food, but also due to facial movements, etc. The cause of various diseases can be:

  • Jaw injury (facial skeleton injury),
  • Complications of dental diseases ( malocclusion ),
  • Endocrine Disorders,
  • Infectious Diseases,
  • Increased stress ,
  • Increased physicalload.

Causes of joint disease

In students and schoolchildren, due to stressful situations, especially during the period of experience, teeth grinding often appears – this leads to abrasion of the teeth and, as a consequence, the manifestation of temporomandibular dysfunction.

Few people thought about the fact that posture disturbance negatively affects the jaw, the ratio of both upper and lower teeth changes

Injuries to the neck, fractures of the facial bones, as well as craniocerebral trauma – all this can damage the temporomandibular joint.

  • Pain, crunch, clicks when the jaw moves.
  • Increased body temperature.
  • Aching pain in the ear
  • Headaches and dizziness
  • Spasms of the facial muscles and neck

In medical practice, the most common:

  1. Joint dislocation . Displacement of joint components: head and disc, sprain, pain and restriction of movement,
  2. Arthritis (possible joint pain, swelling and fever)
  3. Arthrosis .When moving, there is a click, crunch, pain in the joint, disturbances in the movement of the joint.
  4. Ankylosis . Restricting the movement of the lower jaw completely leads to its immobility.
  5. Joint dysfunction .

Treatment

As a rule, in dentistry, TMJ diseases are treated by a general practitioner together with a surgeon and an orthopedist. In our clinic, TMJ diseases are treated by the chief physician of the clinic and maxillofacial surgeon R.S.

  • Rest required: limited mouth opening, soft food.
  • Physiotherapy: electrophoresis, massage, currents.
  • Medicinal: anti-inflammatory and analgesic drugs.
  • Bite correction: dentists use various methods to correct the bite.
  • Surgical: Reconstructive joint surgery.

Neoplasms / Surgical dentistry / Dentistry / Medical services

Each patient, before starting prosthetics, undergoes a thorough examination to identify various diseases and neoplasms in the oral cavity.Sometimes, it allows you to identify tumors (including malignant ones) at the time of inception, when the patient does not even know about it. And this is an opportunity to start treatment early, giving a complete recovery. Basically, for this, the palpation method is used, when the doctor manually checks every centimeter of the patient’s oral cavity.

And although malignant neoplasms are rarely detected, it is recommended to carry out such an examination on a regular basis, since, unlike tumors on other parts of the body, any neoplasms in the oral cavity respond better to treatment and prevention.But in order to protect yourself, you need to know the main symptoms of this disease. It is not without reason that the saying is: “Forewarned means protected.”

There are many diseases that are asymptomatic, do not manifest themselves in any way outwardly and do not cause any trouble to a person. The patient may not even guess that he is not all right, while the disease develops more and more. And only in the last stages can the first signs appear, sometimes very unpleasant and painful, and together with complications.Such pathologies are not uncommon in dentistry. One of these insidious diseases is a tooth cyst.

What is a tooth cyst?

Generally speaking, a cyst is a formation filled with fluid and having a dense membrane. In dentistry, a tooth cyst denotes a formation in the bone filled with liquid contents (mainly dead epithelial cells and bacteria). The disease occurs due to an untreated infection in the tooth. The cyst has a dense membrane (this is a protective reaction of the body so that the inflammatory process does not develop further).But this does not prevent it from growing and reaching sizes of 3-4 cm or more. Many people are dismissive of this kind of formations, but a cyst can give very serious complications – up to cancerous tumors, therefore it is a rather dangerous disease.

Reasons for formation

A dental cyst can form for a variety of reasons, ranging from an unsuccessful fall, in which a tooth is injured, to a banal unsuccessful root canal treatment. To find out exactly why the cyst has formed, the doctor conducts a detailed survey and directs the patient to additional research methods.

The most common causes of dental cysts are:
  • Trauma (tooth displacement provokes the penetration of infection and the rapid growth of microorganisms, since dirt and a large number of pathogenic bacteria usually get into the wound)
  • Poor caries treatment (as a result, an infection enters the root canal and provokes a new inflammatory process – a cyst)
  • Unsatisfactory endodontic treatment (again, the negative influence of pathogenic microflora and the formation of an inflammation focus)
  • General diseases in which pathogenic bacteria enter the peri-maxillary tissues along with the bloodstream
  • Complication of sinusitis (with cysts on the upper jaw)
  • Chronic inflammatory processes under the crown
  • Chronic periodontitis (if left untreated, the infection continues and a root cyst develops
  • Diseases of the nasopharynx
  • Difficult eruption of wisdom teeth.Usually, this forms a “hood” – the part of the gum that covers the unerupted part. Bacteria multiply there, penetrate deep into the tooth, provoking the formation of a cyst

Dentists give the first places among the causes of cysts to two main ones: trauma to the teeth and infection of root canals. Therefore, it is very important to try to avoid getting the infection into the tooth – it is she who triggers the inflammatory process.

Tooth cyst symptoms

The special danger of the disease lies in the fact that the first signs of it appear when the cyst is already impressive in size.The early stages do not manifest themselves in any way. Cysts form rather slowly – the process is measured in weeks. Therefore, the patient has time to detect warning signs that may indicate a tooth cyst:

A tubercle on the gums in the area of ​​the tooth root, increasing in size over time (due to the accumulation of fluid in the cyst cavity)

Unpleasant sensations when eating solid food (due to pressure on the gum with pieces of food)

Formation of a fistula (communication between the oral cavity and the bone in the form of a hollow passage)

Malaise, fever along with pain in the jaw

Headaches that do not go away when taking pills (with cysts formed in the maxillary sinus)

It should be especially noted that the toothache with cysts is not as strong as caries – it can be called pulling.If the cyst becomes inflamed, the pain becomes worse.

A person may not associate these signs with some kind of disease, believing that he “rubbed” the gum, scratched the tongue, etc. In fact, it may be the most real cyst, but, unfortunately, it is really difficult to recognize it.

Diagnostics

As a rule, a tooth cyst is discovered absolutely by accident – during a routine examination or treatment of an adjacent tooth. The disease is detected radiographically.

The image shows a round dark spot, which has clear contours, is located at the apex of the tooth root (surrounds it in the form of a “nimbus”). If the doctor has doubts about whether it is a tumor or a cyst, he sends the patient for a cyst puncture. In this case, the cyst is punctured, a needle is drawn up, and it undergoes a histological examination to determine whether the cells are cancerous.

Cyst treatment

Dental cysts are treated both therapeutically and surgically. Now doctors are trying to save the tooth as much as possible.The “pitfall” in the treatment is the fact that some cysts continue to grow even after tooth extraction, and after any method the tooth must be observed.

The therapeutic method is applicable for early treatment and small cysts (up to 0.8 cm in diameter).

First, the tooth itself is treated, the canals are filled. Even if the tooth has been treated earlier, the canals must be sealed and treated with an antiseptic.

Then the doctor will perform the copper-calcium depophoresis procedure.

A suspension of copper and calcium is introduced into the tooth, and then an electric current is applied.

3-5 sessions are required, after which the tooth can be filled.

The method is very controversial; it has many opponents and supporters. Doctors who advocate this procedure talk about the possibility of saving a tooth and a sparing attitude to dental tissues. Doctors who do not accept this method argue about the possibility of recurrence of the cyst and loss of time.

Of course, the decision must be made on an individual basis.

The surgical method of treatment is subdivided into the following types:

Cystotomy. Incomplete removal of the cyst. It is carried out with large cysts (more than 1.5 cm), when they cannot be completely removed due to possible damage to adjacent tissues.

Cystectomy. Complete removal of the formation, most often together with the apex of the root. An incision is made on the gum, the cyst and the apex of the root are removed, the canal is immediately sealed and the gum is sutured.

Retromolar cysts should be removed with the tooth.With large cysts, a bone substitute drug is injected into their cavity (the most popular today are Cerabon, JASON, Maksresorb).

Any surgical method is accompanied by the appointment of antibiotics, anti-inflammatory drugs (more often it is Tsiprolet), antihistamines (according to indications and individual tolerance).

Possible complications

A cyst not diagnosed in a timely manner grows, destroys bone tissue and provokes the formation of connective tissue.Then complications can lead to the fact that the tooth will be lost.

The following complications are most often recorded by doctors:
  • Purulent inflammation of the cyst (threatens with a severe inflammatory process on the entire jaw, namely osteomyelitis)
  • Melting of the jaw bone tissue (occurs due to the growth of a cyst, again leads to osteomyelitis)
  • Lymphadenitis (inflammation of the lymph nodes, threatens with further spread of infection)
  • Chronic sinusitis (when the cyst grows into the maxillary sinus)
  • Periostitis (inflammation of the periosteum)
  • Abscess on the cheek or gum (occurs due to severe inflammation)
  • Fracture of the jaw due to thinning of the bone in the place where the cyst formed
  • Cellulitis is a severe complication in which soft tissues become inflamed, possibly general blood poisoning
  • Degeneration of cyst cells into malignant, then a tumor is formed

Some complications can directly threaten a person’s life, therefore, a tooth cyst should in no case be treated with disdain and reasoned at the level of “it will resolve itself”.The cyst can become inflamed, break through, but not dissolve in any way, and treatment is necessary here.

Prevention

It is impossible to avoid the occurrence of a cyst, but it is clearly visible at an early stage during X-ray examination, so have it every year. So you will avoid its growth (if detected) and will be protected from many complications.

Make regular visits to the dentist, timely treat teeth and diseases of the nasopharynx. Check with your doctor for any discomfort in your mouth.

Be sure to brush your teeth correctly – this is the prevention of many diseases of the oral cavity. Simple preventive measures will help you avoid serious problems and provide high-quality treatment for a cyst that appears, possibly without surgery.

And every saved tooth is a victory.

Toothache – causes and methods of getting rid of

Hypersensitivity, or, as experts call, dental hyperesthesia

Pain with caries and its complications

Pain in the teeth of non-odontogenic origin

Analgesics

Cold compress

Acupressure massage

Tooth pain is one of the most unbearable pains a person can experience.The expression “to climb the wall in pain” in the case of teeth ceases to be figurative. Suffering caused by toothache was reflected in medieval engravings, canvases of painters, became the subject of literary works.

Toothache is also the topic of folk proverbs and sayings, quotes, aphorisms:

  • The tooth in my mouth is sick.
  • No tooth hurts behind someone else’s cheek.
  • Country relatives, like a toothache.
  • Love conquers everything except poverty and toothache.

Toothache usually begins on Saturday night: this saying reflects the untimely and suddenness of a toothache.

Fortunately, almost all dental facilities have a doctor on duty, or a separate room for patients with so-called acute pain, where you can expect to skip the line. But it also happens – a toothache, according to Murphy’s law, overtakes us at the most inopportune moment, when an immediate visit to the dentist becomes a problem – on the road, in places where Makar does not graze calves, well, or just late at night on the wildest holiday.Agree, given the simply unbearable nature of toothache, the torment is simply comparable to the torment of sinners in hell, which are described by the great Dante.

But even if the toothache is not acute and unbearable in nature, periodic pain in the tooth can also spoil life quite badly, interfering with the normal intake of food.

In fairness, we note that toothache in our time, in most cases, is an indicator of an irresponsible attitude to one’s health. Indeed, before you get an acute toothache, the pathological process in the tooth takes a long time, letting you know about yourself with discomfort or small short-term pain sensations that a person cowardly ignores, taking the position of an ostrich, maybe it will pass, or, absorbed by more important his glance with deeds, is still waiting for that not at all beautiful day (even more so night), when all deeds and aspirations literally fade before a toothache, and you are ready to run to the saving chair of the dentist.How not to remember here another aphorism:

Why do people avoid dentists so much? After all, their patients develop in themselves both patience and generosity.

The fear of toothache is rooted in ancient times, when dental care was limited only to the removal of the culprit tooth, and a blow to the head provided anesthesia. Even if you look not so far, but only 100 years ago, before the era of local anesthetics in dentistry, you can imagine what horror a visit to the dentist inspired a person, since any manipulations were very painful.Let us recall the story of A.P. Chekhov’s “Surgery.” “Fathers, dear fathers, have mercy! I’ll pay three times! Just let it go! Going to kill me! And the tooth has already stopped hurting. ” – the patient laments. Or, for the same Chekhov, in the story “Horse surname”:

“Retired Major General Buldeev had a toothache. He rinsed his mouth with vodka, brandy, applied tobacco soot, opium, turpentine, kerosene to his aching tooth, smeared iodine on his cheek … The doctor came … The general refused to pull out the aching tooth.All the household … each offered his own remedy. ..and the bailiff advised to undergo treatment with a conspiracy. ”

But even in the 21st century, when the problem of pain relief is completely solved, humanity continues to suffer from toothache. And the reason, as a rule, is an untimely visit to a doctor.

Let’s try to figure out in what cases there is pain in the teeth, what it signals and in what cases it is necessary to immediately contact the dentist.

Types and causes of toothache

Hypersensitivity, or, as experts call, hyperesthesia of the teeth

This is a condition in which there are short-term painful sensations in one or more teeth, which quickly pass after the stimulus is removed.Aching pain of varying intensity can occur when eating cold or hot food, sour and sweet foods, when inhaling cold air, even when brushing your teeth with a toothbrush. Increased tooth sensitivity accompanies caries from the very beginning of the process. Hyperesthesia is a symptom of so-called non-carious dental diseases, in which the enamel becomes thinner or completely abraded; enamel hypoplasia, enamel erosion, wedge-shaped defect, abnormal tooth wear. The mechanism of pain in these cases is the same – the protective enamel layer is erased, and through the dentin of the tooth, penetrated by a huge number of holes, the neurovascular bundle (pulp) is freely affected by stimuli.

Pain with caries and its complications

The carious process can be accompanied by painful sensations from the very beginning, when there is still no visible defect. Typically, this is pain when eating cold, sour, or sweet foods. The main difference between caries pain is its rapid cessation after the removal of the irritant.

If the matter has gone far, and the neurovascular bundle of the tooth (pulp) is involved in the process, the nature of the pain changes. The pain gets worse, lasts much longer and becomes paroxysmal.What happens in the dental pulp? The usual inflammatory process (pulpitis) develops, which is always accompanied by the migration of leukocytes from the blood to the tissue. A fluid forms in the tissues, at the beginning of inflammation this fluid is transparent, or, as experts say, serous. The next stage is the formation of pus in the focus of inflammation, as a result of the destruction of leukocytes. If we remember that the neurovascular bundle is located in a limited space inside the tooth and the resulting serous fluid or pus does not have a free outlet, it becomes clear why toothache with complications of caries is so intense.Patients describe the pain as shooting, throbbing, tearing. Painful attacks are replaced by periods of calm – the pain subsides for a short time, when the accumulated inflammatory fluid still finds a way out, usually through the bottom of the carious cavity. This is repeated over and over again. Another feature of pulpitis pain is its irradiation (spreading) to adjacent teeth and even to the ear, temple, orbit, that is, along the nerve located in the jaw. This happens with the so-called diffuse pulpitis, when the patient postpones for some reason a visit to the doctor and the inflammation captures the entire pulp of the tooth – both its coronal part and root.It is characteristic of pulpitis pain that it occurs at night, which is associated with the peculiarities of hormonal regulation of nervous activity. The fact is that in the dark, the production of adrenal hormones decreases, which affect a person’s perception of pain.

Often, the patient cannot localize a bad tooth, and even for a doctor, diagnosis can be difficult, especially if there are several carious teeth.

It would seem that pulpitis will certainly lead the most notorious coward to the doctor.But no, and in our time there are people who prefer to cope with the situation on their own or using folk methods. Indeed, such a hero “courageously” overcomes the period of acute pain, the tooth calms down, and life goes on as usual … For the time being. After all, the carious cavity has not gone anywhere, and the inflamed pulp miraculously did not become healthy. What happens next in the aching tooth? The processes in the pulp proceed according to all the laws of inflammation – the acute phase is replaced by the chronic one. Chronic pulpitis can be almost asymptomatic, but, as a rule, it still makes itself felt with bouts of pain that occurs from temperature stimuli (a characteristic sign of pulpitis is pain from hot) or when food gets into the carious cavity.

Inflammation in the pulp for a long time becomes a source of toxins for the tissues surrounding the tooth. The first are the ligaments of the tooth at its very apex, where the opening of the neurovascular bundle is located, through which not only toxins, but also microorganisms freely enter the outside of the tooth. This process is called periodontitis. Inflammation in periodontitis already captures the periodontal tissues and the focus is located in the jawbone. The process can also be serous and purulent.Pain in acute and exacerbation of chronic periodontitis differs in that it occurs when a load on a diseased tooth. The pain grows, in contrast to pulpitis pain, it has practically no “light” gaps, is aching, pulsating in nature, may be accompanied by a headache, an increase in body temperature. Unlike pulpitis, with periodontitis there are changes in the mucous membrane in the area of ​​the diseased tooth – swelling, redness, fistulas, sometimes the tooth becomes mobile. If the outflow of inflammatory fluid through the tooth canal is disturbed, such dangerous complications as periostitis, abscess, phlegmon occur.

Pain in teeth of non-odontogenic origin

Sometimes there are situations when other diseases are disguised as a toothache. The dentist, as the primary diagnostic unit, bears a great responsibility in such circumstances. In some cases, a delay in seeking medical help threatens with serious complications, up to a threat to life. Let’s consider some of these conditions.

Pain in otitis media (middle ear disease) can spread to the chewing teeth of the upper jaw on the affected side.In this case, both the teeth and the ear hurt at the same time, and the patient is often unable to localize the pain.

Diseases of the maxillary sinuses (sinusitis): the roots of the chewing group of the teeth of the upper jaw are in the immediate vicinity of the maxillary sinus, therefore, the pathological process, for example, acute sinusitis, may be accompanied by pain in the teeth. One of the signs of such pain is its intensification when the head is tilted forward.

With angina pectoris, pain sometimes appears in the teeth of the lower jaw on the left, radiating to the corner of the jaw, the presence of discomfort or pain behind the sternum along with this spreading under the left scapula and left arm facilitates the diagnosis.

The so-called migraine-like cluster headache is accompanied by pain in the eyes and teeth of the upper jaw.

Neuralgia of the trigeminal nerve and its separate symptom complex – dental plexalgia. This is a very unpleasant and difficult to treat disease with an ambiguous etiology. The trigeminal nerve, as the name suggests, has three branches. The second and third are responsible for the innervation of the upper and lower jaw, so pain in both neuralgia and neuritis is localized, according to the patient’s feelings, in the teeth.The pain occurs either for no apparent reason, or when you touch certain areas on the face, the so-called trigger zones. The pain can be paroxysmal, or constant, pulsating in nature, burning, cutting. In the presence of several “suspicious” teeth (carious or previously treated), the diagnosis can be difficult.

An experienced and attentive doctor will certainly refer you to the appropriate specialist, having ruled out the dental cause of pain.

First aid for toothache

Analgesics

Nonsteroidal anti-inflammatory drugs can numb pain for several hours.The most popular drugs are ketotifen and ibuprofen. Of the modern drugs with prolonged action – nimesulide. Regular analgin or paracetamol can only work for mild pain and for a short time. Analgesics are designed to relieve your condition for a while while you get to dental care. If you are taking analgesics yourself, be sure to read the annotation and pay attention to contraindications (erosive and ulcerative diseases of the stomach and intestines, liver and kidney diseases, bronchial asthma, etc.) and the dosage.

Cold compress

A wrapped ice cloth can be used for this. Lifehack is a plastic bottle with frozen water. We emphasize that it is a cold compress that is effective and safe, in no case do not listen to advice to warm a sick tooth. In some cases, this is strictly prohibited.

Acupressure

The point on the hand (if it hurts on the right – the left hand, and vice versa), which is responsible for the area of ​​the teeth, is located in the depression between the phalanges of the thumb and forefinger.Movements clockwise, with moderate pressure, the duration of the massage is about 5 minutes. There are similar points on the ear. It is necessary to place the tips of two fingers on the upper part of the auricle on the side where the toothache is localized. Massage of the upper part of the earlobe on the side opposite to the localization of the toothache is also effective. Massage the points with your thumb and forefinger for at least 7 minutes. Point in the depression between the lower jaw and the zygomatic bone.

Massaging the point in the corner of the lower jaw will relieve pain in the corresponding teeth.

BUDOVSKY – Dental clinic

Opening the mouth is a process that involves the mandible, masticatory muscles, ligaments and temporomandibular joint (TMJ). The temporomandibular joint is paired and has a complex anatomical structure: it consists of the glenoid fossa and tubercle, the articular disc, which acts as a “pillow”, which cushions the movement of the articular head of the lower jaw, ligaments and capsules that hold and guide movement in the joint.

If the structure of any of these elements is violated, the following may occur:

  • Difficulty and pain when opening the mouth.
  • Jaw jamming.
  • Crunch and click.
  • Soreness in the joint, jaw, ear.
  • Headaches.

All these symptoms indicate dysfunction, that is, malfunction, of the temporomandibular joint, which can be a sign of the following diseases:

  • Arthritis – inflammatory changes in the joint.
  • Ankylosis – limitation, up to complete absence, of joint mobility.
  • Subluxation, dislocation, injury of the temporomandibular joint.
  • And some others …

Each disease has its own causes and features during the course, but any of them, in the absence of proper treatment, tends to develop complications such as:

  • Restriction of mouth opening.
  • Disorders of chewing, breathing, diction.
  • Intensive formation of dental plaque and malignant progression of caries.
  • Inflammation of the gums.
  • Facial asymmetry.
  • Underdevelopment of the lower jaw and malocclusion (in children and adolescents).
  • Severe migraine-type headaches, pain in the ears and pressure behind the eyes.

When the first symptoms appear, it is important to seek help as soon as possible in a reliable clinic that has in its arsenal modern dental equipment, instruments and, of course, doctors who are able to make an accurate diagnosis and prescribe the correct treatment.

We will talk about the process of treatment of temporomandibular joint dysfunctions “from and to” in the next article. See you!

Best regards, “Dentistry of Doctor Budovsky”, Moskovsky pr. 37/1 Contact phone: +7 812 602 37 74

When your teeth hurt. What to do and how to relieve a toothache

Probably one of the most terrible pains that a person has is a toothache. When a toothache hurts, it is almost impossible to endure, and then even the most ardent dislike of dentists goes to “surrender” to the doctor.But not everyone knows why their teeth hurt, and how these unpleasant sensations can be avoided. Together with the dentist-therapist of the StilDent clinic Elena Gennadyevna ZIBNITSKAYA, we will deal with the most common causes of toothache.

The most common causes of toothache are tooth decay, pulpitis, periodontitis, and pericoronitis.

Caries

This is a disease of the hard tissues of the tooth, leading to the destruction of enamel and dentin. First of all, caries affects the natural depressions on the teeth (fissures), as well as areas where plaque accumulates in large quantities – these are the interdental spaces and the gum area.With caries, the hard tissues of the tooth are demineralized and softened, and subsequently a defect in the form of a cavity forms on the tooth.

Caries has several stages, the process is initial, superficial, medium and deep. At first, caries is almost asymptomatic – the main inconvenience that a person experiences is associated with food getting stuck in carious cavities. Another symptom of caries, which is usually not paid much attention to, is short-term pain from chemical, mechanical, thermal stimuli.Simply put, damaged enamel no longer protects the tooth from the effects of hot tea or ice water or from mechanical stress, and at this moment we experience pain. But since it only lasts a few seconds, we usually don’t take it seriously.

When the process reaches the last stage – deep caries, it becomes difficult to ignore the unpleasant sensations. With deep caries, the patient experiences pain when food and liquid gets into the damaged area, pain when brushing teeth (irritation from the ingress of paste and brush), pain from any external stimuli, temperature, chemical, mechanical.After the irritant is removed, the pain subsides – until the next episode. At this stage, the quality of life is already significantly reduced. But if a person continues to endure stubbornly and does not go to the doctor, gradually the nerve of the tooth (pulp) is involved in the inflammatory process, and pulpitis begins.

Pulpitis

This is an inflammation of the pulp (nerve) of the tooth, the process is usually accompanied by acute pain. Pulpitis occurs as a reaction to constant exposure to stimuli that enter the pulp through the carious cavity, as well as due to the influence of microorganisms and toxins on the tooth nerve.Irritation of the pulp leads to a change in blood flow, which provokes increased pressure on the nerve fibers.

At the initial stage, pulpitis is manifested by mild pain, which disappears when the stimulus is removed. At this stage, the inflammation goes away on its own if the irritant is removed – that is, to cure caries and fill the tooth, isolating the pulp from external influences.

If nothing is done, the inflammation gradually increases, and the pain increases. The stage of acute pulpitis sets in, irreversible changes take place in the pulp.The pain is easily caused by any irritant. The option “do not eat, do not drink, keep your mouth closed” does not save you from pain. Toothache often worsens at night.

Pain in acute pulpitis can be very different:

  • Sharp or dull

  • Pulsating or constant

  • Localized or spilled

  • Short-term or long-term

If you continue to ignore your condition and do not go to the dentist, then the next stage is complications that are likely to develop in acute pulpitis, including purulent pulpitis.

Purulent pulpitis

This is the most severe form of pulpitis, most often, it ends with pulp necrosis. With purulent pulpitis, the pain becomes especially unbearable and sharp, at night it often intensifies. The pain radiates to the temporal region, to the ear, to the eye socket, to the other teeth – often in this state it seems to a person that all his teeth already hurt.

Chronic pulpitis

In the most patient patients, acute pulpitis can become chronic.The pain becomes not so acute and constant, sometimes it subsides for a long time. If the carious cavity is hard to reach for irritants, chronic pulpitis can be almost painless.

Symptoms of chronic pulpitis

  • Pain in the cold

  • Pain when eating hot food

  • Pain with changes in temperature (for example, when you leave the house on a cold street)

  • Prolonged aching pain if the cavity is clogged with food debris

Chronic pulpitis can aggravate at any time and give you all the unforgettable sensations of acute pulpitis.

If chronic pulpitis is left untreated, it can progress to periodontitis.

Acute periodontitis

Periodontitis is an inflammatory process in the periodontal (periodontal) tissues in the apex of the tooth root. Often, the inflammation traps the cement and dentin of the tooth root, as well as the alveolar bone. Periodontitis in most cases occurs due to damage to the pulp, that is, pulpitis.

Symptoms

  • The pain is constant, throbbing, with a clear localization

  • The pain is worse from any touch of the tooth, including when chewing

  • Pain can spread to part of the face

  • Headache

  • General weakness

  • Temperature increase

  • Swelling of the cheek

  • Gum pain, redness and swelling in it

  • Submandibular and chin lymph nodes are enlarged

  • Possible discharge of pus from the root canal

Chronic periodontitis

Chronic periodontitis sometimes develops asymptomatically or acute periodontitis can progress to this stage.Chronic periodontitis develops when the pulp dies, and favorable conditions for the development of microorganisms are created in the tooth. Sometimes, chronic periodontitis can appear after a tooth injury.

Symptoms

  • Discoloration of tooth enamel

  • The presence of a fistula on the gum

  • Painful sensations when chewing solid food

Chronic periodontitis can have many very serious complications: granuloma, root cyst, pathological fracture of the mandible, periapical abscess, phlegmon, and others.

Pericoronite

This is a difficult teething of wisdom teeth (eights). In the case when the tooth cannot erupt normally, inflammation of the surrounding soft tissues and the periosteum behind the dental fossa begins. The inflamed gums are constantly traumatized when chewing, which further exacerbates the process.

The inflammatory process can gradually lead to the development of purulent pericoronitis.

Symptoms:

  • Constant pain that gets worse when chewing

  • Pain radiates to the ear and temporal region

  • Soreness when opening the mouth

  • Swelling and tenderness in the submandibular lymph nodes

  • Sharp pain when pressing on the gum, purulent discharge is possible

  • Increased body temperature

In the future, the pain continues to intensify, the body temperature rises.The patient’s state of health is significantly deteriorating, and the development of posterior molar periostitis is possible.

How to avoid toothache?

In fact, everything is very simple.

The general condition of the teeth is affected by the general condition of the body and the lifestyle of a person. If a person leads a healthy lifestyle, eats a balanced diet, is attentive to oral hygiene, then he has much more chances of keeping his teeth in perfect order.