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Jaw pain might not be caused by teethDear Dr Reitz: I am a 60-year-old woman with constant pain in all the teeth of my upper left jaw. I have had multiple root canals and extractions by different dentists with no resolution. I now want a dentist to remove my remaining upper teeth because I believe they are my source of pain. My last two dentists could not find a problem with my teeth and are unwilling to do the extractions. My life is already stressful, and I don't need dental pain to make things worse. Where can I find a dentist who will remove my remaining teeth? Jane Dear Jane: An unresolved oral pain can be frustrating for both you and your dentist. However, searching for a dentist who will follow through with your treatment request is not appropriate. Pain in and around the mouth is usually caused by infection or inflammation; infection from decay or gum disease and inflammation in the joint, nerve or muscles of the face. The fact that multiple dentists have not identified the source of the pain indicates a tooth may not be the cause. If the cause of the pain is a tooth, your previous treatment of multiple root canals and extractions should have solved the problem. That's why you're fortunate that a dentist was not willing to go along with your request and needlessly extract the remaining teeth. Before a dental procedure is performed it's important that the dentist identifies the problem by making a diagnosis. If the diagnosis does not warrant extractions, a dentist is not legally obligated to comply with your request. It's been found that 25 to 30 percent of patients seeking relief from dental pain actually suffer from neuropathic pain, or pain originating from nerves. One such pain is called trigeminal neuralgia, which is pain in the face that travels along the branches of the nerve. Diagnosis can be difficult, because the true pain of dental origin and neuropathic pain can feel very similar and be difficult for a dentist or physician to distinguish. If a physical reason cannot be found for the pain, it may be possible the pain does not have an organic origin. If you have been experiencing considerable stress in your life, it's possible that although the pain feels real there is actually nothing physically wrong. Before preceding with any additional extractions it would be advisable to have your dentist work together with your physician to identify the source of your pain. The column is written by John Reitz, DDS, and does not represent the opinion of the Pennsylvania State Dental Board. Dr Reitz answers questions from readers. E-mail them via his Web site at reitzdds.com or mail to John Reitz, DDS, 30 Commerce Drive, Wyomissing PA 19610 John
V. Reitz, D.D.S., F.A.G.D. Copyright
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