The most common causes of pain in the face and jaw area are tooth decay or infections. The pains are distributed in the related tooth region, in the surrounding tissues of the tooth and in the jaws. Tooth and facial pain that is not caused by teeth may spread to the jaws, face, head and neck areas in the tooth groups. Pain that is not caused by the teeth and is felt in these areas can be a sign of important diseases.
In cases of pain in the teeth and related surrounding tissues, jawbones, and face, clinical and radiological examination should be performed first, and it should be investigated whether there is any pathology in these areas. If there is no pathology in the areas of the tooth and surrounding tissues where pain is felt, other causes that may cause pain should be investigated.
Situations that need to be reviewed include jaw joint and toothache, which may develop due to clenching, very severe trigeminal neuralgia pain in the nerves of the teeth, jawbone and face, and constant pain that can be related to sinus diseases and can be felt in the teeth close to this area. Toothache and sensitivities may also occur in viral diseases such as influenza infections and COVID-19. One of the points to be considered while making the differential diagnosis is the characteristics of the pain; It should be evaluated which condition triggers the pain, which regions it progresses to, whether it is sharp, widespread, continuous or intermittent.
The most severe of these pains is called trigeminal neuralgia. Very severe, lightninglike pain in the distribution areas of the nerves that provide sensation to the teeth, surrounding tissues, jaw bones and facial region is initially short-lived, and the incidence is low. In the following days, they become longer and frequently repeated pains during the day.
The characteristic of trigeminal neuralgia pain is that it can start suddenly without any stimulus or by touching any point. Stimuli such as washing the face and shaving can trigger pain; It can make the patient unable to do their daily work. The patient insists that the source of the unbearable facial pain is a tooth.
In the case of trigeminal neuralgia, it should be investigated whether there is a pathology related to the mouth and surrounding tissues, and whether there are intracranial pathologies. It is possible that there may be a pathology in the areas related to this nerve, as well as the possibility of a tumor in the brain.
Although the most important cause of pain in the facial area, which has a complex structure and is nourished and stimulated by different nerve and vascular packages, is the pathologies in the teeth and surrounding tissues, other possible pathologies should always be investigated.
Checks of teeth, mouth and surrounding tissues should be done every 6 months and it should be kept in mind that not all pains are caused by teeth, but there may be another reason.
Prof.Dr.Hülya Koçak Berberoğlu
University of Istanbul
Department of Oral and Maxillofacial Surgery
ISTANBUL
