Medical Matters > Dental: Pain

ME Essential Summer 2021

Question

I’m very prone to pain in my teeth. When I mentioned this to my OT she said that she hadn’t heard of that before as an ME symptom but could be connected to the central nervous system. My dentist tends to say that if there was a problem it would be obvious in a particular tooth or it could be tooth grinding especially at night. I don’t feel it is this as I tend to sleep with my mouth open and I don’t wake up with pain usually but it will come on during the day. Symptoms are varied ranging from a general tension and pressure, generalised aching pain in either the top or bottom teeth, or throbbing pain in certain teeth. The deep throbbing does tend to be in “ vulnerable “ teeth ie ones with deep fillings. Sometimes I will get a very bad pain eg back molar on right lower side then the exact same tooth throbs on the other side. Of course I realise I need to discuss this again with my dentist at the next check up. However, I wondered if people with ME are more susceptible to tooth pain generally? Have even wondered if it’s stress? It’s been particularly bad these last few months and I can’t say I’ve been any more stressed than usual!

Answer

Dr Richard Cantillon (Hon. Dental Adviser, ME Association):

Dental pain can be extremely unpleasant and it is important to realise that even as an ME/CFS sufferer, it is possible to have plain old toothache. The difficulty is that, even after 40 years practicing clinical dentistry, it can be very difficult sometimes to get the correct diagnosis and hence the right treatment.

As you will be aware head and neck pain can also be a feature of ME/CFS for many people, so it’s very easy to dismiss pain as being ME/CFS-related. I think the bottom line for me is to work with your medical advisers, dentist included, until someone is happy with a diagnosis before you undertake any irreversible treatment, like for example having a tooth out or a root canal treatment especially during the Covid pandemic.

Very briefly, dental-related pain is usually triggered by having something in your mouth. Chewing on something or hot or cold food or drink can set it off. Sinus-related pain is usually exacerbated by postural changes like for example bending down or pressure over the sinus. Jaw-joint pain also needs to be considered and is checked for by feeling the joints and checking the chewing muscles for tenderness and having a look at your jaw opening. Unfortunately, it’s often not that simple. There are lots of more rare causes of head and neck pain that need to be eliminated as well. So persist until it’s been sorted out for you.

In the meantime, from the dentist's perspective, find an analgesic you can use, usually ibuprofen or paracetamol for dental pain. Hot salt-water mouth-washing can help a lot of the time as well – even though it sounds old-fashioned, it works. That’s a beaker of hot water with a teaspoon of salt washed around your teeth a few times a day and spat out. Keep to a soft diet and don’t open your mouth wide e.g., yawning, shouting, big food. If you get any swellings or develop a temperature or feel unwell get emergency treatment/advice. Avoid things that aggravate the pain.

More information

  • The ME Association has more information about Dental Care in ME/CFS by Dr Cantillon, which can be downloaded from the website shop.

MEDICAL DISCLAIMER

Medical Matters is for information purposes only. The answers provided by Dr Shepherd and the ME Association’s other expert advisers should not be construed as medical advice. We recommend that any information you deem relevant is discussed with your GP as soon as possible. It is important to obtain advice from a GP who is in charge of your clinical care, who knows you well, and who can consider other likely causes for symptoms. Seek personalised medical advice whenever a new symptom arises, or an existing symptom worsens. Don't assume that new or worsened symptoms are a result of having ME/CFS.

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