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/CFS 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 i.e. ones with deep fillings.

Sometimes I will get a very bad pain e.g. 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/CFS 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

“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.”

Dr Richard Cantillon, Hon. Dental Adviser, ME Association.

See also: Dental: White or Amalgam Fillings
Medical Matters: Jaw Pain

More information

• Dental Care – Your Questions Answered
  We help address common questions about maintaining dental hygiene while ill with ME/CFS. We also consider how to best manage mouth ulcers, anaesthetic sensitivity, and the role of antibiotics in dental practice. This leaflet is available to download from the website shop.