Non-dental Toothaches 

by 

Dr. Kumudu Wijesinghe Suriya

    
The causes of toothache can be dental and non-dental.  The majority of cases fall into dental origin.  For this reason, my previous article on Sensitive to Teeth Sensitivity focused first on toothaches of dental origin.  

This article conceptualizes on some reasons related to toothaches of non-dental origin.   When a patient believes that a toothache is originating from a tooth, the expectation is to treat that tooth.  If a dentist finds a problem in the tooth that a patient is isolating, the treatment of the tooth is often the solution.  When the toothache is present even after a procedure, it may not be a result of an unsuccessful treatment.  It is possible that in addition to a dental problem in the isolated tooth, the patient has unresolved toothaches of non-dental origin.  It is in this sense that looking only for problems in teeth can make diagnosis as well as treatment of teeth problematic.  It is also important to investigate on causes of non-dental origin that can contribute to toothaches.

Here are some non-dental causes of toothaches.

Strain on jaw muscles can refer pain to teeth.

Migraines and cluster headaches 

Headaches that result from changes to nerves and blood vessels in our heads may feel as toothaches.

When heart problems refer pain to shoulder, arm and jaw, it is also possible to spillover pain to teeth.  

Problems in maxillary sinus 

Pain to upper teeth may be a pressure build up in maxillary sinus.  Usually this type of pain is felt in several teeth as well as pressure below eyes.

Salivary gland dysfunction In absence of protective saliva, the health of teeth and supporting structures will be compromised.  In addition, when salivary glands are dysfunctional, referred pain can occur in teeth.

Trigeminal neuralgia Trigeminal nerve provides sensations to face and teeth.  Trigeminal neuralgia is a nervous disorder that affects trigeminal nerve, causing intense pain in areas of face and sometimes mimicking a toothache. 

With advances in medicine and technology, there are new solutions to toothaches.  However, while elimination of pain is possible for some of these situations, other times it is only possible to manage pain.

In attempting to identify causes behind these toothaches, other health issues may be uncovered.  General dentists may need to refer patients to specialists or work in consultations with specialists when dealing with patients who have toothaches of non-dental origin.  When you visit a dentist, try to have an open dialogue without limiting to teeth.

Dr. Kumudu Wijesinghe Suriya, BDS (Peradeniya), DMD (UBC), is a dentist who practices in New Westminster & Surrey.  She is a Clinical Instructor at the University of British Columbia and was a Lecturer at the University of Peradeniya.

Sri Lanka Times (BC, Canada), February 2013