Pain in the lip is observed with various types of cheilitis, herpes, traumatic injuries, atypical form of lichen planus of the oral cavity, trigeminal neuralgia, lip cancer. In the absence of significant skin defects, it is often burning, often combined with itching, with the appearance of cracks - sore, with neurological pathology - extremely intense, shooting. The cause is established on the basis of examination data, instrumental and laboratory methods. Treatment includes anti-inflammatory, anti-allergic, antipruritic local agents, immunomodulators, regeneration stimulants, other drugs of general action, physiotherapy techniques. Surgery is sometimes recommended.
Cheilitis is an extensive group of inflammatory diseases of the mucous membranes and skin of the lips. Occur primarily or develop against the background of other pathologies. Typical signs are pain and burning in the lips when eating, opening the mouth, peeling, hyperemia, the appearance of cracks, crusts, bleeding ulcers. The symptom can be provoked by the following types of cheilitis:
The red border of the lips and the corners of the mouth are the favorite localizations of herpes simplex. The patient feels burning, tingling, bursting. In the affected area, rashes are formed, which are an accumulation of small bubbles. As the changes progress, unpleasant symptoms increase, pain syndrome joins them. Then the bubbles are opened individually or previously merged into one or more multi-chamber bubbles. In their place, irregularly shaped erosions appear, painful to the touch, movements of the lips.
Involvement of the lip (predominantly the upper lip) is characteristic of a rare atypical form of the disease. On the skin and mucous membranes, papules, plaques or ulcers, erosive defects of irregular configuration, covered with a fibrinous coating, are found. The pain syndrome is most pronounced in the presence of ulcers, accompanied by burning. Several forms of lichen planus often combine with each other or transform into one another, so lesions can be present not only on the lips, but also on the gums, tongue, and oral mucosa.
Lip pain
Acute damage to the mucous or skin of the lips occurs as a result of injury by foreign objects, biting. It occurs quite rarely. It is manifested by the formation of a hematoma or an erosive defect. The pain persists for 1-3 days. With secondary infection, erosion transforms into an ulcer, the surrounding tissues swell, and the pain increases.
Chronic trauma is possible when the sharp edges of the anterior carious teeth are damaged. It proceeds with swelling, slight soreness, a feeling of discomfort. With prolonged injury, an ulcer forms. Perhaps the development of a local or widespread inflammatory process with increased pain, swelling, the appearance of purulent discharge.
Lip bruises, as a rule, become the result of fights. Children often develop as a result of falls. They are characterized by rapidly increasing edema, may be accompanied by abrasions of the mucous membrane due to sharp contact with the teeth. Pain sensations are pronounced in the first minutes after the injury, and then gradually subside. Recovery occurs after 1-2 weeks. Wounds of the lips are often torn, manifested by acute sore pain, bleeding.
Multiple shooting intense pain impulses, resembling an electric shock, are noted when the 2nd branch of the trigeminal nerve is involved. The pain extends to the upper lip, upper cheek, upper jaw. With the defeat of the 3rd branch, similar sensations occur in the area of the lower lip, chin, lower jaw, lower cheek. The duration of an attack of neuralgia ranges from a few seconds to 2 minutes.
At the initial stage of lip cancer, there is no symptom. A painless, sometimes itchy sore or area of induration forms on the lip (often the lower one). The pain appears with the germination of nearby tissues. Becomes constant, progresses, reaches considerable intensity. On examination, an ulcer with uneven edges or a node in the form of a wart or cauliflower inflorescence, covered with cracks and sores, is revealed.
The cause of the symptom is determined by a dentist or maxillofacial surgeon. If the pain is neuropathic, a consultation with a neurologist is required, if malignant neoplasia is suspected, an examination by an oncologist is required. With cheilitis, herpes simplex and traumatic injuries, the basis of diagnosis is complaints and examination data, additional studies are not prescribed or are carried out in a minimal amount. Neuralgia is confirmed on the basis of the clinical picture, the results of palpation of trigger points. Taking into account the nature of the disease, the examination plan includes:
Visual inspection of the lips
The list of therapeutic measures is determined taking into account the characteristics of the pathology that causes pain in the lip:
Operative techniques for pain in the lip are used infrequently. Exceptions are open injuries, oncological diseases. With fresh wounds, PST of the wound of the maxillofacial region is necessary. Neoplasms are excised, according to the indications, the Vanach operation, the Krail operation, and other interventions involving the removal of regional lymph nodes are performed. Patients with damage to the branches of the trigeminal nerve with persistent neuralgia can be recommended methods of stereotactic radiosurgery, percutaneous radiofrequency destruction.