Mouth pain occurs with most dental diseases. It can be associated with infectious and inflammatory processes, advanced caries and its complications, allergies, neuralgia, TMJ pathology, oral injuries, and neoplasms. Painful sensations can be localized in the area of the lips, tongue, gums, jaws, palate, oropharynx. To differentiate the causes of pain in the mouth, a visual-instrumental, x-ray, ultrasound, and laboratory examination is required. Treatment consists in prescribing pharmacotherapy, physiotherapy, performing dental manipulations and operations.
Why does it hurt in the mouth
Mouth pain can be caused by both local and systemic factors. Painful sensations in the oral cavity usually do not disturb in isolation. As a rule, they are combined with other symptoms characteristic of a certain pathology: hyperemia and swelling of the mucosa, rashes and ulcers in the oral cavity, plaque, unpleasant odor, difficulty chewing and opening the mouth, salivation. Pain in the mouth, despite its local nature, disrupts the general well-being and performance, prevents normal diction, a full meal.
Lip pain
Has a local or spilled character. It can be caused by traumatic, infectious, chemical, physical factors, tumor lesions. The pain is usually combined with dry lips, cracks, redness, blisters, ulceration, and drying of the crusts. Common causes of lip pain:
- Cheilite. May be the result of sensitization (allergic cheilitis), neurogenic causes (exfoliative, macrocheilitis), adverse climatic factors (meteorological cheilitis), vitamin deficiency (hypovitaminous cheilitis), infection (glandular cheilitis). Common signs are the defeat of the red border, accompanied by dryness, painful cracks and ulcers, swelling, burning, itching.
- labial herpes. In the prodromal period, there is local tingling, tingling, itching in the area of the upper or lower lip. Then a vial containing liquid appears. After a spontaneous or violent opening of the vesicle, an ulcer forms in its place, which, drying up, becomes covered with a scab. When the crust cracks, ichor oozes out from under it. Elements of herpes are sharply painful at all stages. From the prodrome to complete epithelialization takes 10-12 days.
- Lichen planus. May affect the red border of the lips, tongue, oral mucosa. The main elements are papules, which, when merged, form whitish areas of keratinization. Sometimes LP occurs with the formation of weeping areas, erosions, blisters - in these cases, a burning sensation, severe pain in the mouth, which makes it impossible to eat, is added.
- Trigeminal neuralgia. Trigeminal neuralgia is a common cause of facial pain. With damage to the maxillary and mandibular branches of the trigeminal nerve, sharp intense shootings can occur in the cheek, upper or lower lip, jaw, resembling electric shocks.
- Injuries. Lip burns can be caused by drinking hot drinks, exposure to harsh chemicals, exposure to sunlight or open flames. With mild burns, pain, swelling of the lips, hyperemia appear; in severe cases, blisters, scabs, tissue necrosis are formed. Mechanical damage (cuts, biting) of the lips is accompanied by soreness, bleeding.
- Lip cancer. Outwardly, it can be a warty or papillomatous growth, infiltrate. Initially, the elements do not cause discomfort, but their ulceration, infection, decay are accompanied by severe pain in the mouth.
Transient swelling and soreness of the lips are noted after a number of cosmetic procedures and surgical interventions: permanent makeup, piercing, the introduction of hyaluronic fillers, cheiloplasty.
Pain in the mouth
Pain in the gums
As a rule, it is associated with diseases of the oral cavity or behavioral factors (wrong selection of a toothbrush, use of toothpicks, smoking). Pathologies that cause pain in the gums:
- inflammatory processes. Pain in the mouth is a pathognomonic sign of inflammatory diseases: gingivitis, stomatitis, periodontitis. With gingivitis, the gums become swollen, painful, and bleeding. Stomatitis can occur with the formation of plaque in the mouth, extremely painful aphthae and ulcers. With periodontitis, pain in the gums is aggravated by bad breath, the formation of periodontal pockets, suppuration, and loosening of the teeth.
- Periodontitis. In acute periodontitis or exacerbation of a chronic process, a painful swelling of the gums occurs in the area of the affected tooth. When the pyogenic flora is activated, a flux is formed, accompanied by throbbing pain. When it is opened, a fistula may form. Severe pain occurs during chewing and talking.
- Injuries. Damage to the gums can occur both with direct mechanical action, and with difficult teething. In the latter case, pericoronitis develops. Injury to the gum tissues and pain are also accompanied by dental procedures: tooth extraction, installation of a dental crown / prosthesis, dental implantation, operations (gingivotomy, gingivoplasty, etc.).
- Allergy. It may be due to a reaction to denture materials, medications, local anesthetics. It proceeds in the form of allergic stomatitis, cheilitis, glossitis. Hyperemia, burning, swelling of the mucosa, hypersalivation, pain when eating are characteristic.
Pain in the tongue
Pain in the tongue is associated with local infectious-inflammatory, traumatic, allergic, neurogenic, neoplastic processes. In addition to local factors, pain in the mouth can be provoked by systemic diseases: hypovitaminosis B1, B2, B12, pellagra, iron deficiency anemia, collagenosis, leukemia, etc. Local causes of pain in the tongue:
- Glossitis. Pain of varying intensity is noted in desquamative, candidal, herpetic, allergic, traumatic and other glossitis. There may also be swelling, glossodynia, raids, changes in taste sensitivity.
- Xerostomia. It is a consequence of radiotherapy, chemotherapy, medication, smoking, Sjogren's disease, diseases of the salivary glands. Dry mouth makes it difficult and painful to eat, swallow, and speak.
- Glossalgia. It proceeds with bouts of burning pain in the tongue, which are more pronounced in its tip and lateral surfaces. Hyperemia or pallor of the tongue is noted. Recurring pain attacks change the psychological state of patients - they become irritable, suspicious, whiny.
- Galvanism. It develops as a result of irrational prosthetics. It is characterized by swelling and hyperemia of the tongue, sensations of pain, burning, soreness, metallic taste in the mouth.
- neuropathy. Pain in the tongue of neurogenic origin occurs with neuralgia of the glossopharyngeal and hypoglossal nerves. In the first case, the pain is localized in the region of the root of the tongue, in the second - in the back of the tongue. More often it has a unilateral character, occurs paroxysmal, provoked by talking, coughing, swallowing. Has an intense pulsating, boring, burning character.
- Tongue cancer. Manifests with the appearance of painless or slightly painful formations: outgrowths, sores, seals. In the expanded stage, local or diffuse pain radiates to the jaw, ear, and temporal region. Salivation increases, fetid breath appears, spontaneous bleeding from the tongue, articulation and swallowing difficulties.
Dental diagnostics
Diagnostics
To determine the etiology and therapeutic tactics for pain in the mouth, a comprehensive dental examination is performed, if necessary, an examination of the ENT organs. A number of specialists are involved in diagnosing the causes of pain in the mouth: a dentist-therapist, a periodontist, an otolaryngologist, an allergist-immunologist, a neurologist, an oncologist, etc. Taking into account nosology, the list of recommended studies includes:
- x-ray diagnostics (OPTG, CT of the jaws, sialography);
- dental examination (visual and instrumental examination, determination of the periodontal index);
- ENT diagnostics (pharyngoscopy);
- sonography (ultrasound of the salivary glands, tongue);
- allergic examination (allergic tests, the study of individual allergens);
- laboratory studies (analysis of the biocenosis of the oral cavity using bacterial culture, PCR).
Treatment
Diseases accompanied by pain in the mouth require general and local therapy. In some cases, there is a need for surgical intervention. In the treatment are used:
- Systemic therapy : antibacterial, antiviral, antimycotic, antihistamines, NSAIDs, vitamins.
- Local procedures: rinsing the mouth with antiseptics, lubricating the mucous membrane with medicinal formulations, drug treatment and curettage of periodontal pockets, therapeutic dressings.
- Physiotherapy: drug electrophoresis, darsonvalization, laser gum treatment, Vector apparatus.
- Dental treatment: complex therapy of stomatitis, periodontitis, treatment of complicated caries, extraction of decayed teeth, reprosthetics of teeth in case of intolerance to orthopedic structures.
- Dental operations: laxative incision and periostectomy for periostitis; flap surgery for periodontitis; lip resection, hemiglosectomy and glossectomy for cancer.