Dr. Mahantesh

An unpleasant experience which not only disturbs the usual routine of a person but also the psychological peace and causes extreme discomfort is called pain. When this pain involves the region above the neck, below the orbitomeatal line and in front of the ear is called as orofacial pain.

Multiple causes for orofacial pain may exist and the symptoms may include such diverse findings as headaches, neck pain, ear pain, dental pain, facial burning or stabbing sensations, and jaw joint pain.

The complaints may either develop gradually or have a rapid onset and can originate from musculoskeletal, neurovascular or neuropathic causes.

Sources of orofacial pain may include:

1. Trigeminal Neuropathy – ant damage or degeneration to the trigeminal nerves that supplies mainly to the facial structures causes the orofacial pain. This is commonly referred as trigeminal neuralgia.

2. Neurovascular Disorder – migraine is the most common neurovascular disorder that causes the radiating pain to the mouth eyes and other facial muscles.

3. Temporomandibular Disorder – the major cause of orofacial pain is the temporo mandibular joint disorder which causes pain in the lower jaws. Orofacial pain may also be caused by any temporo mandibular joint surgeries and due to failure of joint replacement surgery of the jaw.

4. Burning Mouth Syndrome – this condition is caused due to nerve damage, lack of adequate saliva production, fungal infection, certain medications and also noted for patients with diabetes. Orofacial pain is also noted in burning mouth syndrome.

5. Cervicalgia – pain due to spinal cord injury, damage to spinal nerve, muscle and ligaments may radiate to face and cause orofacial pain.

6. Trauma – accident is the most common cause of temporomandibular disorder and other spinal disorder that causes orofacial pain.

7. Sleep disorders – sleep disorders include grinding or clenching of the teeth during sleep may also cause orofacial pain.

Symptoms –

Though orofacial pain is caused by several factors, its symptoms includes dental pain, ear pain, neck pain, headache, pain in the jaw joint and stabbing sensation over the face. Some patients may also experience burning sensation over the face. Other symptoms include dizziness, insomnia, tinnitus (abnormal ringing or roaring sound in ears), poor muscle coordination, abnormal itching over the face and neck and tingling sensation. If you wish to discuss about any specific problem, you can consult a Dentist.

The treatment will depend on how severely the tooth was damaged.
Breaks can range from small chips to major fractures, so you might need a major procedure, a minor adjustment or no treatment at all. 
A tooth has three layers: the enamel is the hard outer shell, the dentin is found under the enamel, and the pulp, which is the nerve centre, is at the core.
Minor chips are common, and involve loss of some enamel. Usually, little or no pain is felt, 
But if enough tooth enamel is lost the dentin may be exposed which might cause sensitivity to cold.
The most severe breaks expose the pulp, which can cause extreme pain and even bleeding.
If you have a small chip in your tooth, make a routine dental appointment, and try an over the counter pain medicine for sensitivity as long as it is safe for you to take it. 
More serious fractures should be evaluated immediately. Rinse your mouth out with warm water, cover the break with a piece of clean gauze to protect it, and see the dentist as soon as possible. Apply an ice pack to minimize swelling if your mouth or lips were injured, and avoid using aspirin for pain because as it increases the risk of heavy bleeding.

Even if your tooth is only slightly chipped, the dentist is probably going to take an x-ray of the damaged tooth and recommend being gentle with it for a few days.
 A minor chip can often be smoothed out or repaired with white filling material, often without anesthetic. 
Even when a break is severe, a tooth can almost always be saved with a permanent crown if the pulp is not damaged. 
Postponing a crown or replaced filling that has been recommended can place the tooth at risk for a much more serious fracture- perhaps one that cannot be repaired. On those occasions when a tooth must be removed after a fracture, there are several options available for replacing the missing tooth – an implant is often the ideal choice for many people because it provides a permanent solution with a natural appearance.