December 30, 2019

Dental care and treatment can be stressful to people living with chronic pain.

More than 75 percent of the chronic pain patients we have treated also suffer from chronic dental issues.

People with myofascial pain syndrome (MPS) require the highest levels of specialized dental care due to the highly sensitive nature of their conditions.

Certainly, no one is looking to add to your pain.  But maintaining dental hygiene now, even with some discomfort, can offset the possibility of far more pain down the line, should tooth decay set in.

I sought out the advice of a local dentist who specializes in treating patients with chronic pain and asked him for advice:

Won’t dental visits cause me more pain?

Regular dental check-up and cleaning visits are the same as the need for a general overall check-up with your primary care doctor every year; if you don’t do it, any potential issues will have ample time to grow and become more serious (and more complicated to treat) after the issue is finally diagnosed.

Do the due diligence beforehand; seek out a dentist who treats patients with chronic nerve pain and understands your special issues.

Once you’ve found one, ask about specific tools to help minimize and control pain, dental or otherwise, before, during and after treatment.

If your search is unsuccessful, let the person scheduling your appointment know you suffer from chronic nerve pain in advance and remind the staff to chart this important fact again when you arrive.

When the dentist or dental hygienist arrives to begin your treatment, first have a conversation about your neuropathy and ask what special considerations they will make for you.

Be sure that you mutually understand a predetermined signal that you are uncomfortable or in pain.

Medication damage to teeth and gums

One of the unfortunate byproducts of chronic pain management is the common use of medications.

These medications commonly contribute to dry mouth, and without adequate saliva, tooth decay and gum disease are more likely to flourish.

This dry mouth condition is called xerostomia and it has major dental consequences such as:

  • Interference with normal swallowing patterns
  • Taste alterations (dysgeusia)
  • Interference with speech
  • Inability to maintain oral tissue integrity
  • Mucositis (chronic mouth irritation and inflammation)
  • Dental decay
  • Erosion

To combat this condition, keep hydrated by sipping water throughout the day, chew sugarless gum or suck on sugarless hard candy.

You may also wish to use a moisturizing mouth spray, which your dentist can provide.

Oral Health: The Mouth-Body Connection (Web MD)

Periodontal Disease

Over time, gums pull away from the teeth and form pockets that often become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.

Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place.

If not treated, the bones, gums and tissue that supports the teeth are destroyed, requiring extraction of the diseased teeth.

Extractions

Understandably, people with chronic pain avoid potential pain triggers, including dental visits.

So when tooth or gum pain or sensitivity presents, it is often in the latter stages of decay when the tooth cannot be salvaged.

The unfortunate result is the need to remove the diseased tooth.

The best defense is a good offense

In the comfort of your home, brush teeth a minimum of twice daily and floss. (Yes, we know it’s gross, but isn’t it better to get that stuff out of your mouth and into the garbage?)

Give your tongue a good brushing as well to remove bacteria that leads to plaque and chronic bad breath.

Twice-yearly tooth cleanings and exams are necessary to prevent and offset any issues before they become more serious and requiring more invasive treatment.

Talk with your treating physician before your visit to determine any special protocol or medication requirements needed.

Be sure that your doctor and dentist are in touch to fully understand the nature of your care needs.

After your cleaning or dental treatment, allow extra time to rest and recover.

Eat soft food for a few days and avoid foods (meats, popcorn, hard candy) that can potentially become lodged in those clean and disease-free pearly whites!

Prevention of dental disease may very well pay off in good overall health, allowing your immune system to perform at its optimal level.

While, admittedly, it’s not pleasant, it is nonetheless well worth the effort in the long run.


Dr. Michael Cooney is one of 7 certified providers of Calmare scrambler therapy in the U.S. He specializes in treating patients battling severe neuropathy as a result of fibromyalgia, CRPS / RSD, diabetes, shingles, post-surgical pain and pain after chemotherapy. To learn more, call 201-933-4440.