When a Painful Toothache Won't Go Away

You've been to the dentist, perhaps even had a filling or root canal, but your painful toothache still persists. What do you do next? Sometimes the pain isn't coming from a tooth! Did you know tooth pain, jaw pain, and even ear pain can be coming from somewhere else?

You may ask how this that possible? To have a toothache that is not caused by a tooth? To begin to understand how you can experience pain in one area that is being caused by a problem somewhere else, it is important to become familiar with the concept of referred pain. The concept of referred pain has been around for over 50 years. It is used to describe the phenomenon of pain experienced at a site nearby or even at a distance from the pain's origin.

Referred pain is best understood when you consider the most common symptom reported by patients that are about to have or are in the midst of having a heart attack: pain in the left arm, the left side of the jaw, and under the chin. All caused by signals being sent by the heart muscle. You can only imagine that 100 years ago, before this connection was understood, doctors and community healers probably went to great lengths to sooth these left sided symptoms only to often fail with dire consequences.

Recent research has suggested that for no specific reason the nerves that send pain information to the brain from teeth, can become "sensitized". Example: you leave the beach with a sunburn and putting your shirt on (a normal activity) produces pain. What happened is that the threshold for the nerves in your skin to fire has diminished due to the heat from the sun.

The knowledge we have gained about referred pain through medical research not only has helped us recognize the signs of a heart attack, but have enabled us to also understand puzzling toothaches, face pains, ear symptoms, and other problems that often elude quick solutions. Getting back to the young woman with toothache: my evaluation uncovered that her symptoms were due to referred pain from the muscles of her upper neck! My patient was dumbfounded. How could the source of her painful toothache be her neck? But soon after her care began, her symptoms diminished and she is now happily toothache-free. The care I applied was a combination of:

• Changing learned behaviors (posture, especially)
• Home exercises
• Physiotherapy
• Injections

Patients often ask: "Why does my ear, tooth, face, and eye hurt when I have been told by my physician and dentist that there is nothing wrong and they don't see anything?" If this describes you, I assure you, you're not "crazy." Referred pain is real, and you should see a TMJ specialist in your area.