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Question:
For nearly a year, I have experienced a great deal of pain on the right side of my face. This pain includes my gums, head, jaw, eye, and ear. There are times it hurts so severely that I can hardly bear it, yet other times the pain goes away entirely.
Every time the toothache/gum pain is prevelant, the headaches are nearly unbearable. For several days,I've been experiencing flashes of light before my right eye, nausea, and dizziness. I have sharp pains in my upper and lower gums on the right side. For about two weeks, my skin is literally peeling inside my mouth.
I went to a dentist in December and x-rays were done. No indication of an abcess was noted. I take excellent care of my teeth and gums. The tooth in question (#30.28) was capped many years ago and has had swelling and darkening of the skin around the gum line since it was first capped. ...Visitor from FL
Answer:
Pain can be very complicated to diagnose. Often there may be more than one thing which is causing pain and can refer the pain to other parts of the body than where the stimulus is. The description of the intense pain being only on one side following flashes of light is very classic for migrine type headaches. Does laying down in a dark room help and do you feel nausea?
The pain can also be coming from muscles which control the movement of the jaw. They could be guarding the painful tooth, or getting tired from a grinding habit. The habit could be putting pressure on the teeth and making them painful.
The teeth that have had the crowns may have died and have not created enough of a change in the supporting bone to show up in an x-ray (there needs to be a change of at least 70% in the mineral content of the bone before anything will show up in an x-ray). This is why cavities are always
bigger in the mouth than on the x-ray film.
The darkening of the gums may be due to a few reasons. There could have been metal from an old filling which leaked out into the gum tissue or the crown may have a metal margin which is showing through the thin gum tissue.
The swelling may be a problem, however is more likely due to the crown pushing the gums out (flaring) by description of it being there since the crown was placed and have many years without symptoms.
The tissue peeling away, gives rise to a number of different scenarios. There could be a fungus infection, trauma from cheek biting, a connective tissue disorder (pemphigiod or pemphigus) although this would tend to be throughout the whole mouth and not usually limited to one side, or
there could be vessicles which are ulcerating caused by a virus such as herpes Zoster (chicken pox, or shingles in adults).
This last reason may also explain the pain which is felt on the right side only.The virus lives
inside the nerve track and will reproduce when the body gets tired,(when it has the oppurtunity) The virus then sheds through the skin and is released to the outside world to infect another person.
The mouth should heal itself in 7-14 days. If it does not, a trip to an oral medicine dentist would be advised. Also a trip to a general medical doctor and/or a neurologist is advised to seek out the cause of the headaches.
Editorial Staff
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