- Does your face ache?
- Does your jaw hurt?
- Do you have teeth that hurt, despite treatment and assurances that everything looks fine?
- Are you often fatigued and struggling with pain that sets you up for a tough day?
- Does your jaw click, pop, lock, or just not move well?
- Are you concerned about your child’s headaches or their excessive tooth grinding at night?
- Have you already pursued treatment and have become worse each step of the way?
- Along with jaw and facial pain, do you also have a history of neck pain, IBS, gastric reflux
- Have you been told that your child’s orthodontics will require the extraction of teeth (and this
gives you concern)?
If any of these questions pertain to you or someone you care about, I would like to share my over 35 years of experience and provide you with information that should not only make you feel more optimistic, but also direct you to treatment options that have assisted countless patients over the years.
If you are hurting and tired, here are a few essential things you should know:
There Are Two Types Of Pain
- Purposeful Pain:
Often called somatic pain, purposeful pain occurs as a result of tissue injury. For example, a burn from a hot stove leads to inflammation, blistering, and pain. As a result you purposely keep your hand off the stove and take the necessary steps to allow healing to occur. The same can be said for toothache pain due to decay. The pain prompts you to go to the dentist who, after identifying the decay during an exam or with x-rays, will perform the necessary treatment to clean out the decay and restore your tooth.Purposeful pain often occurs as a result of your jaw muscles or joints being overworked, injured, strained or sprained. This pain encourages you to rest your jaw and or get the necessary care – about which this site goes into great depth.Purposeful pain problems are typically addressed successfully when care is directed at the site of the pain.
- Non-Purposeful Pain:
Often called neuropathic pain, non-purposeful pain occurs as a result of a malfunction in the nervous system and does not require an injury, disease, infection, of organ irritation to occur. Neuropathic pain occurs when your brain (pain is not experienced until the brain says so) begins to interpret normal nerve signals as noxious and painful.In simple terms, imagine if your home alarm system goes off when the wind blows instead of when a door lock or a window is broken. In humans, the nerve systems designed to detect injury or irritation can lose this ability and will fire when no injury or irritation is present. This often leads to treatment that fails and patients who become increasingly frustrated and confused.
Non-purposeful pain problems can occur in the face, jaws, and teeth leading to persistent pain and suffering. At times, the treatment received actually makes the pain worse despite providers of care saying that everything “looks fine”. It is of great concern when this pain happens in teeth.
Treatment for non-purposeful pain is very different than the purposeful pain model of care. Treatment must be provided at the source of your pain, not at the site where you feel the pain.
After years of studying the characteristics of patients who pass through my office door, I’ve identified common risk factors that appear to play a significant role in the oral, facial, and jaw-related pain experience. Some of these factors may prompt pain onset, while others make it linger and or intensify.
Factors That Cause Pain or Make Pain Linger or Intensify
- Chronic neck pain and inflammation
- Poor fragmented sleep
- Gastrointestinal problems such as GERD, reflux and IBD
- Domestic PTSD
- A history of other unresponsive pain problems
- Ongoing and challenging life circumstances (stress)
- Medications that over-stimulate the nervous system
As a result of recognizing the impact of these factors, my practice focuses on finding out who you are (the whole you!) before we discuss treatment strategies. Only by knowing the whole you can true success be achieved.
The Intimate Relationship between Sleep and Pain
It’s easy for most people to understand how a pain condition can lead to a poor night’s sleep; particularly if the pain is in your back, neck, or jaw. On the other hand, most people do not appreciate the fact that a night of fragmented sleep or insufficient hours of sleep can lead to pain conditions. Research has shown, however, that an insufficient quantity or quality of sleep will lead to lower pain thresholds and the likelihood that treatment will not produce expected patterns of relief. With inadequate sleep, your body produces lower levels of endorphins (feel good chemicals) and many nerve pathways can malfunction.
Insomnia, which is the inability to get to sleep or stay asleep, afflicts millions of individuals in this world and is responsible for morning headaches, neck and back pains, and also a variety of jaw-related pain problems. There are many reasons why you may not sleep well including an insufficient airway that leads to snoring, obstructive sleep apnea and diminished blood oxygen levels. Your sleep history is a critical part of my evaluation process.
Clues that may suggest a sleep problem intertwined with pain symptoms in children and young people, in particular, include daytime sleepiness, gastrointestinal symptoms, and learning issues that may have been attributed to a diagnosis of ADD or ADHD.
I carefully look at each patient’s facial profile, jaw profile, and oral structures for clues that a sleep problem may be present.
Participation is Crucial
Getting better and resolving pain and sleep problems requires patient participation along with the treatment I provide. Over the last 35 years my practice has made great strides in not only improving our diagnostic abilities, but in communicating to patients their responsibility in the getting better process.
I see both purposeful and non-purposeful pain problems on a daily basis along with a host of sleep-related issues. You can be assured that the problems you may have are familiar, common to my practice and helpable.
I am here to validate your suffering, help you to understand why you have pain, and to the best of my ability and put in place treatments that have a track record of success. Success will likely require your participation and commitment to addressing what has caused your pain in the first place.
My goal is to give you the tools to fix or minimize your problem and its ability to disrupt your quality of life.
Dr. Donald R. Tanenbaum, DDS MPH