Your Toothache Could Be Something Else: Referred Pain in Dentistry

Dr. Kavita Tarale    1754

Referred pain is a fairly common dental concern presented at a dental office. Referred pain is pain perceived in a part of body which is far from the source of pain. In other words, it’s the pain felt in an area other than its true site of origin.

A classic example to explain this condition is the dental-related pain during a heart attack. One of the early signs of heart attack is pain referred to the left side of the teeth, jaws and arms. Similarly, there are other instances like the pain from infected paranasal sinuses being referred to the upper back teeth which is perceived as a toothache.

Chronic musculoskeletal pain, TMJ disorders (temporomandibular joint) or chronic back pain are also referred to the jaws and other parts of the face. Atypical facial pain/neurological pain/trigeminal neuralgia are also perceived as toothache. Shingles, a viral infection, in its early phase is felt as a sharp pain on the affected side of the jaws and or teeth. These are just a few common examples.

The need for accurate and careful dental screening

There are many reported cases in dental literature where unnecessary dental treatments like extractions have been carried out with an intention to help the patient get relief from the pain. Such hasty decisions will only add physical and mental distress to the patient.

Hence, in such cases it’s very crucial to do a thorough dental screening which includes careful listening to the patient’s chief complaint, understanding the patient’s past and present dental history, doing detailed clinical and radiographic examination along with a chairside clinical test. An appropriate way to approach would be to first treat the most obvious dental issues if they are present.

If there are no obvious pre-existing dental issues, then further referral to a medical specialist should be considered before proceeding with any dental procedures. So, if your dentist advises you to see a medical specialist for further evaluation, do not be surprised as it could be a referred pain. It is very important to arrive at an accurate diagnosis before carrying out any procedures.

In a nutshell, referred dental pain could be one of the early signs and symptoms of an ailment present elsewhere in the body and your dentist can help and guide you with further appropriate referrals and treatment.

Dr. Kavita Tarale
BDS, MDS, Specialist Endodontist
Umm Suqeim Clinic, Dubai