Why Dental Care is Important for People with Chronic Pain

No one is looking to add to your discomfort, but maintaining dental hygiene now can save more pain down the line.

Spinal pain can affect just about every part of the body, including the face, head and neck areas. Not surprisingly, this can make scheduling a dentist visit about as appealing as a root canal.

toothbruses in a glassBut because serious dental issues are common in people using medications for acute and chronic back pain, regular trips to the dentist are necessary to catch problems before they become more serious.

The pain medications can often be the root of the cause of some dental decay issues as well.
People with myofascial pain syndrome (MPS) require the highest levels of specialized dental care due to the highly sensitive nature of their conditions.
I sought out the advice of a local dentist who specializes in treating patients with chronic pain conditions and asked him for advice:
Why do I need to go to the Dentist? I am already in pain.
Regular dental 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 in locating a dentist who treats patients with existing pain issues, particularly in the upper body, and understands your special needs. Once you’ve found one, ask about specific tools to help minimize and control pain, dental or otherwise, before, during and after treatment.
I also recommend a call to your primary or pain managerment physician to ask if he or she has any specific treatment protocol your dentist needs to know.
Dry Mouth
One of the unfortunate byproducts of chronic pain management is the common use of medications. These medications often 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.

Peridontal 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 the diseased teeth to be extracted.
Extractions and Tooth Loss
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 tooth.
Certain medications have been known to contribute to tooth decay:
  • Tricyclic antidepressants
  • Non-steroidal anti-inflammatory drugs
  • Aspirin
  • Methadone
The Best Defense is a Strong 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.