Severe Gum Pain During Orthodontic Treatment: Causes and Solutions

Q: Severe Gum Pain During Orthodontic Treatment: Causes and Solutions

Hello： Based on your description of the pain, it is likely that you are experiencing acute pulpitis, which is causing referred pain in various branches of the left trigeminal nerve, resulting in such severe discomfort. <br>Pain from orthodontic issues or temporomandibular joint d

Pain in the upper and lower gums on the left side?

I am currently undergoing orthodontic treatment and am in the seventh month of my braces.
On September 3rd, I had springs placed on my lower teeth.
On September 10th, I was awakened in the early morning by severe pain in the entire left side of my face and gums.
My immediate instinct was that it was related to previous cavities, as both my upper and lower gums were painful.
The pain extended to my neck and caused a headache, with the lower teeth being much more painful than the upper ones.
My cheeks felt sore, but the gums were in so much pain that I couldn't sleep at all.
I went to the emergency department at Cheng Kung University Hospital, where an X-ray was taken.
The doctor said there appeared to be no issues with the teeth or gums, and there was no redness or swelling.
I was prescribed painkillers, but the pain did not decrease at all after returning home.
It continued until September 12th, when it finally lessened, but I still experienced mild pain that persisted until the evening of September 16th, when the pain became severe again.
On the 17th, the pain slightly subsided, and I visited my orthodontist.
The doctor suspected that one of the last two upper teeth on the left side might need a root canal (it had previously been filled due to a cavity), but we continued with the orthodontic adjustments.
Springs were placed on the upper teeth, and the lower teeth also experienced mild pain from the 17th to the 18th (the mild pain was primarily in the upper and lower gums on the left side, with no sensation in the cheeks).
Starting the evening of the 18th, I experienced severe pain again, with the lower teeth being more painful than the upper ones.
This time, I also had soreness in my cheeks, which was much more uncomfortable than the gum pain.
The gums felt like they were throbbing, while the cheeks felt painful with a bit of numbness.
The painful area in my cheeks was below the cheekbone, near the jaw, and I have experienced difficulty closing my mouth after yawning, which has continued until now.
This doesn't happen often, but occasionally I find it hard to open my mouth without pain.
I believe the discomfort is not due to opening my mouth but rather from the pain in my cheeks and gums, which makes the act of swallowing feel very pronounced.
It’s not exactly painful, but it feels slightly uncomfortable compared to normal swallowing.
I visited Chimei Medical Center, where they suspected arthritis and prescribed muscle relaxants, pain relievers, anti-inflammatories, and stomach medication.
However, after taking the medication, the symptoms did not improve within 1-2 hours; instead, the pain became more intense.
I would like to ask the doctor why this is happening, as the pain is unbearable, and I am unable to live normally.

mi, 20~29 year old female. Ask Date: 2011/09/22

Dr. Huang Zhicheng reply Dentistry

Hello: Based on your description of the pain, it is likely that you are experiencing acute pulpitis, which is causing referred pain in various branches of the left trigeminal nerve, resulting in such severe discomfort.
Pain from orthodontic issues or temporomandibular joint disorders would not be as intense.
If X-rays do not show any cavities, a percussive examination of each tooth may reveal cracks that could also lead to extremely painful pulpitis.
Wishing you safety and health.
Sincerely, Dr.
Huang Chih-Cheng, Director of Dentistry, Taoyuan General Hospital, Department of Health.

Reply Date: 2011/09/22

More Info

Experiencing severe gum pain during orthodontic treatment can be distressing and disruptive to daily life. Based on your description, it seems that you are undergoing orthodontic treatment and have encountered significant pain in your gums and jaw, particularly after the placement of springs on your lower teeth. This pain has escalated to the point of affecting your ability to sleep and perform daily activities.

Possible Causes of Your Pain
1. Orthodontic Movement: The application of braces and springs exerts pressure on the teeth and surrounding structures. This can lead to discomfort as the teeth shift into their new positions. The pain you are experiencing could be a normal response to this adjustment, especially if the force applied is significant.

2. Pre-existing Dental Issues: You mentioned having a history of cavities and previous dental work. If there are underlying issues, such as an untreated cavity or a tooth that requires a root canal, these could be exacerbated by the orthodontic treatment. The pressure from the braces can irritate these areas, leading to increased pain.

3. Gum Inflammation: Even if there is no visible redness or swelling, the gums can still be inflamed due to the mechanical forces applied by braces. This inflammation can cause pain, especially when combined with the movement of teeth.

4. Temporomandibular Joint (TMJ) Disorders: The pain radiating to your neck and head, along with the discomfort in your jaw when opening your mouth, might indicate a TMJ disorder. This can occur due to the stress and strain placed on the jaw joint during orthodontic treatment.

5. Muscle Strain: The muscles involved in chewing and jaw movement can become strained due to the constant adjustments and pressure from braces. This can lead to referred pain in the face and neck.

Recommended Solutions
1. Pain Management: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage pain. However, if these are not effective, it may be necessary to consult your orthodontist for stronger prescription medications.

2. Orthodontic Follow-up: It is crucial to communicate with your orthodontist about the severity of your pain. They may need to adjust the tension in your braces or springs to alleviate discomfort. Regular follow-ups can help monitor your progress and address any complications early.

3. Dental Evaluation: Since your orthodontist suspects a possible need for a root canal, it would be wise to have a thorough dental evaluation. This may include X-rays or other diagnostic tools to identify any underlying issues that need to be addressed.

4. TMJ Management: If TMJ disorder is suspected, your dentist may recommend a night guard to reduce strain on the jaw during sleep. Additionally, stress management techniques and muscle relaxation exercises can be beneficial.

5. Soft Diet: Eating softer foods can minimize discomfort while chewing. Avoiding hard or crunchy foods during this period can help reduce strain on your teeth and gums.

6. Warm Compresses: Applying a warm compress to the jaw area can help relax the muscles and reduce pain. This can be particularly effective if you experience muscle tightness.

7. Hydration and Nutrition: Staying hydrated and maintaining a balanced diet can support overall oral health and recovery.

Conclusion
Severe gum pain during orthodontic treatment can arise from various factors, including the mechanical forces of braces, pre-existing dental issues, and potential TMJ disorders. It is essential to maintain open communication with your orthodontist and dental care team to address these concerns effectively. By following the recommended solutions and seeking timely evaluations, you can work towards alleviating your pain and ensuring a smoother orthodontic experience. If your symptoms persist or worsen, do not hesitate to seek immediate medical attention. Your comfort and health are paramount during this treatment process.

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