Chronic Pain & Dentistry

Chronic Pain, CRPS/RSD and Dental Care

Many people living with chronic pain conditions such as complex regional pain syndrome (CRPS) or fibromyalgia face challenges with daily life, and many struggle in the dental environment with finding proper care. Dr. Siegelman is a dentist anesthesiologist that understands. In our office, we have found that the more we know about a person, the better we can customize our care to meet YOUR needs. Pain control before, during, and after dental care are important considerations when deciding on treatment options. Prevention and developing a home care routine are essential tools for patients to help require the least amount of treatment necessary; minimally invasive or non-invasive treatment is always preferred. Treating hysicans are sometimes involved with treatment descions. Our team will work together to provide you personalized dental care. Your comfort and trust are of utmost importance to us.

What Is Complex Regional Pain Syndrome (CRPS)?

CRPS describes ongoing, excess pain and swelling after an arm or leg injury, stroke, or heart attack. Even a mild touch can trigger abnormal severe pain. In some people, this goes away over time. For others, the pain continues and becomes disabling.

What Causes CRPS?

CRPS involves a malfunction of nerve fibers that take pain messages to the brain. After an injury, swelling helps with healing and rest. In CRPS, too much swelling gets triggered.

What Is the Treatment for CRPS?

CRPS treatment involves various interventions to achieve improvement. Examples include physical and rehabilitation therapy, graded motor imagery, or psychotherapy. Neural or spinal cord stimulation or spinal-fluid drug pumps are also used.

Patients have reported relief from different medication regimes, especially early in the disease. Each patients’ medication requirements vary. The following lists common drugs used for CRPS treatment.

  • Acetaminophen
  • Bisphosphonates
  • Botulinum toxin injections
  • Corticosteroids
  • Duloxetine, gabapentin, nortriptyline, and pregabalin
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Opioids
  • Topical lidocaine or fentanyl

Other alternative and holistic therapies have also proven beneficial.

How to Manage Chronic Pain Before Dental Visit?

Did you know that dental problems may cause chronic back pain? Missing teeth, overcrowding, or misaligned bites stress the facial muscles and jaw joints. The facial muscles connect to the neck, shoulder, and back muscles.

Muscular compensation for bite abnormalities causes tension, strain, and pain. Thus, correcting dental problems can reduce some chronic pain.

Medications taken for chronic pain can increase oral problems. Side effects include dry mouth which reduces the saliva that helps remove bacteria. This changes the mouth pH, increases swelling, reduces taste, and erodes tooth enamel.

Teeth grinding often accompanies chronic pain and strains the teeth and jaw. This causes tooth decay, gum disease, and tooth loss.

These complications highlight the importance of proper dental hygiene. To help manage chronic pain before a visit, take an NSAID or other over-the-counter pain med.

Is Anesthesia Needed for Fibromyalgia Patient's Dental Treatments?

Fibromyalgia syndrome involves chronic skeletal pain, stiffness, fatigue, and sleep disruption. Individuals may also have psychiatric problems including depression and anxiety.

Oral components of the syndrome include temporomandibular joint (TMJ) disorder and headaches. Dry mouth, tongue pain, and a bad taste in the mouth can result from the syndrome or treatment.

We offer sedation alternatives to increase comfort. This includes nitrous oxide, oral conscious or IV sedation, and general anesthesia.

What are the Benefits of At-Home Treatments for Fibromyalgia?

At-home treatments for fibromyalgia are vital to your health. Stress promotes inflammation which increases symptoms. Participating in activities to improve your stamina and strength reduces pain and stress. Stress and pain impact oral health which causes more pain and swelling. It’s a vicious cycle. Practice good oral hygiene and know your limits.

Check out this video where Dr. Siegelman provides information and tips on Dental Care and CRPS.

You can follow along with the slides here.

Feel free to reach out to our office to connect with Dr. Siegelman. Our team is happy to help you with dental care and answer any of your questions. You can call our office (212) 974-8737 or fill out a Contact Form here.

Also, check out RSDSA. They offer support for the CRPS community providing many resources and CRPS and Dentistry guidelines.

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