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Have pain in palate, jaw pain, wear dentures. Need help

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Practicing since : 1981
Answered : 922 Questions
I suffer from pain in the palate to the right manifesting itself XXXXXXX behind the nose-this comes about when I talk.I also suffer from "toothache" pain in the right jaw at the 5th "tooth" along ,like a screw driver being driven into the jaw.The pain is constant.I have no teeth and have worn full dentures for many years which have never been a problem.These pains started after a dentist pulling off an implant which had got stuck.I have had the pain for ten years and have been on many different medications which have made me ill and also seen countless specialists all to no avail.These include alternative therapists.I am of a positive nature and do carry on with activities but feel as if I am walking through glue all the time because of the pain.Latterly,however,I have been feeling as if I am "loosing my tether"Otherwise I am healthy, eat a very good vegetarian diet, and do manage to exercise each day.Thank you!
Posted Sat, 25 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Anil Grover 6 hours later
Hi there,
Thanks for writing in.
I am a medical specialist with an additional degree in Cardiology. I read your question with diligence. Straight away, few conditions, which would have merited a look stand exclude dthese are:
1. Canker Sores, can result from viral infection can cause palate pain.
2. Gingivostomatitis : lesion would be obvious pain far less severe and treatable.
3. Herpes Simplex. Lesions would have been visible,
4. Oral Cancer. NO OBVIOUS LESION, no bleeding
5. Thrush. Pain far less, lesion obvious in thrush.
It is reverse logic but when even Pregabalin is not helping we have to think of Nerve Pain. Sensory Nerve to the palate is Trigeminal Neve. So, we have to exclude out or ruled in two conditions which might have been precipitated by the incident of getting stuck while pulling the implant but not a direct consequence. These are Trigeminal Neurologia and Migraine. In fact, sensory nerve for Migraine is Trigeminal and manifestations at least sensory related to mouth are common.

Coming to Trigeminal Neuralgia. Text book description of Nerve pain which is applicable to your situation include:
Well age is slightly older, less than 40 is the usual patient..
• Very painful, sharp electric-like spasms that usually last a few seconds or
minutes, but can become constant
• Pain is usually only on one side of the palate
• Pain may be triggered by touch or sounds
• Painful attacks of trigeminal neuralgia can be triggered by common, everyday
activities, such as:
o     Brushing teeth
o     Chewing
o     Drinking
o     Eating
o     Lightly touching the face

Signs and tests
A brain and nervous system (neurologic) examination is usually normal.
Tests that are done to look for the cause of the problem include:
•     Blood tests
•     MRI of the head
•     Trigeminal reflex testing
Your neurologist, or a pain specialist may be involved
in your care. Certain medicines sometimes help reduce pain and the rate of
attacks. These medicines include pregabalin
• Muscle relaxants (baclofen, clonazepam)
• Tricyclic antidepressants (amitriptyline, nortriptyline, or carbamazepine)
Some patients may need surgery to relieve pressure on the nerve.
Techniques include:
•     Cutting or destroying part of the trigeminal nerve
•     Destroying the trigeminal nerve with a needle or probe placed through the
skin using radiofrequency ablation or an injection of glycerol
•     Electrostimulation
•     Percutaneous balloon microcompression

Expectations (prognosis)
How well you do depends on the cause of the problem. If there is no disease causing the problem, treatment can provide at least some relief.
However, the pain may become constant and severe in some patients.

You please go through this summary I made for you and if you feel that this could apply to you, I will urge you to see your doctor and discuss pros and cons of the diagnosis and treatment. If you have any question for me, I will be more than happy to answer at the soonest. Regards. Good Luck.

With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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