There are a lot of patients who turn to their general practitioners because of the problem related to painful mouth. The very pain can in some of them be enhanced by swallowing and intake of either solid food or fluids. Even inhaling of cold air can increase the intensity of the pain. Since oral cavity contains lots of organs, and different tissues each of them can be affected by some inflammatory process, structural or functional changes and even certain medical conditions which may result in painful sensations. In some cases prolonged usage of certain medications can additionally induce the occurrence of pain.
The doctor must exam the patient, especially the oral cavity and palpate neck lymph nodes. This way structural changes or inflammation can be identified. The processes that have affected deeper tissues of oral cavity can be identified by ultrasonograpy of the neck, CT scan or MRI of the head and neck. After the exact cause of painful mouth has been established the doctor can suggest and prescribe specific treatment.
Causes of Painful Mouth
The problem with differential diagnosis is related to numerous tissues and organs that are present in maxillofacial area. This way the pain can originate from variety of sources.
Still in majority of patients painful mouth is connected to dental issues. The patient can be able to identify the painful tooth or its area. However, innervation of the mouth is rather complex and the pain may be located in nearby or even distant area which can make the setting of the diagnosis harder. In some patients toothache can irradiate towards ears. In elderly people dentures may not fit right and lead to ulcerations or sores. Periodontal disease is commonly followed by pain in the mouth.
The examination of oral cavity can give perfect insight in its structural changes. Namely, the doctor can easily notice sores or ulcer in front part of the oral cavity. Additional instruments such as laryngoscope can be useful not only in examination of the larynx but they can also help in identifying structural abnormalities of the basis of the tongue, the area that is not accessible to routine inspection of the oral cavity. The doctor is due to take biopsy from the identified changes in case they do not withdraw within three weeks after the onset of the treatment.
Ulcers and sores are predominantly caused by viral infections. Herpes simplex viruses, HIV, cytomegalovirus can be only some of the viruses that can lead to sores and ulcers and consequent pain. Bacterial and fungal infection can be other causes of sore mouth.
Different dermatology diseases such as erythema multiforme, lichen planus pemphigus vulgaris and so on can also cause pain in mouth.
Unfortunately, even cancer of oral cavity at some point induces painful sensations. Apart from tumors of oral cavity other malignancies such as leukemia may lead to painful changes of mucous membrane of the mouth.
Deficiency of certain vitamins can be additional cause of painful mouth changes. Even after chemotherapy some patients can complain about pain in this particular region.