Some of the Worst Lyme Related Pain

Since the early 1980's Lyme disease has been reported to be the cause of dental and jaw related pain. The reason for the pain is often miscalculated and many times teeth have been removed in an attempt to stop the pain. The pain, however, remained and the patient continued to suffer.

Some patients with facial/dental pain were mistakenly diagnosed in University hospitals with tetanus, which is more commly referred to as "lock jaw".

To assist readers, I've added a few definitions, some selected scientific abstracts and articles and general articles written by dentists. If you are in search of a health care professional who treats Lyme disease you can go to www.LymeDoc.org

Lucy Barnes

AfterTheBite@gmail.com


Definitions

Trigeminal neuralgia, also known as tic douloureux, sometimes is described as the most excruciating pain known to humanity. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve, which sends branches to the forehead, cheek and lower jaw. Source

Temporomandibular joint (TMJ) syndrome is pain in the jaw joint that can be caused by a variety of medical problems. The TMJ connects the lower jaw (mandible) to the skull (temporal bone) in front of the ear. Certain facial muscles that control chewing are also attached to the lower jaw. Problems in this area can cause head and neck pain, facial pain, ear pain, headaches, a jaw that is locked in position or difficult to open, problems with biting, and jaw clicking or popping sounds when you bite. Temporomandibular joint syndrome is also referred to as temporomandibular joint disorder. Source

Orofacial pain is a broad term used to describe symptoms of pain and/or dysfunction in the head and neck region. Multiple causes for orofacial pain may exist and the symptoms may include such diverse findings as headaches, neck pain, ear pain, dental pain, facial burning or stabbing sensations, and jaw joint pain. Symptoms may also include atypical pains or sensations such as ringing in the ears (tinnitus), dizziness, muscular incoordination or even abnormal itching or tingling in the head and neck region. The complaints may either develop gradually or have a rapid onset and can originate from neurovascular, neuropathic or musculoskeletal causes. Source


Scientific Articles & Abstracts

Part 1

Temporomandibular disorders- (TMJ, jaw pain, etc.)

Some Lyme patients are mistakenly thought to have "lock jaw" and have been hospitalized for it.

QUOTE- "A high prevalence of TMD symptoms was found in patients with Lyme disease."

Clin Oral Investig. 2019 Apr 13. doi: 10.1007/s00784-019-02890-4. [Epub ahead of print]

Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease.

Osiewicz M1, Manfredini D2, Biesiada G3, Czepiel J3, Garlicki A3, Pytko-Polończyk J4, Lobbezoo F5.

https://www.ncbi.nlm.nih.gov/pubmed/30982182

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J Clin Med. 2019 Jun 28;8(7). pii: E929. doi: 10.3390/jcm8070929.

Prevalence of Function-Dependent Temporomandibular Joint and Masticatory Muscle Pain, and Predictors of Temporomandibular Disorders among Patients with LymeDisease.

Osiewicz M1, Manfredini D2, Biesiada G3, Czepiel J3, Garlicki A3, Aarab G4, Pytko-Polończyk J5, Lobbezoo F4.

https://www.ncbi.nlm.nih.gov/pubmed/31261623

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J Oral Maxillofac Surg. 1988 Jan;46(1):78-9.

Lyme disease involving the temporomandibular joint.

Harris RJ1.

Author information

1 Oral and Maxillofacial Surgery in New London, Connecticut.

Abstract

Lyme disease is an increasingly common problem that has spread rapidly across the United States. A case of the disease and its correlation to TMJ pain and dysfunction in a 35-year-old female is described. The patient was diagnosed and cured of her symptoms with antibiotics, possibly sparing her from surgery.

Link Here

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N Y State Dent J. 1989 Nov;55(9):46, 48, 50-2.

Lyme disease misdiagnosed as TMJ syndrome. A case report.

Lader E.

Abstract

Due to the high incidence of Lyme disease, the ease with which it can be misdiagnosed, and its potential for causing irreversible neurologic or cardiac complications and fatalities if left untreated, all patients living in known epidemic areas who manifest intractable facial pain, or what appears to be a case of temporomandibular joint syndrome that does not respond to therapy should be tested for Lyme Borelliosis. It should be remembered however, that not all patients with active Lyme disease produce antibodies, and it is thus imperative for the clinician to obtain a detailed patient history with a focused series of questions directed at the known presentations of the disease, with specific emphasis placed on the prior appearance of an ECM lesion.

Link Here

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J Prosthet Dent. 1990 Jan;63(1):82-5.

Lyme disease misdiagnosed as a temporomandibular joint disorder.

Lader E.

Abstract

Craniomandibular disorders cause many pleomorphic and seemingly unrelated clinical manifestations that mimic other more serious medical problems and thus can present physicians and dentists with a challenge that invites misdiagnosis and improper treatment planning. Conversely, misdiagnosis and ineffective treatment planning are facilitated when serious medical problems manifest a range of signs and symptoms that are clinically similar to temporomandibular joint muscle dysfunction. At times, the patient's response to therapy may be the best method of corroborating a diagnosis, as illustrated in this report of a patient with Lyme disease that was misdiagnosed as a temporomandibular joint disorder.

Lyme disease has already reached epidemic proportions in several parts of the United States and its geographic distribution is spreading. Because Lyme disease is a life-threatening illness whose clinical manifestations can mimic temporomandibular joint/myofascial pain-dysfunction, it is the responsibility of every dentist who treats craniomandibular disorders to become familiar with the clinical presentations of Lyme disease and more proficient in its differential diagnosis.

Link Here

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J Orofac Pain. 1996 Winter;10(1):74-86.

Lyme disease: considerations for dentistry.

Heir GM1, Fein LA.

Author information

Abstract

Although Lyme disease has spread rapidly and it is difficult to diagnose, a review of the dental literature does not reveal many references to this illness. Dental practitioners must be aware of the systemic effects of this often multiorgan disorder. Its clinical manifestations may include facial and dental pain, facial nerve palsy, headache, temporomandibular joint pain, and masticatory muscle pain. The effects precipitated when performing dental procedures on a patient with Lyme disease must also be considered. This study discusses the epidemiology and diagnosis of Lyme disease, its prevention, and factors to consider when making a differential diagnosis. Dental care of the patient with Lyme disease and currently available treatments also are considered. Three case reports are presented.

Link Here

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J Neurol. 1996 Apr;243(4):367-8.

Trigeminal neuralgia as a clinical manifestation of Lyme neuroborreliosis.

Fritz C, Rösler A, Heyden B, Braune HJ.

Link Here

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Dent Clin North Am. 1997 Apr;41(2):243-58.

Differentiation of orofacial pain related to Lyme disease from other dental and facial pain disorders.

Heir GM1.

Author information

1 Department of Oral Pathology, Biology and Diagnostic Sciences, University of Medicine and Dentistry, New Jersey DentalSchool, Newark, USA.

Abstract

The diagnostic process for the orofacial pain patient is often perplexing. Compounding the process of solving a diagnostic mystery is the multiplicity of etiologic factors. The propensity for Lyme disease to present with symptoms mimicking dental and temporomandibular disorders makes the task even more complex. It is hoped that the reader is cognizant of the fact that a pathologic process of dental structures--the teeth and their attachments to the mandible and maxilla, the temporomandibular joints, masticatory musculature, and vascular supply and sensory innervation of the oromandibular anatomy--may also be the source of facial pain.

Although unique, similar complaints may also be manifestations of other causes, including pain associated with Lyme disease. The informed and fastidious clinician does not overlook these possibilities when evaluating the headache and facial pain patient.

The clinician should be equipped with the knowledge and minimal armamentarium to evaluate the patient appropriately. To paraphrase from Sherlock Holmes, we must first eliminate the impossible, whatever is left is the truth, no matter how unlikely. A differential diagnosis must be achieved based on clinical experience, unbiased observations, and probability. Link Here