I have had pain and swelling on the left side of my face for months. Initially, my dentist said it wasn't a dental issue and there was no evidence of teeth grinding? The pain really bothers my ears, temple, upper cheek, eye and areas surrounding my ear. A CT reveled nothing unusal. After a progressive systemic flare up of lymph nodes, my doctor said it is lymph nodes around my ears. So I have taken tons of ibuprofen which helps some. He also said my ears were inflamed but not infected so I have taken several decongestant and nasal sprays even though my sinuses seem relatively clear. I have taken both antibiotics and predinsone with little improvement besides more clicking in ears. I went to the Rhumetologist. I have had a positive ANA with a speckled pattern with some other autoimmune borderline results. She thinks it might br my partoid gland. Possible Sogren's but nothing definitive. I do have dry eyes but my saliva production seems fine. In the mean time, I have had a few episodes of severe tonsillitis. There has been a small pea sized lump right over the TMJ over these part 4 months. If I mess with it at all, the whole side of my face really hurts. Went to the ENT who said my ears looked fine and it is TMJD and I need to see the dentist. I cried in frustration. Seems I have gone full circle on this. How can one identify the difference? is there some type of difinitive diagnistic testing or either of these issues?
Sharp pain in the side of face could be due to injury to a nerve or pinched nerve, an infection or a trauma. Hence it could be Trigeminal neuralgia, abscess in tooth, exposed root canal, internal ear infection, maxillary sinusitis, TMJ, migraine, herpes (recurrent) without rash or fibromyalgia localized to face.
If the pain is due to TMJ, you will find it linked to either opening your mouth wide or to chewing. Also, touching the swelling on the joint aggravates the pain. To get some relief you can try massaging the sore muscles. You have to press on muscles of your face to look for sore points. Then massage these points with short strokes. To massage the masseter muscles on each side of your jaw, place your thumb inside your mouth and squeeze the thick muscle in your cheek with your fingers. To massage the jaw muscles inside your mouth, use your index finger to probe and massage these spots. Massaging the muscles does not help every one. Also if the procedure is nor correct, then it can further aggravate the problem.
Moist heat or cold packs on the face, vitamin supplements, or biofeedback are useful for some people. Usually people find a method that brings relief by trial and error.
Trigeminal neuralgia is diagnosed by clinical examination. Also pressing the area in from of your ear can aggravate the pain. Pain can also be aggravated by chewing or by a cool breeze blowing on your face. For medical treatment of trigeminal neuralgia several types of drugs are tried either singly or in combination. These are anti-epilepsy drugs such as valproate, carbamazepine, lamotrigine, phenytoin, gabapentin, and pregabalin; muscle relaxants such as clonazepam and baclofen; tricyclic antidepressants such as carbamazepine, amitriptyline, and nortriptyline.Sometimes a MRI is done to find out if there is a tumor pressing on the nerve. In this case surgery is the only treatment.
You need a combined approach by a dentist and an ENT specialist. Take a second opinion if possible. Take care!
The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
Thank for your reply. I just had a full set of dental X-rays and cleaning. Everything looks good. I meet with the dentist tomorrow to discuss TMJD and try a month guard. I am not thrilled at this option without knowing for sure it is TMJD. I am really looking for some definitive diagnostics. I am wondering if I could just request a high res MRI of the whole area. Would that show inner ear problems, parotid issues and/ or TMJ?
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