Getting To the Root Cause of Myogenic Tooth Pain

Carol Cote of North Jersey Physical Therapy Associates recently travelled to San Francisco to teach a full one-day program on Feb. 11, 2022 to the U2 Endodontic Study Group, with participants coming from throughout the western states, on the topic of myogenic tooth pain, and how physical therapists with specialty training can collaborate with endodontists to help identify it, and how physical therapists can then treat it.

Muscles can masquerade as tooth pain, which can be then be misdiagnosed resulting in persistent tooth pain, even after common dental procedures, such as a root canal, or even after a tooth extraction.  Close lock and painful problems of the TMJ, head and neck can develop that can limit or prevent an endodontist from performing a tooth saving root canal. Specially trained physical therapists who understand myogenic tooth pain are key members of a dentist’s/endodontist’s collaborative team.  Muscles and sinus issues are the key contribution to tooth pain that is not coming from the tooth.  As an expert in her field, Carol discussed the underlying physiology and how muscles can contribute to tooth pain, especially if it persists after a root canal.  There are three major muscle groups that can masquerade as tooth pain.  These muscle groups are:

  1. Muscles of the jaw
  2. Muscles of the throat (swallowing)
  3. Muscles of the neck

A thorough and extensive Physical Therapy Evaluation is critical to understanding the difference between the symptom of pain, the source of the pain, and the root cause of the pain.  Once the symptom, source, and root cause of the tooth pain are understood and identified, then proper treatment can begin consisting of key manual techniques and exercises unique to this area of the body, and different from traditional physical therapy methods. These typically provide the best strategy to address the root cause, and provide the patient with the means to achieve and maintain pain free function, without necessarily the need for pain medications or muscle relaxants, which typically address only the symptoms and not the root cause.

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