1. Mouth pain can result from a wide range of pathology
Mouth pain can result from a wide range of pathology. Caries and periodontitis are the most common causes. Other causes can include aphthous ulcers or herpetic lesions. Issues that are more prevalent in women include:
Burning mouth syndrome which occurs in 1-2% of women and as much as 40% in menopause. Underlying causes which should be ruled out and treated as noted in the slide. If no cause is found, it may be idiopathic and medications that treat neurologic pain may be helpful, including low dose tricyclic antidepressants and gabapentin.
The presence of eroded teeth should prompt the clinician to consider either severe GERD and/or eating disorders such as bulimia. The former requiring life style changes +/- antihistamines or proton pump inhibitors and the later requiring a more extensive intervention involving behavioral health specialists.
TMJ is more common in women in a 5:1 ratio, triggers include hormonal changes and teeth grinding. A referral to a dental provider is indicated with consideration for a nocturnal mouth guard.
Lastly- any trauma of the mouth or teeth should prompt a provider to consider and ask about violence in the home. Oral trauma may be the only presenting sign of domestic violence.
References
American Dental Association Council on Access, Prevention and Interprofessional Relations. Women’s Oral Health Issues Available at: (Accessed April 15, 2014)
Grushka M, Epstein JB, Gorsky M. Burning Mouth Syndrome. American Family Physician. 2002; 65(4):