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James A. Snyder, DDS, MS

Oral and Facial Pain

At the Center for Dental Anesthesiology in Alexandria, Virginia and serving the entire Washington D.C. area, we see many patients with complaints of pain in the mouth, face, head and neck. Often they have visited a primary care physician and been referred to specialists, sub-specialists, imaging experts  and the pharmacy with no relief. Sometimes they have seen a dentist and had teeth extracted or had root canals, again with no relief. Often, the problem is that the pain seems to be coming from one place when its source is actually somewhere else. Dr. James Snyder has the advanced diagnostic skills to identify the problem at its source. Once identified correctly, many of these problems can be successfully treated non-invasively.

Pain that is felt in one place but actually originates elsewhere is called "referred pain". One common example is a problem with the temporomandibular joint (TMJ). TMJ pain is often felt in the ear or the head or neck rather then specifically in the jaw where it is actually located.

Another example is "soft tissue process" pain which can refer the pain to even more distant sites. This sometimes involves "trigger points" which have been described as micro spasms in a muscle. The trigger point is a banded physical entity that can be felt as a painful bump or lump that is often hotter than the surrounding tissue.  The trigger points may be deep in the tissue and not discernible to the patient but they can be felt easily by a trained health care professional who is looking for the. While they are often painful right at the site when pressed on, they  can generate pain that is felt by the patient at sites quite distant from the point itself.

In order to properly diagnose the cause of pain, the doctor must be thoroughly familiar with the phenomenon of referred pain, when to suspect it, and how to trace its source. Once correctly diagnosed, "TMJ" pain and trigger points in the muscles used for chewing can usually be treated with effective non-invasive techniques. Pain medications my be helpful in the short run for relief but do not resolve the problem and longer term use of these medications can cause additional problems.

Occasionally even pain that seems to come distinctly from a tooth (or the teeth / gums) actually originates elsewhere. Neuralgia, soft tissue pain, arthritis, and even brain tumors and heart attacks can cause pain that seems to come from dental sources. It is important that the dentist be a well trained diagnostician who knows to consider the range of possibilities when evaluating a pain complaint.No doctor is right 100% of the time but all doctors fail if they don't consider 100% of the possibilities.

Even dental pain that really is dental pain can occasionally be hard to diagnose. For example, teeth with microscopic cracks can be insidious. The crack can be invisible even to magnification and a seemingly normal tooth can be afflicted with a crack requiring maximum treatment including root canal and crown. While it is always wise to save teeth if possible, occasionally even extensive treatment cannot stop the pain and an extraction is necessary.

Given the many possibilities for confusion about the actual origin of pain in the mouth, face, head and neck, it is critical that the dentist evaluating the pain is fully trained and experienced in this area. Pain diagnosis and control are elemental to the anesthesia training Dr. Snyder has had. He is board certified by the multi-disciplinary American Academy of Pain Management.  Over 30 years of experience has added to his expertise in this area. If you are suffering from pain in these areas, you should call the Center for Dental Anesthesiology today and find the beginning of the end to your pain.

Contact Our Dental Practice

Visit our dental practice to have a full evaluation and treatment of your pain. We serve Alexandria, Virginia, Washington, D.C., Bethesda, Maryland, and surrounding communities.

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