Going to the dentist with CRPS: how to prepare for a pain-free dental visit

Learn how to best equip yourself to visit the dentist as someone living with CRPS - from informing your dental practioner about your medications to ensuring that you allow time to rest and recover afterwards.

By Georgie Archer

Complex Regional Pain Syndrome (CRPS), a “neuro-inflammatory” condition, causes the nervous and immune systems to malfunction and send constant pain signals to the brain. It is characterised by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch.

Visiting  the dentist can be difficult when you have CRPS. Touch, movement, vibrations, noise, light and needles can worsen symptoms. CRPS symptoms and side-effects can also compound dental issues, causing:

• Difficulties being numbed
• New or recurring pain after dental procedures
• Pain that spreads beyond the mouth
• Swelling and inflammation with no sign of infection
• Brittle teeth 
• Extreme cold sensitivity of the teeth 

Practical dental complications arising from having CRPS can include:

• Medication side effects: some pain medications can worsen dental health, particularly opioids, which can affect your ability to produce saliva, causing Xerostomia (dry mouth). Saliva is crucial for protecting teeth and gums.
• Flossing and brushing: for those whose upper body is affected by CRPS, pain - and reduced strength and dexterity - can reduce the effectiveness of brushing and flossing . When combined with potential extreme head, neck and facial pain, basic dental care can become challenging.
• Poor diet: the troubles associated with CRPS can often lead many living with such chronic pain conditions to comfort-eat sugary snacks, which can have detrimental impacts on dental health.
• Irregular dental check-ups: a fear of visiting the dentist can result in relatively minor dental issues being left untreated, allowing them to develop into more significant dental problems.

Dentists are often unaware of the complications that CRPS can cause in dental issues, so a visit can be daunting if you can even get an NHS appointment – and the costs of a private appointment can be particularly prohibitive to those with CRPS.
However, it is possible to find knowledgeable and sympathetic dentists. It is recommended to raise problems associated with the dentist with your pain medicine specialist, who may be able to recommend an appropriate dentist. If not, they may be able to write to your dentist and explain your condition, raising potential issues and recommending solutions.

Make sure you’re ready for your appointment with your dentist. Here are a few tips to make sure things go smoothly on and before the day:

• Remember to bring a letter from your pain specialist about your symptoms.
• Let your dentist know about the specifics of your CRPS before you go.
• Bring your pain medication or take your prescription with you. 
• Consider what you could bring to alleviate discomfort - perhaps a comfortable pillow. 
• Bring a list of questions or concerns you may have.
• Remember to take some time to rest after a visit to the dentist as your CRPS may start to flare up.

It’s key to share any dental or oral health issues, including allergic reactions or sensitivities to dental products and ingredients as well as medications. Any of the following problems should also be raised with your dentist:

• Burning mouth
• Dry mouth
• Erosion
• Dental decay
• Chronic mouth inflammation/irritation
• Orthodontics
• Muscle issues of the head, neck and jaw
• Tongue and/or salivary gland changes

Developing a sustainable and manageable daily oral hygiene plan with your dentist’s help is crucial. You could use a soft-bristled toothbrush, mouthwash and/or moisturising spray and floss. You could also adopt a diet adapted to promote dental health, and take vitamins as approved by your doctor.
Try to address dental problems as soon as they arise to prevent them from developing into something that will require more significant treatment. It’s crucial to keep stress levels low, as this can worsen CRPS symptoms, including those that affect dental health. Deep breathing, meditation, distraction techniques and yoga can help manage symptoms and the anxiety associated with a visit to the dentist. You could also use a mouthguard if you grind your teeth or clench your jaw to protect yourself from further damage.

Make sure you head to the Burning Nights CRPS Support website for more information and support. You can find us on social media too.