What to do when you have oral pain and discomfort

Having a toothache or pain in your mouth can be debilitating. You can’t eat or sleep comfortably.

Dr Kiewiet Pienaar from the Van der Walt dental practice in Nelspruit consulted with Mopani on what to look out for.

What are the most common causes of oral pain and discomfort?

“There are numerous causes that can lead to oral pain and discomfort”, said Dr Pienaar.

  • Injury

“Injuries are caused when you do things such as bite into your lip, tongue or the sides of your cheeks. Eating food when it is too hot will burn your mouth. This can cause pain and tenderness in your mouth”, he explained.

  • Dry mouth

“Dehydration and underlying health conditions like diabetes can result in your salivary glands not producing enough saliva. This can cause dry mouth. You may feel a burning sensation in your mouth, a rough tongue, mouth sores or feeling parched”, he said.

  • Canker sores

“A canker sore often appears as a white lesion with a red border, a small ulcer on the inside your cheeks, on your tongue and other soft tissue areas in the mouth. It is often triggered by food sensitivities, stress, nutritional deficiencies, a viral infection or hormone fluctuations. It may tingle or burn before they appear. They can be very bothersome”, Dr Pienaar explained.

  • Herpes simplex virus

“Cold sores are caused by the herpes simplex virus (HSV). It is more common on the lips. However, if you are newly infected, you may develop painful lesions on your tongue, gums and throat. You may also experience swollen lymph nodes, fever and muscle aches”, said Dr Pienaar.

  • Other infections

“There are other bacterial and viral infections that may cause sores and lesions in the mouth. These include chickenpox; shingles; hand, mouth and foot disease; HIV and AIDS; infectious mononucleosis and syphilis.”

  • Oral thrush

“This is a fungal infection caused by a type of fungus called Candida albicans. Anyone can get it, and it is common to those with underlying health conditions and weakened immune systems. It appears as cream-coloured lesions all over the inside of the mouth. It may feel sore and it may bleed.”

  • Oral lichen planus

“This condition may develop on the insides of your cheeks, on your gums, or on your tongue. It can appear as raised white patches, red swollen areas, or even as sores. Although usually painless, in some cases irritation and ulcers may develop.”

“What causes oral lichen planus is unknown, but it seems to be tied to an immune response. Triggers often include autoimmune disorders, medications, injury to the mouth or allergic reactions in the mouth.”

  • Squamous papilloma

“This is a noncancerous type of growth, caused by the human papillomavirus (HPV). They often appear on the roof of the mouth and tongue. They are normally painless but can become an issue if the growth is disturbed when you eat.”

  •  Oral cancer

“When cells in your body multiply out of control, it can result in cancer. Oral cancer refers to cancer anywhere in the mouth or salivary glands. It may present as; lesions that won’t heal, lumps or growths, red or white patches, difficulty swallowing and numbness in the face, lips, neck or chin.”

“Men are more susceptible than women, and other risks include the use of tobacco or alcohol, having a family history of cancer, HPV infection or a weakened immune system.”

  • Painful gums

“Many of the mentioned causes may result in painful gums. One must also consider gingivitis, which is caused by a build-up of plaque and bacteria. This can lead to receding, painful gums. Having a poor diet, bad oral hygiene and smoking may progress your gingivitis.”

  • Rough brushing and flossing

“Use a toothbrush with soft bristles and floss gently to avoid any damage to your gums.”

  • Sinus infection

“When your sinuses are swollen and infected, it can cause pain in your upper teeth and gums.”

  • Dental abscess

“This occurs when you get a bacterial infection, causing a pocket of pus to develop around a tooth. This can be extremely painful.”

  • Nutritional deficiencies

“Nutritional deficiencies can cause your tongue to be swollen or sore. You may be low in iron, vitamin B12 or folate. Vitamin C is essential for healthy gums.”

  • Hormonal changes

“Sometimes, a change in hormones can affect and irritate your gums. This tends to be more common with women, especially during; puberty, menstruation, use of oral contraception, pregnancy and menopause.”

  • Geographic tongue

“This occurs when red patches in different shapes and sizes appear on your tongue. They may be painful. The cause is unknown, but we know that certain acidic or spicy foods may irritate it.”

  • Burning mouth syndrome

“You experience a burning or tingling sensation in your mouth. This condition typically affects the tongue, although other areas of the mouth such as the roof can also be impacted.”

  • Salivary gland stones

“These stones form in your salivary glands and block the flow of saliva into your mouth. You may experience pain and swelling. Risk factors include dehydration, some medication and not eating enough. By not eating enough, you produce less saliva.”

  • Neuralgia

“A specific type of neuralgia, is caused by irritating one of the nerves in your head. This will cause pain in the tongue, throat and tonsils.”

  • Wisdom teeth

“Your wisdom teeth may appear between the age of 17 and 25. They might not have a clear path and cause some pain. In some cases, your dentist may recommend that they be removed.”

What are my treatment options?

A variety of over-the-counter OTC remedies can aid in managing the pain and promoting healing:

  • Ibuprofen or paracetamol will help ease pain and discomfort
  • Products that contain benzocaine or hydrogen peroxide may help with lesions and sores, but should not be used with children under the age of two
  • Make a saltwater rinse with half a teaspoon of salt in half a cup of warm water. You may add a pinch of bicarbonate of soda. Swirl the mixture in your mouth for 30 seconds, then spit it out. This will help with sores

  • Ice packs outside the mouth or a block of ice inside on the affected area may relieve pain and swelling
  • Avoid spicy and salty foods
  • Increase your water intake, especially if you have dry mouth
  • Practice good oral hygiene


  • Visit your doctor or dentist if you have any condition that is persistent and recurring, if you have trouble swallowing, eating or drinking, or experience a fever. If you see any lesions, seek medical help immediately to identify whether or not they might be malignant
  • Always check in with your doctor, pharmacist or dentist to make sure your remedies are safe to use on your children
  • Avoid using tobacco products
  • Never put medications directly on an affected area as this can cause a chemical burn. Rather swallow the medication with water as directed
  • Your mouth is close to your respiratory system and your brain. It is best to treat infections, before they end up in your bloodstream

If you would like to book an appointment with Dr Pienaar, contact the Van der Walt dental practice on 0137443520. They are located at 71 Van Wijk Street, Nelspruit.

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