I found this on a google search I think a lot of the links are no good but here's the article, there's a lot of good info in here:Dental issues and Lyme: http://www.lymealliance.org/Medical/MedCategory7/Med15/med15.html
Lyme Disease and Orofacial Pain
Gary M. Heir, DMD
President Elect, American Academy of Orofacial Pain; Associate Clinical
Professor, University of Medicine and Dentistry of NJ; Department of
Oral Biology, Pathology and Diagnostic Services.
Adapted from the Newsletter of the American Academy of Orofacial Pain,
March 1998.
The healthcare provider involved with the diagnoses and management of orofacial
pain disorders must rely on a knowledge of various primary and/or secondary
disorders, which may manifest symptoms for which patients seek our aid. While a
majority of facial pain complaints are due to primary dental or orofacial
pathologies, many patients present with symptoms secondary to a primary
systemic illness. Included in these primary conditions is a spirochetal
infection; Lyme disease.
Lyme Disease is a rapidly emerging infectious disease. It represents 90% of all
vector-borne disease in the United States. Nearly 100,000 cases have been
reported since1980. This represents a 26-fo1d increase during the period of
1982-1996. While 70% of reported cases are found
in the Northeast, Lyme disease is also found in the North Central and Pacific
coastal regions. It must be assumed that children and adults in endemic areas
may be exposed to infection during school, work and recreational activities.
With the ease of travel, Lyme disease may also
present in regions of the country where it is not usually encountered.
It is important that all healthcare providers are familiar with the signs and
symptoms of this infectious disease.
Symptoms associated with Lyme disease include headache and facial pain that
often mimic dental pathology and oromandibular disorders.
Patients with complaints of vague, non-specific dental, facial or head pain,
who present with a multi-systemic, multi-treatment history, are suspect.
A nationwide survey via a questionnaire was distributed to patients with Lyme
disease. Only those subjects with positive testing were included in the study.
Respondents were clustered in the Northeastern states, northern California, the
north central states of Michigan and
Minnesota and central states such as Ohio.
Orofacial Pain Complaints Associated
with Lyme Disease
Recent data suggest that the temporomandibular joints are commonly
associated with a traumatic, non-dysfunctional Lyme arthritis. The data
from 120 patients with laboratory confirmed Lyme disease responding to the
survey found that 75% reported pain of the masticatory musculature and 72%
reported symptoms of TMJ pain. Of those responding, only 4 of 90 patients
reported a history of a traumatic jaw injury. The majority of these patients
reported the spontaneous onset of their temporomandibular pain. Of those with
Lyme disease reporting a temporomandibular disorder or myofascial pain, 75%
indicated that their symptoms intensified on a cyclical basis with other
symptoms related to Lyme disease. In such cases, only palliative treatment is
indicated while the patient is medically evaluated.
Dental pain or toothache, often in the absence of clinical or radiographic
evidence, is another haracteristic of Lyme disease. Dental pain in the absence
of detectable dental pathology was reported by 60% of those responding to this
survey. These patients also reported that their dental pain had a tendency to
move from tooth to tooth, change quadrants, or move from side to side. Of
these, 36% had multiple dental treatments including endodontia and extraction
with little benefit.
Glossodynia, or burning mouth, was reported by 25% of patients, while
70% reported sore throat.
Facial pain complaints other then those simulating toothache or a
temporomandibular disorder are also seen with Lyme disease. A variety of
dyesthesias, neuropathic or vascular complaints are more common then
previously thought. Of Lyme patients reporting facial pain, 88% associated
these complaints with other symptoms of Lyme disease.
Headache is another complaint common to the Lyme patient. It has been
previously reported that 53% of Lyme patients hospitalized for neurological
manifestations of Lyme disease describe some form of
headache disorder. As with other symptoms, these headaches appear to
cycle along with other pain complaints associated with Lyme disease.
The results of this survey found that 49% of patients reported headache
associated with other symptoms of their Lyme disease.
Headache ranged from sinus-like pain through tension-type and migraine. The
dental practitioner may also be confronted with patients manifesting
neurological symptoms.Unilateral facial nerve palsy was
reported by 27% of those responding. Four of the 120 patients reported
bilateral paralysis. Trigeminal neuralgia was reported by 25% of patients.
Summary
Lyme disease is a debilitating illness that may present as dental or orofacial
pain to the dental practitioner. All healthcare providers must be aware of
this clinical entity and be able to consider this infectious disease in
differential diagnoses.
The dentist and allied health care provider can play a significant role in the
early diagnosis and treatment of this often debilitating disease. You are
encouraged to learn more about this illness and
exercise diligence in evaluating suspect patients. A prompt and appropriate
referral to a medial specialist is imperative.
For additional information, contact Dr. Heir at [email protected], or at UMD-NJ
Dental School, OBPDS, 110 Bergen Street, Newark, NJ 0710
------------------------------�------------------------------�-- http://igm-02.nlm.nih.gov/cgi-bin/IGM_robot.pl?
search=Subject=toothache+AND+S�ubject=lyme+OR+Subject=burgdor�feri+OR+Subj
ect=Erythema+Chronicum+Migrans�+OR+Subject=borreli*+ixodes+OR�+Subject=Ery
thema+Migrans+NOT+glossitis+OR�+Subject=garinii+OR+Subject=af�zelii+OR+Subject=neuroborreli*�&datafile=MEDLINE
TITLE: Differentiation of orofacial pain related to Lyme disease from
other dental and facial pain disorders.
AUTHORS: Heir GM
AUTHOR AFFILIATION: Department of Oral Pathology, Biology and
Diagnostic Sciences, University of Medicine and Dentistry, New Jersey
Dental School, Newark, USA.
SOURCE: Dent Clin North Am 1997 Apr;41(2):243-58
CITATION IDS: PMID: 9142482 UI: 97287390
ABSTRACT: The diagnostic process for the orofacial pain patient is often
perplexing. Compounding the process of solving a diagnostic mystery is the
multiplicity of etiologic factors. The propensity for Lyme disease to present
with symptoms mimicking dental and
temporomandibular disorders makes the task even more complex. It is hoped that
the reader is cognizant of the fact that a pathologic process of dental
structures--the teeth and their attachments to the mandible and maxilla, the
temporomandibular joints, masticatory
musculature, and vascular supply and sensory innervation of the oromandibular
anatomy--may also be the source of facial pain. Although unique, similar
complaints may also be manifestations of other causes, including pain
associated with Lyme disease. The informed and
fastidious clinician does not overlook these possibilities when evaluating the
headache and facial pain patient. The clinician should
be equipped with the knowledge and minimal armamentarium to evaluate
the patient appropriately. To paraphrase from Sherlock Holmes, we must first
eliminate the impossible, whatever is left is the truth, no matter how
unlikely. A differential diagnosis must be achieved based on clinical
experience, unbiased observations, and probability.
MAIN MESH HEADINGS: Facial Pain/*etiology Lyme Disease/*diagnosis
Temporomandibular Joint disorders/*diagnosis
ADDITIONAL MESH HEADINGS: Diagnosis, Differentia fibromyalgia/diagnosis
Headache/etiology
Human
Lyme Disease/complications
Myofascial Pain Syndromes/diagnosis
Neuralgia/diagnosis
Stomatitis, Denture/diagnosis
Temporomandibular Joint Disorders/complications
Temporomandibular Joint Disorders/etiology
Toothache/etiology
1997/04
1997/01 00:00
PUBLICATION TYPES: JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
LANGUAGES: Eng
------------------------------�------------------------------�-- http://igm-02.nlm.nih.gov/cgi-bin/IGM_robot.pl?
search=Subject=periodontal+dis�eases+OR+Subject=peridontal+OR�+Subject=den
tal+AND+Subject=lyme+OR+Subjec�t=burgdorferi+OR+Subject=Eryth�ema+Chronicu
m+Migrans+OR+Subject=borreli*+�ixodes+OR+Subject=Erythema+Mig�rans+NOT+glo
ssitis+OR+Subject=garinii+OR+S�ubject=afzelii+OR+Subject=neur�oborreli*&datafile=MEDLINE
TITLE: Lyme disease awareness for the New Jersey dentist. A survey of
orofacial and headache complaints associated with Lyme disease.
AUTHORS: Heir GM; Fein LA
AUTHOR AFFILIATION: Department of Oral Pathology, Biology and
Diagnostic Services, UMDNJ, USA.
SOURCE: J N J Dent Assoc 1998 Winter;69(1):19, 21, 62-3 passim
CITATION IDS: PMID: 9584762 UI: 98245741
ABSTRACT: The incidence of Lyme disease is increasing in New Jersey.
In 1996, 2,190 cases were reported, representing an increase of 487
cases from the 1,703 reported in 1995 [Table 1]. Symptoms associated
with Lyme disease include headache and facial pain that often mimics dental
pathology and temporomandibular disorders. Patients with complaints of vague,
non-specific dental, facial or head pain, who present with a multisystemic,
multi-treatment history, are suspect.
This article discusses Lyme disease in New Jersey and the clinical presentation
of Lyme disease that the dental practitioner may encounter. A summary of data
is provided which was collected from 120
patients diagnosed with laboratory confirmed Lyme disease. The most
common orofacial, head and dental complaints seen in the Lyme disease
patient are reviewed. This information will hopefully aid in establishing a
diagnosis and appropriate referral where indicated.
MAIN MESH HEADINGS: *Dental Care for Chronically Ill
Facial Pain/*diagnosis
Headache/*diagnosis
Lyme Disease/*diagnosis
ADDITIONAL MESH HEADINGS: Facial Pain/etiology
Headache/etiology
Human
Incidence
Lyme Disease/complications
Lyme Disease/epidemiology
New Jersey/epidemiology
Questionnaires
Referral and Consultation
1998/05
1998/19 02:02
PUBLICATION TYPES: JOURNAL ARTICLE
LANGUAGES: Eng
------------------------------�------------------------------�-- TITLE: Lyme
disease: considerations for dentistry.
AUTHORS: Heir GM; Fein LA
AUTHOR AFFILIATION: TMD and Orofacial Pain Center, University of
Medicine and Dentistry, New Jersey Dental School, Newark, USA.
SOURCE: J Orofac Pain 1996 Winter;10(1):74-86
CITATION IDS: PMID: 8995919 UI: 97149111
ABSTRACT: Although Lyme disease has spread rapidly and it is difficult
to diagnose, a review of the dental literature does not reveal many
references to this illness. Dental practitioners must be aware of the
systemic effects of this often multiorgan disorder. Its clinical manifestations
may include facial and dental pain, facial nerve palsy, headache,
temporomandibular joint pain, and masticatory muscle pain.
The effects precipitated when performing dental procedures on a patient with
Lyme disease must also be considered. This study discusses the epidemiology and
diagnosis of Lyme disease, its prevention, and factors to consider when making
a differential diagnosis. Dental care of the
patient with Lyme disease and currently available treatments also are
considered. Three case reports are presented.
MAIN MESH HEADINGS: Facial Pain/*etiology
Facial Paralysis/*etiology
Lyme Disease/*complications
Temporomandibular Joint Dysfunction Syndrome/*etiology
ADDITIONAL MESH HEADINGS: Adult
Case Report
Dental Care for Chronically Ill
Diagnosis, Differential
Female
Human
Lyme Disease/epidemiology
Medical History Taking
Middle Age
Prevalence
United States/epidemiology
1996/01
1996/01 00:00
PUBLICATION TYPES: JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
LANGUAGES: Eng
------------------------------�------------------------------�-- Chap 4 -
Borreliae From Mucous Membranes: http://www.medscape.com/SLACK/JSTD/1999/v06.n02/std0602.ch04.fels/std060
2.ch04.fels.html
Also you might want to look at old LDF conference archives: http://www.geocities.com/HotSprings/Oasis/6455/conferences-links.html
And see(go to the site and use search term 'dental' for the following
results--go to the site and you can click on each reference and get the whole
abstract where available:
http://search.lymenet.org/
The Lyme Disease Network
Medical / Scientific Literature Database
Search Results
The following references met your criteria:
[1] LYME DISEASE AWARENESS FOR THE NEW JERSEY DENTIST. A SURVEY OF OROFACIAL
AND HEADACHE COMPLAINTS ASSOCIATED WITH LYME DISEASE.
Authors: Heir GM Fein LA
Source: J N J Dent Assoc 1998 Winter;69(1):19, 21, 62-3 passim
[2] LYME DISEASE: CONSIDERATIONS FOR DENTISTRY.
Authors: Heir GM Fein LA
Source: J Orofac Pain 1996 Winter;10(1):74-86
[3] DIFFERENTIATION OF OROFACIAL PAIN RELATED TO LYME DISEASE FROM OTHER
DENTAL AND FACIAL PAIN DISORDERS.
Authors: Heir GM
Source: Dent Clin North Am 1997 Apr;41(2):243-58
[4] BORRELIA BURGDORFERI-SEROPOSITIVE CHRONIC ENCEPHALOMYELOPATHY:
LYME NEUROBORRELIOSIS? AN AUTOPSIED REPORT.
Authors: Kobayashi K Mizukoshi C Aoki T Muramori F Hayashi M Miyazu K
Koshino Y Ohta M Nakanishi I Yamaguchi N
Source: Dement Geriatr Cogn Disord 1997 Nov-Dec;8(6):384-90
[5] THE TETRACYCLINES.
Authors: Smilack JD
Source: Mayo Clin Proc 1999 Jul;74(7):727-9
[6] COMMUNITY HEALTH NURSES' KNOWLEDGE OF LYME DISEASE: IMPLICATIONS FOR
SURVEILLANCE AND COMMUNITY EDUCATION.
Authors: Capps PA Pinger RR Russell KM Wood ML
Source: J Community Health Nurs 1999;16(1):1-15
[7] CIRCULAR AND LINEAR PLASMIDS OF LYME DISEASE SPIROCHETES HAVE EXTENSIVE
HOMOLOGY: CHARACTERIZATION OF A REPEATED DNA ELEMENT.
Authors: Zuckert WR Meyer J
Source: J Bacteriol 1996 Apr;178(8):2287-98
[8] BLOOD PRODUCT-ASSOCIATED BACTERIAL SEPSIS.
Authors: Goldman M Blajchman MA
Source: Transfus Med Rev 1991 Jan;5(1):73-83
[9] LYME DISEASE: AN IMPORTANT CONSIDERATION IN THE DIFFERENTIAL
DIAGNOSIS OF TMD.
Authors: Kelsey JH
Source: J Mich Dent Assoc 1990 Apr-May;72(4-5):209-10
[10] LYME DISEASE MISDIAGNOSED AS A TEMPOROMANDIBULAR JOINT DISORDER.
Authors: Lader E
Source: J Prosthet Dent 1990 Jan;63(1):82-5
[11] LYME DISEASE MISDIAGNOSED AS TMJ SYNDROME. A CASE REPORT.
Authors: Lader E
Source: N Y State Dent J 1989 Nov;55(9):46, 48, 50-2
[12] ANTIBIOTIC PROPHYLAXIS: UPDATE ON COMMON CLINICAL USES.
Authors: Weitekamp MR Caputo GM
Source: Am Fam Physician 1993 Sep 15;48(4):597-604
[13] LYME DISEASE--THE GREAT IMITATOR.
Authors:
Source: Wis Dent Assoc J 1988 Sep;64(9):487, 489
------------------------------�------------------------------�--
Title: Lyme disease misdiagnosed as a temporomandibular joint disorder.
Authors: Lader E
Source: J Prosthet Dent 1990 Jan;63(1):82-5
Organization:
Abstract:
Craniomandibular disorders cause many pleomorphic and seemingly unrelated
clinical manifestations that mimic other more serious medical problems and thus
can present physicians and dentists with a challenge that invites misdiagnosis
and improper treatment planning. Conversely,
misdiagnosis and ineffective treatment planning are facilitated when serious
medical problems manifest a range of signs and symptoms that are clinically
similar to temporomandibular joint muscle dysfunction At times, the patient's
response to therapy may be the best method of corroborating a diagnosis, as
illustrated in this report of a patient
with Lyme disease that was misdiagnosed as a temporomandibular joint disorder.
Lyme disease has already reached epidemic proportions in several parts of the
United States and its geographic distribution is spreading. Because Lyme
disease is a life-threatening illness whose
clinical manifestations can mimic temporomandibular joint/myofascial
pain-dysfunction, it is the responsibility of every dentist who treats
craniomandibular disorders to become familiar with the clinical presentations
of Lyme disease and more proficient in its differential diagnosis.
Keywords:
Adult, Case Report, Diagnosis, Differential, Female, Human, Lyme
Disease, DIAGNOSIS, DRUG THERAPY, Penicillins, THERAPEUTIC USE,
Temporomandibular Joint Syndrome, DIAGNOSIS
Language: Eng
Unique ID: 90112183
------------------------------�------------------------------�--Title: Lyme
disease misdiagnosed as TMJ syndrome. A case report.
Authors: Lader E
Source: N Y State Dent J 1989 Nov;55(9):46, 48, 50-2
Organization:
Abstract:
Due to the high incidence of Lyme disease, the ease with which it can
be misdiagnosed, and its potential for causing irreversible neurologic or
cardiac complications and fatalities if left untreated, all patients living in
known epidemic areas who manifest intractable facial pain, or what appears to
be a case of temporomandibular joint syndrome that does not respond to therapy
should be tested for Lyme Borelliosis. It should be remembered however, that
not all patients with active Lyme disease produce antibodies, and it is thus
imperative for the clinician to obtain a detailed patient history with a
focused series of questions
directed at the known presentations of the disease, with specific emphasis
placed on the prior appearance of an ECM lesion.
Keywords:
Adult, Case Report, Diagnosis, Differential, Female, Human, Lyme
Disease, DIAGNOSIS, PHYSIOPATHOLOGY, New York, Temporomandibular Joint
Syndrome, DIAGNOSIS
Language: Eng
Unique ID: 90045239
quote:
Originally posted by DJP:
I have a terrible toothache in a tooth that has a cap on it. Don't know if it is Lyme related or not.Anyhow, I remember reading about Lyme affecting teeth on this site. I looked in the newbie links but didn't find anything. Search isn't working for me.
Anyone have any information I can read up on? I'm calling the dentist, but would like to read up on it incase it could be Lyme related.
Thanks