Pain inside the cheek

There are nerves, ligaments, lymph nodes and muscles in the cheek area. Inflammation in some of these areas will cause pain and may even cause mumps. Mumps is the most obvious disease that causes cheek pain and is also the most common. It can cause measles, influenza, and even fever and dizziness.

Pathological etiology

Mumps virus belongs to the same paramyxovirus family as parainfluenza, measles, respiratory syncytial virus and other viruses. It is a ribonucleic acid (RNA) type. It was isolated from the saliva of patients in 1934 and successfully infected monkeys and "volunteers". The virus diameter is 85 to 300 nm, with an average of 140 nm. It is very sensitive to physical and chemical factors. 1% cresol soap solution, 70% ethanol, 0.2% formaldehyde solution, etc. can inactivate it within 2 to 5 minutes, and it dies quickly when exposed to ultraviolet rays. Its activity can be maintained for 2 months at 4°C and for 24 hours at 37°C. It loses its activity after 10 to 20 minutes when heated to 55 to 60°C. It has considerable resistance to low temperatures. The virus is found only in humans but can be propagated in monkeys, chicken embryos, amniotic membranes, and various human and monkey tissue cultures. Monkeys are most susceptible to this virus. The virus has a stable antigenic structure and has only one serotype. But there are six genotypes, namely A to F. In 1998, Chinese scholars discovered a new genotype with differences ranging from 0.8% to 4.5% at the nucleotide level and from 3.5% to 12.3% at the amino acid level.

The nucleocapsid protein of mumps virus has a soluble antigen (S antigen), and its outer surface contains neuraminidase and a hemagglutinin glycoprotein, which has a viral antigen (V antigen). The S antigen and V antigen each have their corresponding antibodies. S antibody appears on the 7th day after onset, reaches a peak within 2 weeks, and then gradually decreases, lasting for 6 to 12 months. It can be measured by complement fixation method. S antibody is not protective.

V antibody appears relatively late and can only be detected 2 to 3 weeks after onset. It reaches its peak after 1 to 2 weeks, but exists for a long time. It can be detected by complement fixation, hemagglutination inhibition and neutralizing antibody methods. It is the best indicator for detecting immune response. V antibody has a protective effect. After infection with the mumps virus, an immune response can be produced regardless of whether the disease develops or not, and reinfection with the disease is rare.

In the early stages of the disease, mumps virus can be isolated from saliva, blood, cerebrospinal fluid, urine or thyroid. This virus rarely mutates, and the antigenicity of each strain is very similar.