You have chronic pain in your teeth. Any action that requires concentration (e.g., maintaining a spell) requires a successful DC 10 + (IE) Constitution saving throw per round to maintain concentration. The pain makes talking difficult, causing a penalty of −(IE) on social Charisma checks, and spells with a verbal component require a successful DC 8 + (IE) Dexterity check to cast successfully. Because this also causes eating difficulty, you must succeed on a DC 8 + (IE) Constitution saving throw to maintain concentration while eating or drinking. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.

Real-world Examples

Gingivitis, Tooth Decay, Periodontitis, Atypical Odontalgia, Charcot-Marie-Tooth Disorder, Amelogenesis Imperfecta

Assistive Options

Sucking on a piece of ice can reduce the IE by 1 while the ice remains in the mouth and wears off 1 minute after the ice melts or is removed.

Magical Assistance

A healing spell can target the teeth and reduce the IE by 2 for 1 hour instead of regaining hp.

The inside of your mouth has decay, including your gums and/or lining. It causes halitosis (GM discretion on social interactions), and every twenty-eight days, the player must roll above the IE on 1d20 or lose a tooth (Roll 1d20 for location: 1−10 top row left-right, 11–20 bottom row left-right).

Real-world Examples

Gingivitis, Periodontitis, Malnutrition

Assistive Options

Normally, this is managed by hygiene and diet, but this awareness requires a technological level not normally available in a fantasy RPG world.