Orofacial Pain : The New Dental Specialty

All About Orofacial Pain

• Orofacial Pain as a recognized dental specialty
• Importance of understanding orofacial pain assessment, diagnosis, and treatment

Evaluation of Orofacial Pain Patients:

1. Medical and Dental History

• Gathering detailed information on medical and dental background

1. Chief Complaint and Pain History

• Factors to consider: pain quality, duration, affected side, initiating/exacerbating/relieving factors, associated symptoms

1. Physical Examination

• Vital signs, intraoral examination, head & neck examination, cranial nerve assessment

1. Radiological and Other Special Investigations

• Cranial nerve screening examination, laboratory blood examination, MRI, bone scan

Definition of Pain and Classification by Origin:

• Pain as an unpleasant sensation transmitted to the central nervous system
• Classification into three main categories: somatic pain, neuropathic pain, and psychogenic pain

Causes of Orofacial Pain:

I) Local Causes (Somatic)

• Diseases affecting teeth, periodontium, oral mucosa, jaws, antrum, salivary glands, TMJ, ears, eyes, sinuses, nasopharynx

II) Neurological Causes (Neuropathic)

• Trigeminal Neuralgia, Glossopharyngeal Neuralgia, Herpes Zoster, Post Herpetic Neuralgia, Geniculate Herpes, Bell’s Palsy, Intracranial Tumors, Causalgia

III) Psychogenic Causes

• Atypical Odontalgia, Atypical Facial Pain, Burning Mouth Syndrome

1. IV) Vascular Causes

• Migraine, Periodic Migranous Neuralgia, Referred Pain

Neurologic Pain:

• Trigeminal Neuralgia: Characteristics, drug and procedural treatments
• Peri Trigeminal Neuralgia: Aching dental pain without abnormalities
• Vagoglossopharyngeal Neuralgia: Radiating pain and treatment options
• Herpes Zoster and Post Herpetic Neuralgia: Symptoms and treatments
• Geniculate Herpes (Ramsay Hunt Syndrome): Eruption and surgical options
• Bell’s Palsy: Unilateral facial palsy and antiviral treatments
• Multiple Sclerosis and Causalgia: Treatment approaches

Pain of Vascular Origin:

• Migraine: Types, symptoms, and treatment options
• Periodic Migranous Neuralgia: Triggers and treatment methods
• Giant Cell Arteritis: Symptoms, ocular involvement, and treatment

Somatic Pain:

• Maxillary Antrum/Nasopharynx: Sinusitis, malignancy, and related pain
• Salivary Glands: Infection and duct obstruction
• Oral Mucosa: Zoster and geniculate herpes
• Jaw/Masticatory Muscles: TMJ disorders, including myofascial pain dysfunction syndrome, osteoarthritis, and more

Psychogenic Pain:

• Atypical Facial Pain: Symptoms, prevalence, and treatment options
• Atypical Odontalgia: Similarities to atypical facial pain
• Burning Mouth Syndrome: Symptoms, diagnostic tests, and treatment approaches

Conclusion:

• Orofacial pain as an evolving field within dentistry
• Importance of comprehensive evaluation and understanding of pain classification
• Diverse causes of orofacial pain and their respective treatments
• Continued advancements in research and specialized training for optimal patient care

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