Orofacial Pain : The New Dental Specialty
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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
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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

 

Reference:

Author

  • Dr Mriganka Sekhar Ghose

    Dr Mriganka Sekhar Ghose is a dental surgeon, a medical researcher, a medical inventor and a medical author. He has done many certificate trainings from the Royal Colleges Of Surgeons of England & Edinburgh.

Dr Mriganka Sekhar Ghose is a dental surgeon, a medical researcher, a medical inventor and a medical author. He has done many certificate trainings from the Royal Colleges Of Surgeons of England & Edinburgh.

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