Orofacial pain

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Orofacial pain
Dermatomes of the face.
MeSH D005157
Orofacial pain is a general term covering any pain which is felt in the mouth, jaws and the
face. Orofacial pain is a common symptom, and there are many causes.
[1]
t is estimated that
over !"# of cases of orofacial pain result from dental causes $i.e. toothache caused
%y pulpitis or a dental a%scess&.
[']
(fter dental pain, the second most common cause of
orofacial pain istemporomandi%ular joint dysfunction $)*+, pain,dysfunction syndrome&.
[-]
(ll
other causes of orofacial pain are rare in comparison, although the fulldifferential diagnosis is
e.tensive.
Contents
[hide]
1 +efinition
' /lassification
- 0pidemiology
1 +ifferential diagnosis
" 2eferences
Definition[edit]
+efined %oundaries of the orofacial pain region.
Orofacial pain has %een defined as 3pain locali4ed to the region a%ove the neck, in front of
the ears and %elow the or%itomeatal line, as well as pain within the oral cavity5 [including]
pain of dental origin and temporomandi%ular disorders3.
[1]
6owever, some orofacial pain
conditions may involve areas outside this region, e.g. temporal pain in )*+. )oothache, or
odontalgia, is any pain perceived in the teeth or their supporting structures $i.e.
the periodontium&. )oothache is therefore a type of orofacial pain. /raniofacial pain is an
overlapping topic which includes pain perceived in the head, face, and related structures,
sometimes including neck pain.
["]
Classification[edit]
)here are 1 main classifications which attempt to classify the causes of orofacial pain, %ut no
system is universally accepted.
[7]

)he nternational /lassification of 6eadache +isorders second edition $/6+,'&, a

pu%lication %y the nternational 6eadache 8ociety.
[9]

)he /lassification of /hronic :ain second edition, a pu%lication %y thenternational

(ssociation for the 8tudy of :ain.
[;]

(merican (cademy of Orofacial :ain

)he 2esearch +iagnostic /riteria for )emporomandi%ular +isorders

$see temporomandi%ular joint dysfunction<diagnostic criteria&.
t has also %een suggested that the most %asic etiologic classification of orofacial pain is into
the following - groups=
[!]
1. :rimarily somatic, arising from musculoskeletal $e.g. )*+ pain or periodontal pain&
or visceral structures $e.g. pulpal pain or pain from the salivary glands&, and
transmitted via an intact pain transmission and modulation system.
'. :rimarily neuropathic, which occurs as a result of a%normal or damaged pain
pathways, e.g. a surgical or traumatic injury to a peripheral nerve.
-. :rimarily psychological, which is rare $8ee= psychogenic pain&.
Epidemiology[edit]
Orofacial pain is common pro%lem. For e.ample, in the >nited 8tates, one report estimated
that ''# of the general population had suffered from some form of facial pain at some point
in the 7 month period %efore ?uestioning, of which 1'# was toothache.
[1@]
n the >nited
Aingdom, 9# of the general population reported having some degree of chronic orofacial
pain.
[11]
Other reports indicate a prevalence of 1@B1"# for )*+ in the general population.
[11]
Differential diagnosis[edit]
This list is incomplete; you can help by expanding it.
+ental causes
:ulpal
:ulpitis
+entin hypersensitivity
/racked tooth syndrome
:eriodontal
:eriapical periodontitis and periapical a%scess
:eriodontal a%scess
:ericoronitis and pericoronal a%scess
Curning mouth syndrome
Oral ulceration $e.g. aphthous stomatitis, erosive oral lichen planus, etc.&
Oral cancer
:ersistent idiopathic facial pain $atypical facial pain&
(typical odontalgia