[6] Because of these unique mechanisms and the requirement for specialist knowledge of the complex anatomy and physiology of the orofacial PLX-4720 mw region, diagnosis may be difficult. Many patients have consulted multiple clinicians for their condition yet remain undiagnosed or with an incorrect diagnosis.[7, 8] Our aim is to provide the headache physician with a guide to orofacial pain presentations and diagnoses informed by our clinical experience in the fields of medicine as well as dentistry, and to review the literature relevant to these conditions. We provide an overview of the common presentations of orofacial pain including dental causes of pain, non-dental causes of intraoral pain, and extraoral facial pain syndromes,
as the signs and symptoms of many of these conditions can overlap significantly, causing diagnostic difficulty. We also present a discussion of history, diagnosis, and management considerations relating to the biopsychosocial model of diagnostic formulation and management. This approach is particularly relevant and important in the field of orofacial pain given the significant level of psychological distress and social dysfunction that is associated with these disorders.[9, 10] As with other types of chronic pain, there is often
a mismatch between the patient’s expectation of a cure for their pain, and the reality that for many types of chronic pain, a cure is seldom possible. Medicine alone does not have the tools to manage a condition that has a neurophysiological cause but is also experienced emotionally, socially, financially, and spiritually.[11] Recognition of psychological comorbidities click here is essential for appropriate diagnosis and successful pain management. This is a narrative, clinically orientated review of orofacial pain conditions encountered in a specialist orofacial pain clinic, with references to relevant literature. Quotations from patients are included to illustrate relevant points Orotic acid as these also form part of the evidence base.[12] The types of orofacial pain have been divided into sections as
shown in Figure 1 —. Information regarding dental causes of orofacial pain is included as this area is often unfamiliar to medical practitioners. Evidence-based management options, as far as possible, for the specific diagnoses are summarized and presented in a tabulated form (Table). In the second half of the paper, we discuss holistic management approaches to orofacial pain. There are few causes for dental pain; however, because of significant neural convergence in the jaws and face, it may be referred, poorly localized, or misdiagnosed. The 4 major causes of dental pain are pulpitis, cracked tooth syndrome, dental abscess, and dentine sensitivity.[13] These are often acute conditions, but because they are common, they may coexist with other chronic pains.[14] Both the dental pulp and periodontal ligament contain nociceptors.