Abstract
Chronic orofacial pain (COFP) is an umbrella term used to describe painful regional syndromes with a chronic, unremitting pattern. This is a convenience term, similar to chronic daily headaches, but is of clinically questionable significance: syndromes that make up COFP require individually tailored diagnostic approaches and treatment. Herein we describe the three main categories of COFP: musculoskeletal, neurovascular, and neuropathic. For many years, COFP and headache have been looked upon as discrete entities. However, we propose the concept that because COFP and headaches share underlying pathophysiological mechanisms, clinical characteristics, and neurovascular anatomy, they should be classified together.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Macfarlane TV, Blinkhorn AS, Davies RM, et al.: Orofacial pain: just another chronic pain? Results from a population-based survey. Pain 2002, 99:453–458.
•• Sharav Y, Benoliel R: Orofacial Pain and Headache. Edinburgh: Mosby Elsevier; 2008. This is the first text that integrates orofacial pain at pathophysiological, clinical, and classification levels.
Benoliel R, Sharav Y, Tal M, Eliav E: Management of chronic orofacial pain: today and tomorrow. Compend Contin Educ Dent 2003, 24:909–920, 922–924, 926–928 passim; quiz 932.
Goulet JP, Lavigne GJ, Lund JP: Jaw pain prevalence among French-speaking Canadians in Quebec and related symptoms of temporomandibular disorders. J Dent Res 1995, 74:1738–1744.
Gesch D, Bernhardt O, Alte D, et al.: Prevalence of signs and symptoms of temporomandibular disorders in an urban and rural German population: results of a population-based Study of Health in Pomerania. Quintessence Int 2004, 35:143–150.
Dworkin SF, LeResche L: Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992, 6:301–355.
de Leeuw R (Ed): Orofacial Pain: Guidelines for Assessment, Classification, and Management. The American Academy of Orofacial Pain. Chicago: Quintessence Publishing Co., Inc.; 2008.
Svensson P, Bak J, Troest T: Spread and referral of experimental pain in different jaw muscles. J Orofac Pain 2003, 17:214–223.
•• Benoliel R, Birman N, Eliav E, Sharav Y: The International Classification of Headache Disorders: accurate diagnosis of orofacial pain? Cephalalgia 2008, 28:752–762. This article offers a careful analysis of the IHS classification system as it relates to the diagnosis of orofacial pain. It also examines MMP and NVOP, both entities less known to headache specialists.
Gerschman JA: Chronicity of orofacial pain. Ann R Australas Coll Dent Surg 2000, 15:199–202.
Dworkin SF, Huggins KH, LeResche L, et al.: Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. J Am Dent Assoc 1990, 120:273–281.
Alstergren P, Kopp S: Prostaglandin E2 in temporomandibular joint synovial fluid and its relation to pain and inflammatory disorders. J Oral Maxillofac Surg 2000, 58:180–186; discussion 186–188.
Nitzan D, Benoliel R, Heir G, Dolwick F: Pain and dysfunction of the temporomandibular joint. In Orofacial Pain and Headache. Edited by Sharav Y, Benoliel R. Edinburgh: Mosby Elsevier; 2008:149–192.
de Leeuw R, Boering G, Stegenga B, de Bont LG: Radiographic signs of temporomandibular joint osteoarthrosis and internal derangement 30 years after nonsurgical treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995, 79:382–392.
Benoliel R, Sharav Y: Paroxysmal hemicrania. Case studies and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998, 85:285–292.
van Vliet JA, Eekers PJ, Haan J, Ferrari MD: Features involved in the diagnostic delay of cluster headache. J Neurol Neurosurg Psychiatry 2003, 74:1123–1125.
Benoliel R, Elishoov H, Sharav Y: Orofacial pain with vascular-type features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997, 84:506–512.
Daudia AT, Jones NS: Facial migraine in a rhinological setting. Clin Otolaryngol Allied Sci 2002, 27:521–525.
Penarrocha M, Bandres A, Penarrocha M, Bagan JV: Lower-half facial migraine: a report of 11 cases. J Oral Maxillofac Surg 2004, 62:1453–1456.
Hussain A, Stiles MA, Oshinsky ML: Pain remapping in migraine: a novel characteristic following trigeminal nerve injury. Headache 2009 April 27 (Epub ahead of print).
Harriott AM, Gold MS: Serotonin type 1D receptors (5HTR) are differentially distributed in nerve fibres innervating craniofacial tissues. Cephalalgia 2008, 28:933–944.
Bartsch T, Knight YE, Goadsby PJ: Activation of 5-HT(1B/1D) receptor in the periaqueductal gray inhibits nociception. Ann Neurol 2004, 56:371–381.
Olesen J, Bousser MG, Diener HC, et al.: The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004, 24(Suppl 1):24–150.
Nurmikko TJ, Eldridge PR: Trigeminal neuralgia–pathophysiology, diagnosis and current treatment. Br J Anaesth 2001, 87:117–132.
Tyler-Kabara EC, Kassam AB, Horowitz MH, et al.: Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: comparison of results following microvascular decompression. J Neurosurg 2002, 96:527–531.
Benoliel R, Sharav Y: Trigeminal neuralgia with lacrimation or SUNCT syndrome? Cephalalgia 1998, 18:85–90.
Sjaastad O, Pareja JA, Zukerman E, et al.: Trigeminal neuralgia. Clinical manifestations of first division involvement. Headache 1997, 37:346–357.
Fromm GH, Graff-Radford SB, Terrence CF, Sweet WH: Pre-trigeminal neuralgia. Neurology 1990, 40:1493–1495.
Scala A, Checchi L, Montevecchi M, et al.: Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 2003, 14:275–291.
• Patton LL, Siegel MA, Benoliel R, De Laat A: Management of burning mouth syndrome: systematic review and management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007, 103(Suppl):S39.e1–13. This article contains a meta-analysis of evidence-based treatments for BMS.
Zakrzewska JM, Forssell H, Glenny AM: Interventions for the treatment of burning mouth syndrome. Cochrane Database Syst Rev 2005:CD002779.
Carlson CR, Miller CS, Reid KI: Psychosocial profiles of patients with burning mouth syndrome. J Orofac Pain 2000, 14:59–64.
Benoliel R, Birenboim R, Regev E, Eliav E: Neurosensory changes in the infraorbital nerve following zygomatic fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005, 99:657–665.
Polycarpou N, Ng YL, Canavan D, et al.: Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing. Int Endod J 2005, 38:169–178.
Gregg JM: Neuropathic complications of mandibular implant surgery: review and case presentations. Ann R Australas Coll Dent Surg 2000, 15:176–180.
Cheung LK, Lo J: The long-term clinical morbidity of mandibular step osteotomy. Int J Adult Orthodon Orthognath Surg 2002, 17:283–290.
Walton JN: Altered sensation associated with implants in the anterior mandible: a prospective study. J Prosthet Dent 2000, 83:443–449.
Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C: Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1117 surgical extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001, 92:377–383.
Berge TI: Incidence of chronic neuropathic pain subsequent to surgical removal of impacted third molars. Acta Odontol Scand 2002, 60:108–112.
Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C: Lingual nerve damage after third lower molar surgical extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000, 90:567–573.
Campbell RL, Parks KW, Dodds RN: Chronic facial pain associated with endodontic therapy. Oral Surg Oral Med Oral Pathol 1990, 69:287–290.
Benoliel R, Eliav E, Tal M: No sympathetic nerve sprouting in rat trigeminal ganglion following painful and non-painful infraorbital nerve neuropathy. Neurosci Lett 2001, 297:151–154.
Fried K, Bongenhielm U, Boissonade FM, Robinson PP: Nerve injury-induced pain in the trigeminal system. Neuroscientist 2001, 7:155–165.
Benoliel R, Eliav E, Sharav Y: Self-reports of pain-related awakenings in persistent orofacial pain patients. J Orofac Pain 2009, 23:330–338.
Macfarlane TV, Blinkhorn AS, Craven R, et al.: Can one predict the likely specific orofacial pain syndrome from a self-completed questionnaire? Pain 2004, 111:270–277.
Dando WE, Branch MA, Maye JP: Headache disability in orofacial pain patients. Headache 2006, 46:322–326.
Storm C, Wanman A: Temporomandibular disorders, headaches, and cervical pain among females in a Sami population. Acta Odontol Scand 2006, 64:319–325.
Disclosure
No potential conflicts of interest relevant to this article were reported.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Benoliel, R., Sharav, Y. Chronic Orofacial Pain. Curr Pain Headache Rep 14, 33–40 (2010). https://doi.org/10.1007/s11916-009-0085-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11916-009-0085-y