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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

No attempt has been made to deal with all of the various diseases that the dentist has to consider when diagnosing orofacial pain. One of the most important causes of facial pain--so-called temporomandibular joint or myofascial pain dysfunction (MPD) syndrome--has not been mentioned, yet it accounts for many of the patients attending facial pain clinics. There are several textbooks devoted to the MPD and the reader is referred to these for a full description of the condition. Whenever a patient presents for evaluation of orofacial pain the dentist must remember: (1) to take a detailed history of the characteristics of the pain; (2) to complete a full examination of not only the teeth and the oral cavity but also the face, head, and neck; (3) not to assume that the patient in his chair necessarily has a dental condition producing his pain; (4) that if he is unaware of the existence of certain diseases he will never diagnose them!; and (5) to have no hesitation in referring a patient for evaluation rather than perform irreversible dental procedures.
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PMID:Differential diagnosis of orofacial pain. 27 25

Patients with chronic orofacial pain must be treated with methods different from those used with patients with acute pain. If different methods are not used, the characteristics of chronic pain may become firmly entrenched. Dentists should be aware of the various methods of treatment for this separate pain entity.
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PMID:Recognition and treatment of patients with chronic orofacial pain. 29 56

Ultrasonic destruction of the trigeminal spinal nucleus was conducted in 12 patients with the deafferentation orofacial pain syndrome. The etiological factors and clinical manifestations of the deafferentation syndrome are analysed. The surgical techniques of destruction of the trigeminal spinal nucleus and the principles of intraoperative electrophysiological control are described. The length of the nucleus destruction and the clinical effect of the surgical intervention are compared. To relieve pain and dysesthesia in the peri- and intraoral areas the terminal nucleus must be destroyed at the level of the obex of the fourth ventricle.
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PMID:[Ultrasonic destruction of the spinal trigeminal nucleus in the deafferentation orofacial pain syndrome]. 133 4

The two most common types of pain presented to dentists are acute orofacial pain and chronic craniofacial pain. This article presents some newer concepts in the understanding of the pathophysiology of pain. Pain perception, modulation and transmission are briefly described, followed by a discussion of the physiological and biochemical aspects of chronic and recurrent facial pain.
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PMID:The pathophysiology of pain. 138 Feb 64

This prospective cohort study investigated orofacial pain occurring as a manifestation of vincristine neurotoxicity. Forty cancer patients (28 to 63 years of age) receiving vincristine were given baseline interviews and orofacial examinations, which were repeated weekly for 7 weeks of treatment. Twenty-two patients (55%) had neurotoxicity manifesting as orofacial pain. Onset was usually 3 days after vincristine administration; mean duration was 2 days. Twenty patients (50%) were affected in the first week: nine (22%) with severe and five (12%) with moderate pain. Symptoms were mild and infrequent in subsequent weeks. Eighteen control patients receiving chemotherapy without vincristine had no comparable orofacial symptoms. Multiple sites in the distribution of the trigeminal and glossopharyngeal nerves were affected: primarily the temporomandibular joint, mandible, throat, ears, and mandibular teeth. The frequency of orofacial pain increased with younger age. Pain was significantly associated with smaller body surface area (p less than 0.05), indicating a dose-related toxicity, and with sociodemographic variables including smoking (p less than 0.05).
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PMID:Jaw and other orofacial pain in patients receiving vincristine for the treatment of cancer. 140 90

Dental pathology is definitely the most common cause of orofacial pain. Dentists astutely diagnose and treat the various pathologic dental conditions. The restoration of the masticatory system is usually achieved in a proficient, straightforward and predictable manner. Certain patients' orofacial pains do not have a dental etiology and are refractory to treatment. The protean manifestations of temporal arteritis may present with major pain complaints mimicking dental pathology. A case report of such a patient is presented.
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PMID:Temporal arteritis mimics TMJ/myofascial pain syndrome. 143 38

34 patients with chronic idiopathic orofacial pain were assessed by a structured clinical interview for diagnosis of mental disorders according to the Diagnostic and Statistical Manual for Mental Disorders (DSM-III-R). Five (15%) had a history of post traumatic stress disorder (PTSD) which coincided with the pain onset. The majority of these PTSD sufferers also had a personality disorder. The implications of these findings in the diagnosis and management of post-traumatic chronic TMJ pain syndromes is discussed.
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PMID:Prevalence of post-traumatic stress disorder in patients with chronic idiopathic facial pain. 145 Jan 57

The heading craniomandibular disorders covers a wide range of abnormal and pathologic conditions accompanied by orofacial pain and impaired mandibular function, the masticatory muscles and the temporomandibular joints being the structures most frequently involved. Prevalences of severe craniomandibular disorders accompanied by headache and facial pain urgently in need of treatment are 1-2% in children, about 5% in adolescents, and 5-15% in adults, with higher values in women than in men. With respect to physiology and ergonomics, masticatory muscles are comparable to other human skeletal muscles, e.g. of shoulder, neck and lower back. Therefore these muscles share pathogenesis, symptoms and signs of muscular disorders caused by prolonged, low-level static contractions or intermittent isometric contractions at higher levels. Since the same elements of performance in the masticatory muscles are influenced by occlusal factors, they link the development of muscular fatigue, discomfort and pain to the dental occlusion. Furthermore, changes of the occlusal surfaces, e.g. due to dental treatment, may influence the performance of the masticatory muscles, and consequently interfere with local muscular function.
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PMID:Craniomandibular disorders and masticatory muscle function. 155 1

Orofacial pain can have an inflammatory, neurologic or musculoskeletal cause. Inflammatory diseases include dental abscess, sinusitis, temporal arteritis, sialolithiasis and infections of the parotid gland. Common neurologic diseases that cause facial pain are trigeminal neuralgia, glossopharyngeal neuralgia, paratrigeminal neuralgia and cluster headaches. Musculoskeletal causes include temporomandibular joint syndrome and myofascial pain dysfunction syndrome. A clear understanding of pertinent anatomy and an organized approach to diagnosis will facilitate the evaluation of patients with orofacial pain.
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PMID:Orofacial pain: diagnosis and treatment. 136 Jul 64

Chronic orofacial pain often requires pharmacologic treatment in conjunction with surgical, physical, and psychologic treatments. Myofascial pain, neuralgias, vascular pain, and limbic system dysfunction are the elements of orofacial pain that may respond to treatment with nonsteroidal anti-inflammatory drugs, anticonvulsants, membrane-stabilizing and monoaminergic medicines, respectively.
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PMID:Pharmacologic treatment for chronic facial pain. 180 9


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