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Quintessence Publishing: Journals: OFPH
Journal of Oral & Facial Pain and Headache

Edited by Barry J. Sessle, BDS, MDS, BSc, PhD, FRSC

Official Journal of the American Academy of Orofacial Pain,
the European, Asian, and Ibero-Latin Academies of Craniomandibular
Disorders, and the Australian Academy of Orofacial Pain

ISSN 2333-0384 (print) • ISSN 2333-0376 (online)

Fall 2004
Volume 18 , Issue 4

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Management Issues of Neuropathic Trigeminal Pain From a Dental Perspective

Edmond Truelove, DDS, MSD

Pages: 374 - 380
PMID: 15636023

Neuropathic trigeminal pain conditions are more common than is generally appreciated. Sites inside the mouth as well as involvement of extraoral tissues are common manifestations of these disorders. There is a general lack of recognition of the complex characteristics of neuropathic trigeminal pain that frequently lead to mischaracterization of the nature of the complaint. Dentists are in an excellent position to detect the presence of neuropathic trigeminal pain and help to provide a rational diagnosis. The high prevalence of orofacial pain of dental origin and the dramatic similarities between neuropathic orofacial pain and odontogenic and other pathologic pains in the region frequently lead to incorrect diagnoses and, more importantly, inappropriate treatments that are frequently invasive and irreversible. The records of patients presenting with neuropathic pain at our university pain clinic were reviewed to gain insight into dental factors as they related to the etiology, presentation, diagnosis, and management of neuropathic pain of the trigeminal system. Relative to etiology, the records review revealed that most onsets were associated with a specific dental treatment or odontogenic symptom that resulted in a dental diagnosis or treatment. Initial treatment modalities that either caused the pain or were used to address painful symptoms commonly included replacement of restorations, endodontic therapy, apicectomy, extraction, splint therapy, and occlusal equilibration. Correct diagnosis, and particularly early definitive diagnosis, of neuropathic trigeminal pain is crucial to avoid invasive and potentially more damaging forms of treatment.

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