Differential diagnosis for orofacial pain, including sinusitis, TMD, trigeminal neuralgia.

@article{Hegarty2011DifferentialDF,
  title={Differential diagnosis for orofacial pain, including sinusitis, TMD, trigeminal neuralgia.},
  author={Anne M. Hegarty and Joanna M. Zakrzewska},
  journal={Dental update},
  year={2011},
  volume={38 6},
  pages={
          396-400, 402-3, 405-6 passim
        }
}
UNLABELLED Correct diagnosis is the key to managing facial pain of non-dental origin. Acute and chronic facial pain must be differentiated and it is widely accepted that chronic pain refers to pain of 3 months or greater duration. Differentiating the many causes of facial pain can be difficult for busy practitioners, but a logical approach can be beneficial and lead to more rapid diagnoses with effective management. Confirming a diagnosis involves a process of history-taking, clinical… 

Figures and Tables from this paper

Multi-dimensionality of chronic pain of the oral cavity and face

Facial pain patients should be managed by a multidisciplinary team using accepted pharmacotherapy with psychological support and a combination of antidepressants and cognitive behaviour therapy is effective.

Orofacial Pain: A Guide for the Headache Physician

A holistic approach to orofacial pain management is important, and the social, cultural, psychological and cognitive context of each patient needs to be considered in the process of diagnostic formulation, as well as in the development of a pain management plan according to the biopsychosocial model.

Various diagnostic possibilities for zygomatic arch pain: Seven case reports and review of literature.

Zygomatic arch pain is a common complaint encountered in the orofacial pain clinic but may lead to misdiagnosis, and Clinicians must have in-depth knowledge of the possible differential diagnoses and evaluation tools.

Pain Part 3: Acute Orofacial Pain.

The mechanisms underlying the pain experience, diagnosis and subsequent management of acute trigeminal pain are discussed, encompassing pre-, peri- and post-operative analgesia.

Orofacial pain: an enigma for diagnosis and treatment; a prospective clinical study

Chronic orofacial pain is a diagnostic challenge and it is possible therefore to make a misdiagnosis Multidisciplinary OFP assessment ideally also includes psychometrics, pain profiling, quantitative sensory testing, haematology and imaging where indicated.

Orofacial pain: An update on differential diagnosis

The differential diagnosis of Orofacial pain is discussed, which is a challenge to the clinician to make a proper diagnosis thereby providing an optimal treatment.

Orofacial Pain- Challenge To Dental Surgeons

Orofacial pain constitutes any symptom that occurs from a large number of disorders and diseases that result in a sensation of discomfort or pain felt in the region of face, mouth, nose, ears, eyes, neck, and head.

Comparison of patients with orofacial pain caused by trigeminal neuralgia and/or temporomandibular joint disorder

A thorough clinical evaluation of symptoms as well as MRI as the gold standard for TMJ diagnostics also includes a neurological examination in cases of uncommon orofacial pain conditions.

Orofacial Pain- How Do We Classify Orofacial Pain?

There is an urgent need for a robust classification system for orofacial pain recently emphasized by the confusion arising amongst dental practitioners understanding of chronic oroFacial pain conditions and the preliminary report of a working group in this area is thrown a light on the various classifications published so far.

Systemic considerations for orofacial neuropathy

The prevalence, pathophysiology, clinical presentations and management of these conditions will be reviewed and infectious and autoimmune diseases with orofacial neuropathic manifestations such as post-herpetic neuralgia, paroxysmal neuralgias, painful trigeminal sensory neuropathies, peripheral neuritis and oral dysaesthesia will be discussed.

References

SHOWING 1-10 OF 38 REFERENCES

Diagnosis and Management of Non-Dental Pain

Careful history-taking improves diagnosis of non dental orofacial pain, a not uncommon group of conditions, and some form of classification is useful when attempting to make a diagnosis to facilitate treatment decisions and predict future outcome.

Diagnosis and management of non-dental orofacial pain.

Although the majority of pain seen in general dental practice is dental in origin, chronic non-dental orofacial pain must be recognized as its management is entirely different.

Facial pain: an update

  • J. Zakrzewska
  • Medicine, Psychology
    Current opinion in supportive and palliative care
  • 2009
The first international guidelines on management of trigeminal neuralgia have now been published and should help all clinicians seeing patients seeing these patients.

Practice Parameter: The diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review)

Routine head imaging identifies structural causes in up to 15% of patients and may be considered useful in distinguishing STN from classic trigeminal neuralgia and the role of surgery vs pharmacotherapy in the management of TN in patients with MS remains uncertain.

AAN‐EFNS guidelines on trigeminal neuralgia management

Carbamazepine or oxcarbazepine should be offered as first‐line treatment for pain control and microvascular decompression may be considered over other surgical techniques to provide the longest duration of pain freedom in patients with TN.

Management of burning mouth syndrome: systematic review and management recommendations.

Pain and the quality of life in patients referred to a craniofacial pain unit.

The data indicated that facial pain had a substantial impact on daily life and that its most common outcomes were psychologic and musculoskeletal based.

Neuropathic Pain

Head-to-head clinical trials comparing NP therapies are needed to help assess the relative clinical efficacy of treatments, ideally using HR-QOL and utility outcomes, and to facilitate future cost-effectiveness research in NP.

Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner.

It was not their purpose to present a thorough and critical review of the vast amount of literature available but to summarize the at-present generally accepted clinical approach.

Diurnal variation in pain reports in temporomandibular disorder patients and control subjects.

Self-reported pain patterns may not be used to reliably infer the times when parafunctional activities occur, and the presence of lower pain levels during the weekend probably reflects reduction in psychosocial stressors associated with the work week.