Towards a new taxonomy of idiopathic orofacial pain

Abstract

There is no current consensus on the taxonomy of the different forms of idiopathic orofacial pain (stomatodynia, atypical odontalgia, atypical facial pain, facial arthromyalgia), which are sometimes considered as separate entities and sometimes grouped together. In the present prospective multicentric study, we used a systematic approach to help to place these different painful syndromes in the general classification of chronic facial pain. This multicenter study was carried out on 245 consecutive patients presenting with chronic facial pain (>4 months duration). Each patient was seen by two experts who proposed a diagnosis, administered a 111-item questionnaire and filled out a standardized 68-item examination form. Statistical processing included univariate analysis and several forms of multidimensional analysis. Migraines (n=37), tension-type headache (n=26), post-traumatic neuralgia (n=20) and trigeminal neuralgia (n=13) tended to cluster independently. When signs and symptoms describing topographic features were not included in the list of variables, the idiopathic orofacial pain patients tended to cluster in a single group. Inside this large cluster, only stomatodynia (n=42) emerged as a distinct homogenous subgroup. In contrast, facial arthromyalgia (n=46) and an entity formed with atypical facial pain (n=25) and atypical odontalgia (n=13) could only be individualised by variables reflecting topographical characteristics. These data provide grounds for an evidence-based classification of idiopathic facial pain entities and indicate that the current sub-classification of these syndromes relies primarily on the topography of the symptoms.

Ati̇pi̇k Di̇ş Ağrisi

“…17 Son yıllardaki literatürlerde migren ve atipik diş ağrısı ilişkisinin çok fazla olmadığı görülmüş ve bu teori bilimsel olarak desteklenmemiştir. 16,18 …”

An update on pain

“…The main categories are topographical (odontogenic versus non-odontogenic) and chronic versus acute. A recent cluster analysis 6 (Fig. 3) has revolutionised the way many of or ophthalmic division pain, compris ing mainly of headaches and giant cell arteritis.…”

Case studies illustrating the management of trigeminal neuropathic pain using topical 5% lidocaine plasters

“…2 Sensory nerve injury in post-traumatic neuralgia often results not only in numbness, which is a common misapprehension, but also in altered sensation and or pain ( Table 2). The impact of trigeminal pain is often underestimated, commonly interfering with speech, eating, kissing, make-up application, shaving and drinking; in fact, just about every social interaction we take for granted.…”