From Volume 42, Issue 9, November 2015 | Pages 856-865
Orofacial chronic pain provides a significant challenge to all clinicians and the patients seeking treatment for it. Due to the anatomical and regional complexities, diagnosis can be extremely difficult, and due to the lack of cross specialty training, patients will undergo a variety of treatment under different disciplines. Dysfunctional pain provides a unique challenge for patient management and requires a multidisciplinary team.
This is defined as pain that is present one year or longer post-surgical procedure, that is unexplained by local factors and is best described as neuropathic in nature.
Non-odontogenic dysfunctional pain is often difficult to diagnose because it is poorly understood.1 Even defining and categorizing such persistent pain is challenging. Non-odontogenic pain may represent half of all cases of persistent tooth pain, as shown by a recent systematic review of prospective studies that reported the frequency of non-odontogenic pain in patients who had undergone endodontic procedures. Non-odontogenic pain was defined as dento-alveolar pain present for 6 months or more after endodontic treatment without evidence of dental pathology. Endodontic procedures reviewed were non-surgical root canal treatment, retreatment, and surgical root canal treatment: 770 articles were retrieved and reviewed, 10 met the inclusion criteria with a total of 3,343 teeth enrolled within the included studies; 1,125 had follow-up information regarding pain status. The authors identified non-odontogenic pain in 3.4% (95% confidence interval, 1.4–5.5% frequency of occurrence).2
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