Patient with Chronic Orofacial Pain in a Private Dental Office - Diagnostic Dilemmas

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Patients with chronic orofacial pain (COP), which means pain lasting almost always more than six months and serving no obvious purpose, very often present a quite diagnostic dilemmas. In some instances, this may especially create problem in a private dental office as various variants and manifestations of COP should be treated differently.

COP may have several clinical manifestations; however, it is usually classified in three basic categories: (1) neural pain, caused by functional or structural irregularities within neural components; (2) somatic pain, caused by disturbances within the muscular/skeletal system; and (3) atypical pain, mainly caused by emotional stress and consequent changes of psychological response.

Diagnosis and treatment of any kind of COP should be undertaken only after thorough and meticulous diagnostic procedures, preferably done multidisciplinary in institutions particularly orientated to the treatment of COP syndromes. Choice of treatment method should be directed to control the basic cause of chronic pain, which is ascertained by detailed clinical assessment, and fully adjusted to the particular needs of each patient. That is why the treatment of most frequent chronic orofacial syndromes - paroxysmal trigeminal neuralgia, temporomandibular joint pain dysfunction syndrome, and atypical pains - after diagnosis of chronic pain made in a private dental office, should be often, and preferably, done in institutions particularly orientated to the treatment of COP syndromes.

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