Chapter

Orofacial pain

Tara Renton and Joanna Zakrzewska

in Oxford Textbook of Anaesthesia for Oral and Maxillofacial Surgery

Published on behalf of Oxford University Press

Published in print June 2010 | ISBN: 9780199564217
Published online July 2011 | e-ISBN: 9780199697854 | DOI: http://dx.doi.org/10.1093/med/9780199564217.003.0022

Series: Oxford Textbook in Anaesthesia

 Orofacial pain

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Orofacial pain is effectively pain within the trigeminal system. The trigeminal nerve supplies general sensory supply to face, scalp, and mouth. A vast proportion of the sensory cortex represents the trigeminal input (over 40%). The trigeminal sensory region is very complex, incorporating the cranium, ears, eyes, sinuses, nose, pharynx, infratemporal fossa, jaw joint, teeth, jaws, salivary glands, oral mucosa, and skin. As many medical students are rarely exposed to ear, nose, and throat (ENT), otolaryngology, and dentistry, this region remains an enigma to most, with their singular experience of trigeminal pain being based on trigeminal neuralgia in relation to neurosurgical procedures.

Chronic orofacial pain syndromes represent a diagnostic challenge for any practitioner. Patients are frequently misdiagnosed or attribute their pain to a prior event such as a dental procedure, ENT problem or facial trauma. Psychiatric symptoms of depression and anxiety are prevalent in this population and compound the diagnostic conundrum. Treatment is less effective than in other pain syndromes, thus often requires a multidisciplinary approach to address the many facets of this pain syndrome.

Chapter.  11372 words.  Illustrated.

Subjects: Anaesthetics ; Pain Medicine

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