Advances in the dental and surgical management of orofacial pain

Research and clinical observations of the last two to three decades have broadened our understanding of the heterogeneity of orofacial pain. Often, the underlying cause of such pain is not a disorder of the masticatory system but various pathologies in other structures of the head and neck. Sometimes the pain is referred from distant organs (e.g., the heart), or it can be an ectopic manifestation of primary headaches. Several of these conditions do not present with specific signs and do not have biomarkers, and a comprehensive pain history thus becomes central in the differential diagnostic process, as noted in Chapter 6. This chapter highlights recent advances in the dental and surgical management of pain originating from structures of the masticatory system (e.g., teeth, muscles, and temporomandibular joint [TMJ]) or from damage to the trigeminal nerve. As with all other clinical recommendations of treatments or medications, the astute clinician must consider the material discussed here as merely one source of information that must be updated as new studies are published and integrated with patient-specific factors such as the medical history.