Abstract
Atypical facial pain is an unrecognised and unhelpful diagnosis but one which describes chronic pains that do not fit the present classification system. Due to the site of the pain, patients may seek and, indeed, receive treatment from dental practitioners and specialists, but the pain is often unresponsive and may have more in common with unexplained medical symptoms affecting other areas of the body, than with other dental symptoms. This review suggests a need for a diagnostic category of "chronic facial pain", which demands a multidisciplinary approach to diagnosis and management.
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Selected References
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- Barsky A. J., Borus J. F. Somatization and medicalization in the era of managed care. JAMA. 1995 Dec 27;274(24):1931–1934. [PubMed] [Google Scholar]
- Clark N. M., Gong M. Management of chronic disease by practitioners and patients: are we teaching the wrong things? BMJ. 2000 Feb 26;320(7234):572–575. doi: 10.1136/bmj.320.7234.572. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Derbyshire S. W., Jones A. K., Devani P., Friston K. J., Feinmann C., Harris M., Pearce S., Watson J. D., Frackowiak R. S. Cerebral responses to pain in patients with atypical facial pain measured by positron emission tomography. J Neurol Neurosurg Psychiatry. 1994 Oct;57(10):1166–1172. doi: 10.1136/jnnp.57.10.1166. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dohrenwend B. P., Raphael K. G., Marbach J. J., Gallagher R. M. Why is depression comorbid with chronic myofascial face pain? A family study test of alternative hypotheses. Pain. 1999 Nov;83(2):183–192. doi: 10.1016/s0304-3959(99)00100-1. [DOI] [PubMed] [Google Scholar]
- Donovan J. L., Blake D. R. Qualitative study of interpretation of reassurance among patients attending rheumatology clinics: "just a touch of arthritis, doctor?". BMJ. 2000 Feb 26;320(7234):541–544. doi: 10.1136/bmj.320.7234.541. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Feinmann C., Harris M. Psychogenic facial pain. Part 2: Management and prognosis. Br Dent J. 1984 Mar 24;156(6):205–208. doi: 10.1038/sj.bdj.4805304. [DOI] [PubMed] [Google Scholar]
- Feinmann C. The long-term outcome of facial pain treatment. J Psychosom Res. 1993 May;37(4):381–387. doi: 10.1016/0022-3999(93)90140-b. [DOI] [PubMed] [Google Scholar]
- Graff-Radford S. B., Solberg W. K. Atypical odontalgia. J Craniomandib Disord. 1992 Fall;6(4):260–265. [PubMed] [Google Scholar]
- Hamilton J., Campos R., Creed F. Anxiety, depression and management of medically unexplained symptoms in medical clinics. J R Coll Physicians Lond. 1996 Jan-Feb;30(1):18–20. [PMC free article] [PubMed] [Google Scholar]
- Madland G., Feinmann C., Newman S. Factors associated with anxiety and depression in facial arthromyalgia. Pain. 2000 Feb;84(2-3):225–232. doi: 10.1016/s0304-3959(99)00210-9. [DOI] [PubMed] [Google Scholar]
- Magni G. On the relationship between chronic pain and depression when there is no organic lesion. Pain. 1987 Oct;31(1):1–21. doi: 10.1016/0304-3959(87)90002-9. [DOI] [PubMed] [Google Scholar]
- Marbach J. J. Is phantom tooth pain a deafferentation (neuropathic) syndrome? Part I: Evidence derived from pathophysiology and treatment. Oral Surg Oral Med Oral Pathol. 1993 Jan;75(1):95–105. doi: 10.1016/0030-4220(93)90413-x. [DOI] [PubMed] [Google Scholar]
- Mock D., Frydman W., Gordon A. S. Atypical facial pain: a retrospective study. Oral Surg Oral Med Oral Pathol. 1985 May;59(5):472–474. doi: 10.1016/0030-4220(85)90086-6. [DOI] [PubMed] [Google Scholar]
- Pettengill C. A., Reisner-Keller L. The use of tricyclic antidepressants for the control of chronic orofacial pain. Cranio. 1997 Jan;15(1):53–56. doi: 10.1080/08869634.1997.11745992. [DOI] [PubMed] [Google Scholar]
- Raphael K., Marbach J. J. Evidence-based care of musculoskeletal facial pain: implications for the clinical science of dentistry. J Am Dent Assoc. 1997 Jan;128(1):73–79. doi: 10.14219/jada.archive.1997.0028. [DOI] [PubMed] [Google Scholar]
- Romano J. M., Turner J. A. Chronic pain and depression: does the evidence support a relationship? Psychol Bull. 1985 Jan;97(1):18–34. [PubMed] [Google Scholar]
- Sharav Y., Singer E., Schmidt E., Dionne R. A., Dubner R. The analgesic effect of amitriptyline on chronic facial pain. Pain. 1987 Nov;31(2):199–209. doi: 10.1016/0304-3959(87)90036-4. [DOI] [PubMed] [Google Scholar]
- Wessely S., Nimnuan C., Sharpe M. Functional somatic syndromes: one or many? Lancet. 1999 Sep 11;354(9182):936–939. doi: 10.1016/S0140-6736(98)08320-2. [DOI] [PubMed] [Google Scholar]