Chronic Orofacial Pain Management

Abstract

Chronic orofacial pain is a multifactorial stressful condition. It devastates patients’ lives and depletes medical and dental services. Assertion of a particular effective pharmacological treatment is difficult due to psychological involvement and variation of pain etiology. Proper diagnosis plays a crucial role in determining the proper therapeutic agent. Pharmacological therapy is the first-line treatment of chronic orofacial pain with multiple drug classes to consider. This review aimed to focus on temporomandibular joint-related chronic orofacial pain as a common dental practice type of chronic pain and trigeminal neuralgia. Highlighting their effective and available pharmacological treatment and promising therapies. For mild-to-moderate pain, nonsteroidal anti-inflammatory drugs are preferred; however, pain chronicity requires another class that tends to modulate neurology- and psychology-associated factors. Common in-practice drugs are antidepressants and anticonvulsants. In most instances, the combination of different pharmacological treatments with a diverse mechanism of action is required for better pain control and reduced monotherapy-related adverse reaction. Opioids should reserve to severe pain and as dual therapy. Palmitoylethanolamide is a promising nutritional therapy that needs further research to establish its effect and safety.