Orofacial pain and sensory characteristics of chronic patients compared with controls

Abstract

To investigate orofacial and sensorial characteristics of patients with orofacial pain and healthy controls. Case-control. Seventy-five patients (61 women) who had chronic orofacial pain for more than 6 months (i.e.,idiopathic trigeminal neuralgia, burning mouth syndrome, persistent idiopathic facial pain, nonidiopathic neuropathic pain, fibromyalgia or temporomandibular disorders were compared with 41 healthy subjects (19 women). They were evaluated with a quantitative sensory testing protocol involving a combination of gustative, olfactory, thermal, mechanical and pain stimuli. Mean pain duration in this population was 6.27±6.06 years. Orofacial characteristics (masticatory and articular abnormalities), oral health and sensitivity to muscular palpation were assessed. The majority of patients (73.3%) had pain upon craniofacial muscle palpation and 46.7% had numbness. High cold thresholds were observed with burning mouth syndrome and nonidiopathic neuropathic pain (P=.017), while high tactile thresholds were observed in persistent idiopathic facial pain patients (P=.048). Persistent idiopathic facial pain and temporomandibular disorders were associated with a low threshold for pain perception (P<.002). Several of these sensorial alterations were associated with positive musculoskeletal findings. Sensorial abnormalities were observed in neuropathic and somatic pain patients. The masticatory system is associated with and may be a secondary cause of pain in such patients.