Pain in teeth and mucogingival tissues, pain in the face, ear, head, and neck, are usually symptoms associated with soft and mineralized tissues of the oral cavity and face and receive the generic name of Orofacial Pain. "The components involved include skin, blood vessels, bones, teeth, glands or muscles. By definition, orofacial pain is, therefore, a set of signs or symptoms that may be related to pathologies or problems related to the head, face, ear and cervical spine", explains Alexandre Machado, specialist in Orofacial Pain at Hospital Nove de Julho.
As in other parts of the body, when orofacial pain persists for more than three months, it takes on the character of chronic pain and is considered a disease. Many are the factors that can lead to pain of this nature. They can result from latent diseases of the facial structures, they can be neural in origin, or they can occur without any detectable abnormality. The structures from which chronic orofacial pain can originate are ears, eyes, nose, sinuses, lymph nodes, salivary glands and neck. Also, the buccal area and associated structures are included, such as the dental pulp, periodontium, mucogingival tissues, and tongue.
"The causes of chronic orofacial pain include intracranial lesions such as neoplasms, aneurysms or abscesses. They can also result from neurogenic disorders, the most common being trigeminal nerve neuralgia. There are also temporomandibular joint disorders. It can also manifest as migraines or tension-type headaches," says he. According to him, though, one of the most common causes of orofacial pain is inflammatory diseases of the dental pulp.
"Often, problems originating in the teeth end up generating an effect we call Referred Pain. This means that the patient feels pain in one area (such as a headache, for example), but the source of this symptom is in another area (in this case, the inflammation of the tooth pulp)", he explains. The dentist adds that headaches in the frontal or frontoparietal region are often confused with symptoms of other origins such as sinusitis or migraines. "Another type of referred pain, usually of intense severity and that sometimes presents diagnostic difficulties, is the so-called trigeminal neuralgia, cranial nerve", he says. The pain always manifests on one side of the face and can affect the forehead, cheek or the region of the lower dental arch (mandible).
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