New Frontiers of Orofacial Pain

Pain and dentistry are inseparable in the minds of many patients, resulting in dentist being the health care provider that more than 70 % of chronic orofacial pain patients turn to for help. Orofacial pain represents an important clinical pain issue and consists of a heterogeneous group of condition, ranging from a simple pain of dental origin to temporomandibular disorders (TMDs) to medically unexplained chronic facial pain such as persistent idiopathic facial pain (PIFP) and atypical odontalgia (AO). These orofacial pain patients have traditionally been treated by different health care professionals including dentists, general medical practitioners, ENT, neurologists, psychologists and surgeons with different approaches to diagnosis, classification and treatment. The heterogeneity of the disorders can result in diagnostic dilemmas which are frustrating to both the patient and physician. There is therefore a great need to find a robust way to help diagnose these conditions and therefore to prevent unnecessary and irreversible treatment. Once patients have acquired a diagnostic label it is often very difficult to change it and so leads to further inappropriate treatment. Dentistry has come a long way since the day that Costen’s syndrome was first proposed to describe chronic orofacial pain in 1934, which later known as temporomandibular disorder (TMD), an