Atypical or Idiopathic facial pain

Dental Health Advice

What is Atypical Facial Pain (now technically known as Persistent Idiopathic Facial Pain)?

According to the International Association for the Study of Pain (IASP), chronic facial pain refers to symptoms which have been present for at least 6 months. ‘Atypical’ pain is a diagnosis of exclusion after other conditions have been considered and eliminated (i.e. it is of unknown cause) and is characterised by chronic, constant pain in the absence of any apparent cause.

Atypical facial pain is very variable in its presentation. Often it is characterized by continuous, daily pain of variable intensity which can be felt in apparently normal teeth or root-treated teeth and occasionally in extraction sites.

Typically, the pain is deep and poorly localized, is described as dull and aching, and does not waken the patient from sleep. Moreover, the toothache frequently remains unchanged for months or years, occasionally spreading to adjacent teeth, especially after extraction of the painful tooth.

Atypical facial pain is more common in women than in men; most patients attending a facial pain clinic are women aged between 30 and 50 years. Although any area of the face can be involved, the most commonly affected area is the upper jaw. In the majority of patients there is no disease or other cause found.

What causes Atypical Facial Pain?

By definition, the cause of Atypical Facial Pain is unknown.

However, in a few patients the symptoms may represent serious disease or be one consequence of significant psychological or psychiatric disease.

Genetic factors may also be important in some patients developing chronic facial pain as their nerves are susceptible to damage from minor insults that would not produce chronic pain in a ‘normal’ patient. This can be seen in patients where protracted pain follows a successful minor procedure such as a tooth extraction.

Treatment of Atypical Facial Pain

Idiopathic facial pain is managed by a variety of methods including drugs, psychological treatments and physical treatments such as acupuncture and TENS nerve stimulation.

In some patients, modern drug treatment can completely eliminate the pain. However the treatments, whether medical, psychological or physical, more commonly only reduce the intensity of symptoms and the consequent pain-related disability. In many patients the pain in some form will remain lifelong. The pain syndromes themselves rarely lead to any life-threatening complications although in severe cases severe depression must be assessed. However, complications can follow multiple invasive treatments in an effort to abolish the pain, particularly destructive surgical procedures on nerves, which should be avoided.

How can the247dentist help with Atypical Facial Pain?

It is essential to establish a clear diagnosis for the pain being experienced. Atypical facial pain is relatively rare, and the pain is more likely to be caused by a troublesome tooth or gum, or as a result of other pathology, such as oral cancer.

The247dentist can help diagnose the cause of the pain and assist you in obtaining the correct treatment.