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Pain in the teeth, mouth, face or head usually has a local cause, often the sequelae of dental caries (odontogenic pain). However, psychogenic, neurological and vascular conditions, and conditions where pain is referred from elsewhere, may be responsible . The real significance to the patient of orofacial pain apart from the pain itself, can range from the benign to potentially lethal conditions. Some orofacial pain or headaches have an obvious but relatively unimportant cause, others types of pain have no obvious underlying organic pathology, some can threaten important faculties such as sight, or even life.
Pain is known to negatively impact the person experiencing it, affecting social functioning, physical and psychological wellbeing. Comprehensive measurements of these impacts are commonly captured using quality of life instruments. Orofacial pains are also known to have a negative impact on the person experiencing it . Orofacial pain, which is estimated to affect 28% of people in the USA9, is known to exert a considerable economic impact on wider society through increased lost workdays and the use of the health care .
In the dentistry area, pain is usually a situation to be treated, the capacity of the professional is key to get to the source of pain, in some situations it is necessary to collaborate with different areas of oral health to combine efforts and reach a correct diagnosis. Most common dental pains are caused by microorganisms triggering inflammatory reactions and exposing primary afferent neurons to algogenic substances. Some of these molecules are known to drive phenotypic and functional changes in nerve and surrounding glial, immune and vascular cells .
Most conditions with acute pain can be treated, and usually subside when healing of the tissue has taken place. Chronic pain, on the other hand, persists months and years after apparent tissue healing, and attempts to alleviate pain often fail. Moreover, chronic pain conditions also appear to be associated with structural and functional alterations in the central nervous system .