The influence of deep pain intensity, quality, and duration on the incidence and characteristics of referred orofacial pain

Keywords: pain referral, orofacial pain, tmj, headache, pain management, mystery tooth pain

Pain can often get crossed in the trigeminal nucleus caudalis (TNC), causing referred pain, like TMJ disorders causing headaches or muscle spasms in the neck creating facial pain. Dr. Stan Farrell is a Diplomate of the American Board of Orofacial Pain and has extensive training in identifying the many triggers for TMJ disorders, facial pain and migraine headaches. If you suffer from pain in your neck, face or jaw call and schedule an appointment with Dr. Farrell at 480-945-3629.

This study examined the effects of the intensity, quality, and duration of odotogenic pain on the incidence, pattern, and clinical characteristics of pain referral in the orofacial region. Four hundred consecutive patients reporting with posterior toothache to the dental emergency clinic were included. Patients completed a standardized clinical questionnaire consisting of a numerical rating scale for pain intensity and chose verbal descriptors from a list of adjectives describing the quality of their pain. In addition, patients indicated sites to which pain referred by drawing on a mannequin of the head and neck. Pain intensity was found to significantly affect the presence of referred pain (P < .005). However, neither duration nor quality of pain influenced the incidence of referred pain. Finally, pain referral occurred in vertical laminations as indicated on mannequin drawings, but these were not found to be diagnostic because of extensive horizontal overlap. The association of intensity and referral is attributed to central nervous system hyperexitability causing expansion of receptive fields and spread and referral of pain. Falce/Reid/Rayens Pages: 232-239 PMID: 9161228