Medication Treatment Efficacy and Chronic Orofacial Pain

Glenn T Clark; Mariela Padilla; Raymond Dionne

doi:10.1016/j.coms.2016.03.011

Medication Treatment Efficacy and Chronic Orofacial Pain

Oral Maxillofac Surg Clin North Am. 2016 Aug;28(3):409-21. doi: 10.1016/j.coms.2016.03.011.

Authors

Glenn T Clark¹, Mariela Padilla², Raymond Dionne³

Affiliations

¹ Ostrow School of Dentistry, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089, USA. Electronic address: gtc@usc.edu.
² Ostrow School of Dentistry, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089, USA.
³ Department of Pharmacology, Brody School of Medicine, 6S19 Brody Medical Science Building, 600 Moye Boulevard, East Carolina University, Schools of Medicine and Dental Medicine, Greenville, NC 27834-4354, USA.

PMID: 27475515
DOI: 10.1016/j.coms.2016.03.011

Abstract

Chronic pain in the orofacial region has always been a vexing problem for dentists to diagnose and treat effectively. For trigeminal neuropathic pain, there are 3 medications (gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors) to use plus topical anesthetics that have therapeutic efficacy. For chronic daily headaches (often migraine in origin), 3 prophylactic medications have reasonable therapeutic efficacy (β-blockers, tricyclic antidepressants, and antiepileptic drugs). The 3 Food and Drug Administration-approved drugs for fibromyalgia (pregabalin, duloxetine, and milnacipran) are not robust, with poor efficacy. For osteroarthritis, nonsteroidal anti-inflammatory drugs have therapeutic efficacy and when gastritis contraindicates them, corticosteriod injections are helpful.

Keywords: Chronic daily headaches; Medication efficacy; Myofascial pain; Temporomandibular osteoarthritis; Trigeminal neuropathic pain.

Publication types

Review

MeSH terms

Chronic Pain / drug therapy*
Facial Pain / drug therapy*
Humans
Pain Management
Pain Measurement