Topical anaesthesia degree is reduced in temporomandibular disorders patients: A novel approach to assess underlying mechanisms of the somatosensory alterations

J Oral Rehabil. 2020 Feb;47(2):113-122. doi: 10.1111/joor.12874. Epub 2019 Sep 6.


Background: Changes in quantitative sensory testing (QST) parameters following topical anaesthesia could contribute to better elucidate underlying mechanisms of somatosensory alterations in temporomandibular disorder (TMD) pain patients. This placebo-controlled crossover investigation compared the somatosensory profile following topical anaesthesia between TMD patients (n = 20) and healthy participants (n = 20).

Methods: Cold detection threshold, warm detection threshold, cold pain threshold, heat pain threshold, mechanical detection threshold, mechanical pain threshold, wind-up ratio and pressure pain threshold were assessed on the skin overlying the masseter at three consecutive days (baseline and immediately after lidocaine 4%/placebo cream). Mixed ANOVA and a coding system that accounts for the diversity of types of peripheral axons associated with the somatosensory parameters were applied for data analysis.

Results: The lidocaine application caused no changes in the somatosensory sensitivity in the masseter region in TMD patients (P > .050), but sensitivity to cold, cold pain, touch and pinprick stimuli were reduced after topical anaesthesia in healthy participants (P < .050). Also, the degree of topical anaesthesia was greater in healthy participants (P = .008). The coding system suggested that TMD patients presented only Aδ-fibre block, whereas a combination of either Aβ- and/or C-fibre block was observed in 35% of healthy participants in addition to Aδ-fibre block following lidocaine application.

Conclusion: Quantitative sensory testing can be successfully applied to identify meaningful differences in the degree of hypoalgesia and hypoesthesia following short-time topical anaesthesia.

Keywords: central sensitisation; local anaesthesia; musculoskeletal pain; pain thresholds; sensory thresholds; temporomandibular disorders.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia, Local*
  • Humans
  • Lidocaine*
  • Pain
  • Pain Measurement
  • Pain Threshold*
  • Temporomandibular Joint Disorders*


  • Lidocaine