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Objective:To determine the relation between the degrees of chronic pain and drowsiness levels.Methods:The study was conducted with 115 patients, who answered the questionnaire as diagnostic criteria in the survey. After evaluation based on the protocol of chronic pain registry RDC/TMD- Axis II, the Epworth Sleepiness Scale was applied to assess drowsiness levels.Results:Among the participating patients, there were more females (80%), and the type of pain more prevalent was chronic (70.4%). Concerning the grades of chronic pain, grade II predominated (38.3%), corresponding to high pain intensity and low disability. The ratio observed for levels of sleepiness was more prevalent for sleep debt average (38.3%).Conclusion:The grades of chronic pain and the levels of sleepiness did not correlate with each other or with the gender of patients.

Pregabalin produced a marked antinociceptive effect in rat models of facial inflammatory pain as well as in facial neuropathic and cancer pain models, suggesting that it may represent an important agent for the clinical control of orofacial pain.

BACKGROUND AND OBJECTIVES: Chronic pain patients have lower pain threshold, thus having pain in other parts of the body. This study aimed at evaluating the presence of temporomandibular disorders in patients with chronic pain in different parts of the body comparing them to a pain-free control group. In addition, we tried to determine which group had more temporomandibular disorder symptoms and myofascial changes in masticatory muscles. METHODS: Sample was made up of 180 individuals divided in 2 groups, being 90 patients with chronic pain in different parts of the body: study group, and 90 pain-free patients: control group. The questionnaire proposed by the American Academy of Orofacial Pain was used to diagnose temporomandibular disorder symptoms. A directed and validated physical evaluation was performed. Analyses were done to determine the frequency of temporomandibular symptoms both in the control group and the study group, and the presence of muscular temporomandibular disorders in both groups. RESULTS: Among chronic pain patients, 70% had temporomandibular disorder symptoms and in the control group they were 55%. Patients with symptoms were physically evaluated and it was observed that 45% had masticatory muscles myofascial pain as compared to 28% in the control group. CONCLUSION: The prevalence of temporomandibular disorder symptoms and masticatory muscles pain was higher among chronic pain patients as compared to the control group and should be taken into consideration when the proposal is to evaluate and control all pains of such patients.

Clinical Correspondence

Objectives: The impairment of the temporomandibular joint and masticatory muscles has a negative impact on functions of the stomatognathic system, such as swallowing. Thus, an atypical swallowing pattern may contribute to the development of temporomandibular disorder (TMD). The aim of the present study was to evaluate acoustic aspects of swallowing and determine the occurrence of atypical swallowing dynamics. Methods: Sixty-two individuals [16 males (25.8%) and 46 females (74.2%); mean age 39.84 (± 9.40); 47 with TMD and 15 without TMD] were evaluated using an ultrasound detector during the swallowing of three consistencies: liquid, pasty and solid. The acoustic signals were recorded and subsequently analyzed using the DeglutiSom® software. Results: The majority of the sample (81%) with TMD presented atypical swallowing biodynamics, with a significantly greater frequency of food residuals for the three consistencies. The signal suggestive of aspiration was more frequent with the liquid consistency (37% of the group). Conclusion: There is a relation between TMD and an atypical swallowing pattern, which underscores the need for the multidisciplinary evaluation of individuals with this disorder.

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BACKGROUND AND OBJECTIVES:Orofacial pain is a major diagnostic challenge for the most experienced clinicians. Due to the complexity regarding the trigeminal-cervical joint, orofacial pain with the same etiology may present different symptoms, and pain with similar symptomatology may have different causes. The objective of this study was to alert health professionals about the importance of differential diagnosis in the hypothesis of trigeminal neuralgia, where the inclusion of the dentist in the medical-hospital team is of paramount importance in establishing the correct diagnosis. CASE REPORT: Twenty-nine-year-old female patient complained of electric shock and pulsatile orofacial pain that covered the third division of the fifth cranial nerve on the right side. Magnetic resonance imaging revealed the presence of trigeminal Schwannoma, causing neuralgia due to its neural compressive nature. Two different neurosurgery departments suggested tumor resection. However, after the evaluation by a third neurosurgery department, in which a dentist, specialized in orofacial pain was part of the team, the complete evaluation established the final diagnosis of right lower first molar odontalgia, with irreversible acute pulpitis as the cause of the symptoms and the expansive lesion was only a radiological finding. CONCLUSION: Interdisciplinary evaluation among physicians and dental surgeons is necessary to obtain the correct diagnosis when considering the hypothesis of trigeminal neuralgia.