The Periodontium as a Potential Cause of Orofacial Pain: A Comprehensive Review

Abstract

Introduction:Orofacial pain of periodontal origin has a wide range of causes, and its high prevalence and negative effect on patients' quality of life make intervention mandatory. This review provides a periodontological overview of the field of orofacial pain, focusing on the entities which involve the periodontal tissues and may be the cause of this pain or discomfort.Methods:The study comprised a literature search of these pathologies conducted in the MEDLINE/PubMed Database. Acute infectious entities such as gingival and periodontal abscesses are emergencies that require a rapid response. Periodontitis associated with endodontic processes, necrotizing periodontal disorders, desquamative gingivitis, gingival recession, and mucogingival herpetic lesions, cause mild to severe pain due to tissue destruction and loss. Other lesions that lead to periodontal discomfort include gingival enlargement and periodontal ligament strains associated with occlusal trauma, parafunctional habit and the impaction of food or foreign bodies.Conclusion:A range of therapeutic, pharmacological and surgical alternatives are available for the management of these injuries. However, the wide variety of causes of orofacial pain or periodontal discomfort may confuse the clinician during diagnosis and may lead to the wrong choice of treatment.

Effects of acute pain and strain of the periodontium due to orthodontic separation on the occlusal tactile acuity of healthy individuals

“…The elastic adaptation of the periodontal fibers to the new enlarged conformation might explain why no significant differences were observed in the OTA after the removal of the separators in GS. Impaction of foreign bodies (dental floss, toothpick, rubber dam), food impaction, or presence of defective restorations has been listed among the possible cause of periodontal discomfort due to pressure, ischemia, and inflammation of the PDL [44]. It is common clinical experience that patients presenting these conditions also refer uncomfortable dental occlusion.…”

Cortical representation of experimental periodontal pain: a functional magnetic resonance imaging study

“…Odontogenic pain can severely impact quality of life 1 and originates usually from either the dental pulp or the periodontium 2 . Periodontal pain is often perceived as more locally restricted, as compared to the rather diffuse pain sensation stemming from dental pulp pathologies 3 . Common causes are bacterial infections 3 or excessive mechanical forces following occlusal trauma or orthodontic treatment 3 , 4 .…”

“…Periodontal pain is often perceived as more locally restricted, as compared to the rather diffuse pain sensation stemming from dental pulp pathologies 3 . Common causes are bacterial infections 3 or excessive mechanical forces following occlusal trauma or orthodontic treatment 3 , 4 . Periodontal pain is encountered in 70–95% of patients undergoing orthodontic treatment 5 , 6 , manifesting as pressure pain, tension, or soreness 7 , sometimes even causing treatment discontinuation 4 .…”

Clinical characterization of gingival type of burning mouth syndrome: a cross-sectional study

“…The main causes of periodontal discomfort include inflammatory/reactive manifestations, infections and malignancies. In a recent review on periodontium as potential cause of OFP, the discomfort at gingival site is associated with acute infectious entities, herpetic lesions, periodontitis and necrotizing periodontal disorders, desquamative gingivitis, gingival recession, gingival enlargement and periodontal ligament strains ( 9 ). In addition, trigeminal neuralgia can be responsible for gingival pain causing electric shock-like pain over maxillary or mandibular gingiva ( 10 ).…”