Orofacial Pain--Part II: Assessment and management of vascular, neurovascular, idiopathic, secondary, and psychogenic causes.

Chronic orofacial pain is a common health complaint faced by health practitioners today and constitutes a challenging diagnostic problem that often requires a multidisciplinary approach to diagnosis and treatment. The previous article by the same authors in this issue discussed the major clinical characteristics and the treatment of various musculoskeletal and neuropathic orofacial pain conditions. This second article presents aspects of vascular, neurovascular, and idiopathic orofacial pain, as well as orofacial pain due to various local, distant, or systemic diseases and psychogenic orofacial pain.

Orofacial pain--Part I: Assessment and management of musculoskeletal and neuropathic causes.

Orofacial pain is a common complaint, affecting the lives of millions of people around the world. Chronic orofacial pain often constitutes a challenging diagnostic problem that can be complicated by psychosocial factors and typically requires multidisciplinary treatment approaches. The fundamental prerequisite for successful management of orofacial pain is an accurate diagnosis.

Trigeminal neuralgia in a patient with multiple sclerosis and chronic inflammatory demyelinating polyneuropathy.

Background: Trigeminal neuralgia (TN) is characterized by unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve. Symptomatic or secondary TN involves TN-like pain that develops owing to a central nervous system lesion (benign or malignant) or to multiple sclerosis (MS).

Case Description: The authors present a report of a unique case of a 43-year-old patient with unilateral TN, MS and concomitant chronic inflammatory demyelinating polyneuropathy.

Superficial mucocele of the labial mucosa: a case report and review of the literature.

Superficial mucocele is considered a relatively common, uncomplicated, and truly benign oral lesion, although a systematic review of the literature revealed only 27 well-documented cases. The general dentist frequently is confronted with questions from patients regarding these often recurrent blisters. While trauma is suspected to be the cause, the etiology of these lesions is not understood clearly due to the insufficient number of reported cases; as a result, their optimal management remains in question.

Referring patients for stress-related disorders.

Stress and psychological disorders can have a profound effect on the etiology, duration, and outcome of nearly all physical conditions. They also can interfere with the dentist's diagnosis and treatment of patients, particularly those who suffer from chronic pain. Dentists should be able to identify the possibility of the presence of stress and psychological disorders in patients and to make an appropriate referral when it is indicated.