Chronic temporomandibular disorders are not necessarily associated with a compromised endogenous analgesic system.

Aims: To test whether temporomandibular disorders (TMD) case-control differences in conditioned pain modulation (CPM) exist, using a mechanically evoked temporal summation (TS) model.

Methods: A series of 10 repetitive, mildly noxious, mechanical stimuli were applied to the fingers of 30 women with TMD, who had a primary diagnosis of masticatory myofascial pain, and 30 age-matched healthy women. The subjects rated the pain intensity caused by the 1st, 5th, and 10th stimuli in the series.

Evidence for indirect effects of pain catastrophizing on clinical pain among myofascial temporomandibular disorder participants: the mediating role of sleep disturbance.

Sleep disturbance and pain catastrophizing are important mediators of the chronic pain experience. To date, these factors have not been considered concurrently despite compelling theoretical rationale to do so. In the present study, we examined whether pain catastrophizing not only has direct effects on clinical pain and pain-related interference, but also indirect effects through its association with sleep disturbance.

Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder.

Study Objectives: We characterized sleep disorder rates in temporomandibular joint disorder (TMD) and evaluated possible associations between sleep disorders and laboratory measures of pain sensitivity.

Design: Research diagnostic examinations were conducted, followed by two consecutive overnight polysomnographic studies with morning and evening assessments of pain threshold.

Setting: Orofacial pain clinic and inpatient sleep research facility.

Temporal summation of pain characterizes women but not men with temporomandibular disorders.

Aims: To examine differences in temporal summation of mechanically evoked pain between women and men suffering from chronic pain associated with temporomandibular disorders (TMD), as well as between male TMD patients and healthy controls.

Methods: Series of 10 repetitive, mildly noxious mechanical stimuli were applied to the fingers of 27 female TMD patients, 16 male TMD patients, and 20 healthy men. The subjects rated the pain intensity caused by the 1st, 5th, and 10th stimulus in the series.

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.

Attitudes of advanced dental education students toward individuals with AIDS.

The number of patients with HIV/AIDS who receive dental care is increasing. This study was undertaken to gain a better understanding of the attitudes of dentists enrolled in postgraduate training toward AIDS and homosexuals. Each respondent received a 500-word patient case vignette and two scales for recording impressions of the person described in the vignette.

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.

Attitudes of dental hygiene students toward individuals with AIDS.

This study was undertaken to gain a better understanding of dental hygiene students' attitudes toward AIDS and homosexuals. Each respondent received a 500-word patient case vignette and two scales for recording impressions of the person described in the vignette. There were four vignettes, identical except that the portrayed individual's illness was identified as either AIDS or leukemia, and sexual preference as either homosexual or heterosexual.

Tooth erosion caused by chewing aspirin.

Background: Although the effects of aspirin on the oral mucosa are well-documented, there is little documentation of the effects of aspirin-chewing on the enamel and dentin.

Case Description: The authors present two cases of patients with damage to their tooth enamel and dentin. Both patients had similiar symptoms, but had not been told that chewing aspirin could harm tooth structure.

Sex differences in temporal summation of pain and aftersensations following repetitive noxious mechanical stimulation.

Several studies demonstrate that women are more sensitive to experimental pain than men. In addition, women exhibit greater temporal summation of heat and mechanically evoked pain. Since temporal summation of pain is centrally mediated, its greater expression in women suggests a central nociceptive hyperexcitability relative to men.

Evidence for up-regulated central nociceptive processing in patients with masticatory myofascial pain.

Aims: Previous work suggests that hyperexcitability of central nociceptive neurons may play a role in the pain of temporomandibular disorders (TMD). The aim of this study was to test this theory by assessing differences, between myalgic TMD patients and pain-free controls, in temporal summation of mechanically evoked pain and aftersensations following repetitive noxious stimulation.

Methods: Sixteen series of 10 repetitive, mildly noxious mechanical stimuli were applied to the fingers of 25 female TMD patients with masticatory myofascial pain and 25 age-matched, pain-free female subjects.

Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature.

Facial pain can, on rare occasions, be the presenting symptom of lung cancer. This report describes a patient with non-metastatic lung cancer, which was associated with attacks of debilitating facial pain, presenting as cluster headache. Moreover, 32 reported cases of lung cancer-related facial pain (including the present one) are reviewed, and their clinical features are summarized.

Chronic paroxysmal hemicrania: a case report and review of the literature.

Chronic paroxysmal hemicrania (CPH) is a rare type of headache that is characterized by daily, multiple, short-lasting attacks of severe pain and associated autonomic symptoms. The pain is strictly unilateral and presents most commonly in the ocular, temporal, maxillary, and frontal areas. The excruciating, throbbing pain of CPH can be misdiagnosed as pain associated with dental pathology, especially when located in the maxillary area.

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.

The use of an oral exercise device in the treatment of muscular TMD.

Forty-five patents with a primary diagnosis of muscular MD were evaluated and treated in a university based facial pain center. The patients were equally and randomly assigned to one of three treatment groups. Group 1 patients were treated with traditional therapies appropriate for the particular patent.