Pain is a universal experience with profound effects on the physiology, psychology, and sociology of the population. Orofacial pain (OFP) conditions are especially prevalent and can be severely debilitating to a patient’s health-related quality of life. Evidence-based clinical trials suggest that pharmacologic therapy may significantly improve patient outcomes either alone or when used as part of a comprehensive treatment plan for OFP. The aim of this article is to provide therapeutic options from a pharmacologic perspective to treat a broad spectrum of OFP. Clinical-based systemic and topical applied pharmaceutical approaches are presented to treat the most common OFP syndromes.
Key points
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Orofacial pain (OFP) is a complex process whose causes originate from the trigeminal nociceptive reflex arcs within the central and peripheral nervous systems.
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The primary management of intraoral, neuropathic, and neurovascular OFP within the soft and hard tissues of the head, face, and neck is based on sound and rational pharmacotherapy.
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The current perspectives of OFP management require the clinician to be cognizant of comorbid conditions and apply balanced pharmacologic paradigms for optimal outcomes. Many of the drugs in combination can elicit both beneficial and adverse effects in patients treated.
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Evidence-based clinical trials characterize opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, anticonvulsants, and several topical medicaments as viable choices in the pharmacologic management of pain associated with OFP syndromes.
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New innovations in routes of pharmacotherapy will augment not only the efficacy of medication but allow for combination therapy that has fewer adverse effects and greater prolongation of relief in patients who have OFP.
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