Background: Pain due to trauma and infections are easy to characterize, diagnose and treated. In the orofacial region, the cause and nature of pain are sometimes atypical presenting a dilemma to both clinician and patients.

Aim: To study the presentation, diagnosis, treatment and outcomes of non typical orofacial pain and temporo-mandibular joint symptoms in a Nigerian patient population.

Materials and methods: In a 2 year prospective study, we documented the presenting complaints, clinical features, diagnosis, treatment measures, and outcome of treatment in consecutive patients referred to The Pain clinic at the Dental centre, University of Port Harcourt Teaching Hospital, Nigeria.

Results: Twenty-seven patients presented with non typical orofacial pain and TMJ symptoms comprising 11 males and 16 females. The diagnoses include atypical odontalgia (3), oral dysaethesia (4), myofascial pain (3), TMJ dysfunction (11), trigeminal neuralgia (4), postherpertic neuralgia (1), and phantom pain (1). Treatment was essentially medical including analgesics, multivitamins, anticonvulsants, antidepressants and steroids. Other treatment modalities include counselling, manual massage and referrals. Background systemic diseases were identified in 13 patients. Clinical improvement where achieved, was generally short-lived but remarkable improvement was noted in 3 patients.

Conclusion: The diagnosis and management of atypical orofacial pain and TMJ symptoms remains a clinical enigma.

Conflict of interest: None declared.