The classification and differential diagnosis of orofacial pain

Abstract

There are currently four main pain classification systems relevant to orofacial pain (OFP): the International Association for the Study of Pain, International Classification of Headache Disorders, the American Academy of Orofacial Pain and the Research Diagnostic Criteria for Temporomandibular Disorders. Of the four, the Research Diagnostic Criteria for Temporomandibular Disorders is the most biopsychosocial system, with the remaining three focusing more on the biomedical aspects. Unsurprisingly, clinical scientists and clinicians have both reported perceived deficiencies in the published systems and have proposed further modified classifications and nomenclature for OFP. Establishing a standardized biopsychosocial classification of OFP is essential for ensuring continuity for patient care since it creates a standardized language with which to communicate healthcare information, thus enabling improved and more specific (epidemiological) research and patient care. Despite ongoing attempts, an accepted overarching classification of OFP is still a work in progress. There is an urgent need for a robust classification system for OFP. This review aims to highlight the recent debate and continued struggle to attain a consensus on a classification of OFP and highlight some recent developments that assist differential diagnosis of these conditions.

Keywords::

• classification
• oral and facial region
• temporomandibular disorders
• trigeminal neuralgia
• trigeminal neuropathy

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

ICHD: International Headache Classification.

Data taken from [26].

^†Taxonomy is based on a mixture of regional, temporal and Axes.

Data taken from [27].

Reproduced with permission from [44].