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Professor of Oral Surgery, King's College London; Honorary Consultant in Oral Surgery, King's College Hospital NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust, London
Pain is often the reason for which patients seek help from the dental team. Although dental pain is likely to be the most common cause, chronic pain conditions, such as headaches, may also show similar symptoms to toothache, resulting in mismanagement and a delay in diagnosis. Many patients experience headaches, which are often debilitating. Despite this, dentists have a lack of knowledge about both headaches and neurovascular pain. The dental team should be able to identify when the pain is likely to be of neurovascular origin rather than toothache, and the team should be able to provide advice and an appropriate referral, if necessary. This should help reduce unnecessary dental treatment and improve the pain relief to these patients.
CPD/Clinical Relevance: This article provides information on how to initially manage neurovascular pain primary care.
Article
Pain in the head and neck region is often the driving factor for patients to seek care from the dental team. It is not rare for chronic orofacial pain conditions to manifest with similar symptoms to dental pain. This can often lead to a misdiagnosis and inappropriate treatment resulting in complications for both the clinician and the patient.1 Diagnosis and management of these patients can be particularly challenging; however, a correct diagnosis is mandatory to ensure patient safety and care.
Headaches are predicted to affect up to 46% of the worldwide population and they have been ranked as being one of the top 10 most disabling disorders.2 Therefore, the implications for healthcare, and the patients, should not be underestimated. The International Headache Society updated their classification in 2018.3 It is those that fall into the group of ‘primary headaches’ which are most relevant and may be encountered by the dental team; however, an awareness of the other types may also be beneficial. A general overview of the classification is shown in Table 1.
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