References

Renton T. Tooth-related pain or not?. Headache. 2020; 60:235-246
Chong MS, Renton T. Pain part 10: headaches. Dent Update. 2016; 43:448-460
The international classification of headache disorders. Cephalagia. 2018; 38:1-211
Lambru G, Elias LA, Yakkaphan P, Renton T. Migraine presenting as isolated facial pain: a prospective clinical analysis of 58 cases. Cephalalgia. 2020; 40:1250-1254 https://doi.org/10.1177/0333102420933277
Wei DY, Moreno-Ajona D, Renton T, Goadsby PJ. Trigeminal autonomic cephalalgias presenting in a multidisciplinary tertiary orofacial pain clinic. J Headache Pain. 2019; 20 https://doi.org/10.1186/s10194-019-1019-7
Coulthard P, Horner K, Sloan P, Theaker E. Oral and Maxillofacial Surgery, Radiology, Pathology and Oral Medicine, 3rd edn. London: Churchill Livingstone; 2013
Weatherall MW. The diagnosis and treatment of chronic migraine. Ther Adv Chronic Dis. 2015; 6:115-123
Nixdorf DR, Velly AM, Alonso AA. Neurovascular pains: implications of migraine for the oral and maxillofacial surgeon. Oral Maxillofac Surg Clin North Am. 2008; 20:221-235 https://doi.org/10.1016/j.coms.2007.12.008
Yoon MS, Mueller D, Hansen N, Poitz F Prevalence of facial pain in migraine: a population-based study. Cephalalgia. 2010; 30:92-96 https://doi.org/10.1111/j.1468-2982.2009.01899.x
Smith JG, Karamat A, Melek LN, Jayakumar S, Renton T. The differential impact of neuropathic, musculoskeletal and neurovascular orofacial pain on psychosocial function. J Oral Pathol Med. 2020; 49:538-546 https://doi.org/10.1111/jop.13071
Speciali JG, Dach F. Temporomandibular dysfunction and headache disorder. Headache. 2015; 55:72-83 https://doi.org/10.1111/head.12515
NICE. Migraine. 2021. https://cks.nice.org.uk/migraine#!references (accessed September 2021)
The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache. 2019; 59:1-18 https://doi.org/10.1111/head.13456
Puledda F, Messina R, Goadsby PJ. An update on migraine: current understanding and future directions. J Neurol. 2017; 264:2031-2039 https://doi.org/10.1007/s00415-017-8434-y
Harris P, Loveman E, Clegg A Systematic review of cognitive behavioural therapy for the management of headaches and migraines in adults. Br J Pain. 2015; 9:213-224 https://doi.org/10.1177/2049463715578291
May A. Hints on diagnosing and treating headache. Dtsch Arztebl Int. 2018; 115:299-308 https://doi.org/10.3238/arztebl.2018.0299
De Luca Canto G, Singh V, Bigal ME Association between tension-type headache and migraine with sleep bruxism: a systematic review. Headache. 2014; 54:1460-1469 https://doi.org/10.1111/head.12446
Glaros AG, Urban D, Locke J. Headache and temporomandibular disorders: evidence for diagnostic and behavioural overlap. Cephalalgia. 2007; 27:542-549 https://doi.org/10.1111/j.1468-2982.2007.01325.x
Jensen RH. Tension-type headache – the normal and most prevalent headache. Headache. 2018; 58:339-345 https://doi.org/10.1111/head.13067
Yu S, Han X. Update of chronic tension-type headache. Curr Pain Headache Rep. 2015; 19 https://doi.org/10.1007/s11916-014-0469-5
List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017; 37:692-704 https://doi.org/10.1177/0333102416686302
Abu Bakar N, Matharu M, Renton T. Pain part 9: trigeminal autonomic cephalalgias. Dent Update. 2016; 43:340-352 https://doi.org/10.12968/denu.2016.43.4.340
Bahra A, May A, Goadsby PJ. Cluster headache: a prospective clinical study with diagnostic implications. Neurology. 2002; 58:354-361 https://doi.org/10.1212/wnl.58.3.354
Wei DY, Khalil M, Goadsby PJ. Managing cluster headache. Pract Neurol. 2019; 19:521-528 https://doi.org/10.1136/practneurol-2018-002124
Kingston WS, Dodick DW. Treatment of Cluster Headache. Ann Indian Acad Neurol. 2018; 21:S9-S15 https://doi.org/10.4103/aian.AIAN_17_18
Garg N., Garg A. Textbook of Endodontics, 3rd edn. London: JP Medical Ltd; 2003
Balasubramaniam R, Turner LN, Fischer D Non-odontogenic toothache revisited. Open J Stomatol. 2011; 1:92-102

An update on headaches for the dental team

From Volume 48, Issue 9, October 2021 | Pages 743-750

Authors

Pav Chana

BDS MFDS RCPS (Glasg) PGCert (Medical Education)

Dental Core Trainee 3, Arrowe Park Hospital, Wirral, UK

Articles by Pav Chana

Tara Renton

BDS, MDSc, PhD

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

Articles by Tara Renton

Abstract

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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