This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Tenenbaum, H.C. Articles by Davis, K.D. Search for Related Content PubMed PubMed Citation Social Bookmarking                         What's this?

Sensory and Affective Components of Orofacial Pain: Is it all in your Brain?

Department of Dentistry, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Department of Wasser Pain Management Centre, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, MRC Group in Periodontal Physiology, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G IG6, Canada, howard.tenenbaum{at}utoronto.ca

D. Mock

Department of Dentistry, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Department of Wasser Pain Management Centre, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G IG6, Canada

A.S. Gordon

Department of Neurology, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Department of Wasser Pain Management Centre, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Department of Medicine, Faculty of Medicine

M.B. Goklberg

Department of Dentistry, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Department of Wasser Pain Management Centre, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G IG6, Canada

M.L. Grossi

D. Locker

Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G IG6, Canada

K.D. Davis

Department of Wasser Pain Management Centre, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada, Department of Surgery, FAculty of Medecine, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, Canada M5T-2S8

In this paper, we shall review several chronic orofacial pain conditions with emphasis on those that are essentially refractory to treatment. We shall present a review of current and past literature that describes the various pain phenomena as well as their underlying central mechanisms. New data concerning refractory pain will be used to underscore the importance of central processing of pain, with particular emphasis on neuropsychological and cognitive function and capacity that may play important roles in pain processing and maintenance of the pain state. Further, neurophysiological data showing that the anterior cingulate cortex (ACC) and other structures in the brain may play key roles in modulation of chronic pain will also be discussed. Although peripheral triggering events surely play an important role in initiating pain, the development of chronic and, in particular, refractory pain may depend on changes or malfunctions in the central nervous system. These changes may be quite subtle and require sophisticated approaches, such as functional MRI, to study them, as is now being done. New findings obtained therefore may lead to more rational and reliable treatment for orofacial pain.

Key Words: Refractory pain • temporomandibular disorders • atypical neuralgia • fMRI • facial pain.

Critical Reviews in Oral Biology & Medicine, Vol. 12, No. 6, 455-468 (2001)
DOI: 10.1177/10454411010120060101


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				H. Forssell, O. Tenovuo, P. Silvoniemi, and S. K. Jaaskelainen Differences and similarities between atypical facial pain and trigeminal neuropathic pain Neurology, October 2, 2007; 69(14): 1451 - 1459. [Abstract] [Full Text] [PDF]