WordNet

cause emotional anguish or make miserable; "It pains me to see my children not being taught well in school" (同)anguish, hurt
a symptom of some physical hurt or disorder; "the patient developed severe pain and distension" (同)hurting
a bothersome annoying person; "that kid is a terrible pain" (同)pain in the neck, nuisance
a somatic sensation of acute discomfort; "as the intensity increased the sensation changed from tickle to pain" (同)pain_sensation, painful sensation
emotional distress; a fundamental feeling that people try to avoid; "the pain of loneliness" (同)painfulness

PrepTutorEJDIC

〈C〉〈U〉(肉体のある部分の)『苦痛』,『痛み』 / 〈U〉(精神的な)『苦痛』,心痛 / 《複数形で》骨折り,苦労,努力 / 〈C〉不快感,いやな感じ;うんざりさせるもの,やっかい者 / (肉体的・精神的に)…‘に'苦痛を与える(受動態にできない)
《補語にのみ用いて》腹を立てて / 《補語にのみ用いて》(心が)鐘ついて / 不愉快な,気まずい
とうちゃん(papa)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/05/22 22:37:46」(JST)

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Orofacial pain is a general term covering any pain which is felt in the mouth, jaws and the face. Orofacial pain is a common symptom, and there are many causes.^[1] It is estimated that over 95% of cases of orofacial pain result from dental causes (i.e. toothache caused by pulpitis or a dental abscess).^[2] After dental pain, the second most common cause of orofacial pain is temporomandibular joint dysfunction (TMD, pain-dysfunction syndrome).^[3] All other causes of orofacial pain are rare in comparison, although the full differential diagnosis is extensive.

Definition

Defined boundaries of the orofacial pain region.

Orofacial pain has been defined as "pain localized to the region above the neck, in front of the ears and below the orbitomeatal line, as well as pain within the oral cavity; [including] pain of dental origin and temporomandibular disorders".^[4] However, some orofacial pain conditions may involve areas outside this region, e.g. temporal pain in TMD. Toothache, or odontalgia, is any pain perceived in the teeth or their supporting structures (i.e. the periodontium). Toothache is therefore a type of orofacial pain. Craniofacial pain is an overlapping topic which includes pain perceived in the head, face, and related structures, sometimes including neck pain.^[5]

Classification

There are 4 main classifications which attempt to classify the causes of orofacial pain, but no system is universally accepted.^[6]

The International Classification of Headache Disorders second edition (ICHD-2), a publication by the International Headache Society.^[7]
The Classification of Chronic Pain second edition, a publication by the International Association for the Study of Pain.^[8]
American Academy of Orofacial Pain (AAOP): www.aaop.org.
The Research Diagnostic Criteria for Temporomandibular Disorders (see temporomandibular joint dysfunction#diagnostic criteria).

It has also been suggested that the most basic etiologic classification of orofacial pain is into the following 3 groups:^[9]

Primarily somatic, arising from musculoskeletal (e.g. TMD pain or periodontal pain) or visceral structures (e.g. pulpal pain or pain from the salivary glands), and transmitted via an intact pain transmission and modulation system.
Primarily neuropathic, which occurs as a result of abnormal or damaged pain pathways, e.g. a surgical or traumatic injury to a peripheral nerve.
Primarily psychological, which is rare (See: psychogenic pain).

Epidemiology

Orofacial pain is common problem. For example, in the United States, one report estimated that 22% of the general population had suffered from some form of facial pain at some point in the 6-month period before questioning, of which 12% was toothache.^[10] In the United Kingdom, 7% of the general population reported having some degree of chronic orofacial pain.^[11] Other reports indicate a prevalence of 10–15% for TMD in the general population.^[11]

Differential diagnosis

Dental causes
- Pulpal
  - Pulpitis
  - Dentin hypersensitivity
  - Cracked tooth syndrome
- Periodontal
  - Periapical periodontitis and periapical abscess
  - Periodontal abscess
  - Pericoronitis and pericoronal abscess
Burning mouth syndrome
Oral ulceration (e.g. aphthous stomatitis, erosive oral lichen planus, etc.)
Oral cancer
Persistent idiopathic facial pain (atypical facial pain)
- Atypical odontalgia
Neuropathic pain
- Trigeminal neuralgia
- Glossopharyngeal neuralgia
- Mental nerve neuralgia
Headache
- Migraine
- Cluster headache
Temporomandibular joint dysfunction (TMD)
Eagle syndrome

References

^ Martin, WJ; Perez, RS; Tuinzing, DB; Forouzanfar, T (December 2012). "Efficacy of antidepressants on orofacial pain: a systematic review.". International journal of oral and maxillofacial surgery. 41 (12): 1532–9. doi:10.1016/j.ijom.2012.09.001. PMID 23041255.
^ Scully, Crispian (2008). Oral and maxillofacial medicine : the basis of diagnosis and treatment (2nd ed.). Edinburgh: Churchill Livingstone. pp. 98–108. ISBN 9780443068188.
^ Manfredini, D; Guarda-Nardini, L; Winocur, E; Piccotti, F; Ahlberg, J; Lobbezoo, F (October 2011). "Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings.". Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 112 (4): 453–62. doi:10.1016/j.tripleo.2011.04.021. PMID 21835653.
^ Shephard, Martina K.; MacGregor, E. Anne; Zakrzewska, Joanna M. (December 2013). "Orofacial Pain: A Guide for the Headache Physician". Headache: The Journal of Head and Face Pain. 54 (1): 22–39. doi:10.1111/head.12272. PMID 24261452.
^ Armijo Olivo, S; Magee, DJ; Parfitt, M; Major, P; Thie, NM (Fall 2006). "The association between the cervical spine, the stomatognathic system, and craniofacial pain: a critical review.". Journal of orofacial pain. 20 (4): 271–87. PMID 17190026.
^ Renton, T; Durham, J; Aggarwal, VR (May 2012). "The classification and differential diagnosis of orofacial pain.". Expert Review of Neurotherapeutics. 12 (5): 569–76. doi:10.1586/ern.12.40. PMID 22550985.
^ "2nd Edition of The International Headache Classification". International Headache Society. Retrieved 25 July 2013.
^ "Classification of Chronic Pain" (second ed.). International Association for the Study of Pain. Retrieved 26 July 2013.
^ Hupp JR, Ellis E, Tucker MR (2008). Contemporary oral and maxillofacial surgery (5th ed.). St. Louis, Mo.: Mosby Elsevier. pp. 619–627. ISBN 9780323049030.
^ Hargreaves KM, Cohen S, eds. (2010). Cohen's pathways of the pulp. Berman LH (web editor) (10th ed.). St. Louis, Mo.: Mosby Elsevier. p. 50. ISBN 978-0-323-06489-7.
^ ^a ^b Zakrzewska, Joanna M (2013). "Multi-dimensionality of chronic pain of the oral cavity and face". The Journal of Headache and Pain. 14 (1): 37. doi:10.1186/1129-2377-14-37. PMC 3642003 . PMID 23617409.

UpToDate Contents

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1. 頭蓋顔面痛の概要overview of craniofacial pain [show details]
…unusual causes of mouth pain include geographic tongue, candidiasis, diabetes, denture-related pain, thyroid abnormalities, and menopause . Treating the underlying cause of mouth pain, if found, usually …
2. 緩和ケア：終末期に行う口腔ケアの概要palliative care overview of mouth care at the end of life [show details]
…obstruction. Swallowing disturbances in palliative care patients are addressed in detail elsewhere. Orofacial pain conditions of noninfectious etiology, such as myofascial pain and neuropathic pain disorders …
3. 成人における顎関節症temporomandibular disorders in adults [show details]
…different study populations. In one survey of adults in the United Kingdom, the prevalence of orofacial pain was 26 percent, with 6 percent reporting pain in the temporomandibular joint (TMJ) and 6 percent …
4. 三叉神経痛trigeminal neuralgia [show details]
…continuous or near-continuous facial pain of moderate intensity in the affected area, thereby meeting ICHD-3 criteria for classic TN with concomitant continuous facial pain, also known as atypical TN or …
5. 中枢神経障害顔面痛central neuropathic facial pain [show details]
…potential for causing central neuropathic facial pain. Facial pain attributed to multiple sclerosis is characterized by unilateral or bilateral facial pain, with or without dysesthesia, attributed to …

English Journal

The associations between psychosocial aspects and TMD-pain related aspects in children and adolescents.

Al-Khotani A1,2, Naimi-Akbar A3, Gjelset M4, Albadawi E5, Bello L6, Hedenberg-Magnusson B4,7,8, Christidis N4,7.
The journal of headache and pain.J Headache Pain.2016 Dec;17(1):30. doi: 10.1186/s10194-016-0622-0. Epub 2016 Apr 5.
BACKGROUND: Temporomandibular disorders (TMD) in children and adolescents is prevalent with pain as a common component, and has a comorbidity with psychosocial problems such as stress, depression, anxiety as well as somatic complaints. Therefore, the aim of the study was to investigate if psychosoci
PMID 27044436

Nigrostriatal dopaminergic depletion increases static orofacial allodynia.

Dieb W1,2,3, Ouachikh O4, Alves S5, Boucher Y6,7, Durif F8,9, Hafidi A10.
The journal of headache and pain.J Headache Pain.2016 Dec;17(1):11. doi: 10.1186/s10194-016-0607-z. Epub 2016 Feb 17.
BACKGROUND: This study investigated mesencephalic dopamine depletion effects on static mechanical allodynia (SMA) elicited by chronic constriction of the infraorbitary nerve (CCI-IoN).METHODS: Dopamine depletion (6-OHDA administration into the medial forebrain bundle) effects on CCI-IoN-induced SMA
PMID 26885825

High-flow oxygen therapy in cluster headache patients has no significant effect on nociception specific blink reflex parameters: a pilot study.

Haane DY1,2, Plaum A3,4, Koehler PJ5, Houben MP6.
The journal of headache and pain.J Headache Pain.2016 Dec;17(1):7. doi: 10.1186/s10194-016-0597-x. Epub 2016 Feb 12.
BACKGROUND: The exact pathophysiology of cluster headache is unclear. We examined the influence of interneurons on the trigemino-facial reflex arch and the effect of oxygen, by using the nociception specific blink reflex parameters.FINDINGS: There is no significant effect of oxygen, immediately and
PMID 26868278

Japanese Journal

Clonidine Reduces Nociceptive Responses in Mouse Orofacial Formalin Model : Potentiation by Sigma-1 Receptor Antagonist BD1047 without Impaired Motor Coordination