Orofacial Pain, TMJ Disorders & Dental Sleep Medicine Specialists

Nerve Pain

What Is Neuropathic Pain?

Neuropathic pain is a chronic pain condition that results from a disorder or injury to the nervous system. The nervous system is divided into two parts: the central nervous system (the brain and spinal cord) and the peripheral nervous system (nerves that go to the limbs, face, and other parts of the body). When nerves in either of these systems are damaged, they can send pain signals to the brain, leading to a chronic condition.

Neuropathic pain can be continuous or episodic. Continuous pain is often described as a prolonged aching, burning, or tingling sensation, while episodic pain may feel like an electric shock. When these symptoms affect a patient’s mouth or face, they are referred to as Orofacial Neuropathic Pain.

Common Types of Orofacial Neuropathic Pain

Trigeminal Neuralgia

This is the most common form of orofacial neuropathic pain. It’s a disorder of the trigeminal, or 5th cranial, nerve that causes sudden, severe, shock-like pain in the face. The trigeminal nerve has three branches that reach throughout the face and oral cavity. A disorder can affect one or more of these branches, causing pain in areas like the forehead, cheeks, jaw, and teeth.

Episodes typically last a few seconds but can repeat throughout the day. The condition can worsen over time, with episodes becoming more frequent.

There are two types:

Type 1: Characterized by sudden sharp, shock-like pain.

Type 2: Characterized by constant aching, burning, or “pins and needles” sensations.

Atypical Odontalgia

Also known as phantom tooth pain, this condition involves chronic pain in a tooth or teeth with no identifiable cause. It often develops after a dental procedure like a root canal or extraction. Because there is no clear cause, diagnosis can be difficult and is typically made after other potential issues are ruled out.  

Oral Nerve Injury

Neuropathy to the nerves in the mouth, such as the inferior alveolar or lingual nerve, often occurs as a complication of a dental procedure, most commonly wisdom tooth extraction. This can result in pain, a burning sensation, numbness, or tingling in the tongue, mouth, or lower lip.

Complex Regional Pain Syndrome (CRPS)
This rare chronic pain condition can affect the craniofacial region, although it is more common in the arms and legs. It is characterized by a continuous burning pain, often accompanied by changes in skin temperature, color, and texture.

Diagnosing Neuropathic Pain

Diagnosing orofacial neuropathies can be complex because their symptoms overlap with many other disorders. A thorough physical examination is essential to rule out other potential causes.

Trigeminal Neuralgia: Diagnosis relies on an accurate interpretation of a patient’s symptoms and health history, as there is no single test for this condition.

Complex Regional Pain Syndrome: While no single test exists, an MRI or a triple-phase bone scan can provide clues to a diagnosis by showing changes in tissues, blood circulation, or bone minerals.

Oral Nerve Injury: An electromyogram (EMG), a nerve conduction study, or an MRI/MRA can be used to identify nerve damage. If you’re experiencing undiagnosed facial pain, recurring toothaches or similar symptoms described above without a clear cause, or have been told your pain is psychological, you may be suffering from a neuropathic pain disorder. Our team of U.S. Residency-trained Specialists can help you get a proper diagnosis and an effective treatment plan.