A search of PubMed was performed to identify dentally relevant clinical case reports and case series using the following terms: jaw pain, orofacial pain, toothache, temporomandibular disorders, otalgia, neuralgia, and neuropathicpain crossed with angina, myocardial infarction, carotid artery, esophagus, mediastinum, thyroid, heart, pericardium, aorta, lung, thymus gland, and stomach.
Numerous acute, visceral disorders of the throat and chest have been reported to produce pain in the orofacial region, which may be difficult to distinguish from dental-related diseases on the basis of symptoms alone. Chest organs and structures reported to cause such pain include the heart, aorta, esophagus, stomach, lungs, and mediastinum. Throat organs and structures reported to cause pain in the orofacial region include the thyroid gland, carotid arteries, and vagus and glossopharyngeal nerves. Coronary artery diseases, aortic and carotid dissection, mediastinal tumors, subacute thyroiditis, and gastroesophageal reflux disease have a predilection for referring pain orofacially.
Misdiagnosis of referred visceral orofacial pain can lead to delayed diagnosis and unnecessary treatment. Dentists can play a key role in the management of these conditions by means of ruling out odontogenic facial pain, promptly referring patients to medical specialists, and educating patients. Future research is needed to determine the incidence and mechanism of orofacial pain in these disorders. Visceral pain referred to the orofacial region may not be as rare a phenomenon as is sometimes assumed.
使用以下术语对PubMed进行搜索,以识别与牙齿相关的临床病例报告和病例系列:下颌疼痛,口面部疼痛,牙痛,颞下颌关节紊乱病,耳痛,神经痛,神经性疼痛与心绞痛交叉,心肌梗塞,颈动脉,食道,纵隔,甲状腺,心,心包,主动脉,肺,胸腺,和胃。
许多急性,据报道,喉咙和胸部的内脏疾病会在口面区域产生疼痛,仅根据症状可能很难与牙科相关疾病区分开。据报道引起这种疼痛的胸部器官和结构包括心脏,主动脉,食道,胃,肺,和纵隔。据报道,在口面区域引起疼痛的喉咙器官和结构包括甲状腺,颈动脉,迷走神经和舌咽神经.冠状动脉疾病,主动脉和颈动脉夹层,纵隔肿瘤,亚急性甲状腺炎,胃食管反流病有口面疼痛的倾向。
误诊性内脏口面部疼痛可导致延误诊断和不必要的治疗。通过排除牙源性面部疼痛,牙医可以在这些疾病的管理中发挥关键作用,及时将患者转诊给医学专家,和教育病人。需要进一步的研究来确定这些疾病中口面部疼痛的发生率和机制。涉及口面区域的内脏疼痛可能不像有时认为的那样罕见。