Chronic dental pain

Definition

Chronic dental pain is chronic pain that is caused by a disorder involving the teeth or associated tissues (pulpal, periodontal or gingival pain) and that occurs for two hours or more per day on at least 50% of the days during at least three months. The typical causative factor will be caries or trauma to a tooth or teeth or associated tissues. In addition to clinical examination, imaging (intraoral x-rays, CT scans etc.) may facilitate the correct diagnosis. If the etiology is vague, consider using codes in the section of chronic primary pain. For most purposes, patients receive a diagnosis according to the underlying causes, and some secondary headache and orofacial pain disorders present with typical headache and orofacial pain phenotypes. It can be difficult to separate between primary and secondary headache in some cases (e.g., chronic primary orofacial pain, persistent idiopathic dentoalveolar pain). For chronic secondary orofacial pain conditions, some of the disorders may be listed under musculoskeletal diseases or diseases of the digestive system Each distinct type, subtype, or subform of headache or orofacial pain that the patient has must be separately diagnosed and coded. When a patient receives more than one diagnosis, these should be listed in the order of importance to the patient. Diagnostic Criteria: Criteria A to E are fulfilled: A. Chronic orofacial pain (persistent or recurrent for longer than 3 months) is present. B. The pain occurs for 2 hours or more per day on at least 15 days or more per month. C. There is clinical and/or imaging evidence of a disorder or lesion of one tooth or more teeth and / or associated tissues, known to be able to cause headache / orofacial pain D. There is evidence of causation demonstrated by at least two of the following: D1. the orofacial pain has developed in temporal relation to the onset of the disorder or appearance of the lesion D2. At least one of the following: a) the orofacial pain has significantly worsened in parallel with worsening or progression of the disorder or lesion b) the orofacial pain has significantly improved or resolved in parallel with improvement in or resolution of the disorder or lesion D3. the orofacial pain is exacerbated by palpation, probing or pressure applied to the affected tooth or teeth or associated tissues D4. in the case of a unilateral disorder or lesion, headache / orofacial pain is localized and ipsilateral to it E. The pain is not better accounted for by another chronic pain condition.

Index Terms