Abstract
In order to understand the cognitive aspects of chronic orofacial pain patients, this education lecture describes about poor pharmacotherapeutic prognosis of painful posttraumatic trigeminal neuropathy, meta-analysis of brain imaging studies which revealed functional or structural changes in the brain of the chronic orofacial pain patients, and the recent review in complementary medicine intervention in the emotional and cognitive aspects of chronic pain patients that may be effective for pain relief. By integrating recent scientific advances in chronic pain, future direction of the chronic pain patient management was proposed.
To manage chronic orofacial pain "patients", pain clinician must be familiar with sensory, emotional, and cognitive aspects of pain. Thorough medical interview and the use of questionnaires may be adding insight to understand chronic pain patients. Recent clinical study showed that pharmacotherapeutic prognosis of "patients" with painful posttraumatic trigeminal neuropathy may not be effective, and pointed out the limited number of drugs available, their limited efficacy and side-effect profile. Most chronic pain conditions can be referred to as a “centralization of pain”, which may be explained by functional, structural, or chemical changes of brain. Brain neuroimaging has diagnostic potential to understanding chronic orofacial pain patients. The intervention in the cognitive aspects of chronic pain "patients" of complementary medicine such as cognitive behavioral therapy may be effective; therefore, it is necessary for orofacial pain dentists to consider not only pharmacotherapy in combination with bio-psychosocial approach, also multidisciplinary management with other specialists such as neurologist and/or psychiatrist.
