Abstract
Patient: A 48-year-old woman presented with persistent pain in the left upper and lower molars and numbness in the left arm. The pain began about five years ago and the patient was referred to our pain center after having received medication and endodontic treatment at many medical institutions. The pain was spontaneous and fluctuated daily. The patient had poor oral hygiene and had abandoned dental treatment of many teeth. Our treatment at each visit was as follows: we listened to her complaints, explained the pathophysiology of her pain, and instructed her through psychological intervention to recognize oral parafunctional activities as pain behaviors and to relax masticatory organs. The patient experienced a change in pain intensity and decided to restart dental treatment. Approximately 12 months after both dental treatment, in which her teeth had been fixed with crowns and bridges, and our treatment, the patient could now eat without pain.
Considerations: It is better to avoid invasive dental procedures for idiopathic toothache. It could cause aggravation of the oral environment and an increase in patient anxiety, leading to discontinuation of endodontic treatment until the pain improves. We postulate that the patient's awareness of the pain changed through exercise therapy, including psychological intervention, and therefore she could receive treatment at the dental clinic, which lead to a reduction in pain.
Conclusion: Jaw exercise therapy, including psychoeducation about pain, in cooperation with a dental clinic may be a useful procedure to treat persistent dentoalveolar pain.
