Management of Pain of Oral-Dental Origin: An Evidence-Based Approach

Abstract

Dental management of tooth-related facial pain is well established. As mentioned in another chapter, odontogenic pain is so prevalent that pain of oral-dental origin should be presumed odontogenic (tooth-related) until ruled out (Lipton et al., J Am Dent Assoc 124:115–121, 1993). Management of tooth-related pain is amenable to randomized clinical trials due to its prevalence, standard presentation, and objective physical and imaging findings. It is the ability to do randomized clinical trials that creates the highest levels of evidence for evidence-based management.

Non-odontogenic pain of oral-dental origin lacks the level of evidence made possible by the prevalence and objective findings associated with most odontogenic pain entities. Because of the low prevalence, subjective nature of pain, and the frequent lack of objective physical and imaging findings associated with the pain, high levels of evidence for many management strategies are limited to level V. Helpful information may still be gleaned from reviews of large series (Level V)