Orofacial pain beyond trigeminal neuralgia

Orofacial pain is complex and can arise from over 160 conditions. It can significantly impact patients both psychosocially and functionally, reflecting the importance of the trigeminal nerve neurobiology. The high misdiagnosis rates are often blamed on siloed training, resulting in delayed diagnosis and patient harm. Dental pain (the most common form of orofacial pain) can vary in its presentation depending on the stage of dental abscess formation, resulting in misdiagnosis of headaches and trigeminal neuralgia. Trigeminal neuralgia is the rarest form of orofacial pain. Other conditions including temporomandibular joint disorders and post-traumatic neuropathic pain related to dental interventions are far more common but often overlooked. This review aims to break down this siloed approach and highlight the more common conditions that present with paroxysmal, elicited or spontaneous allodynia/neuralgia within the trigeminal system, conditions that should be considered before diagnosing a patient with trigeminal neuralgia.