Facial Pain is primarily mediated through either the Trigeminal Nerve (Cranial Nerve V) and /or the Facial Nerve (Cranial Nerve 7)
According to John Hopkins “Atypical Facial Pain is a pain disorder of the face which shares some features with trigeminal neuralgia. The pain may be different – most often longer in duration (minutes, hours, or continuous), and of a dull, aching, burning, sharp, squeezing, or crushing quality. Sometimes the pain may be precipitated by sinus surgery, dental work, or facial trauma. Atypical facial pain may also be caused by an injury to a small branch of one of the three divisions of the trigeminal nerve.”
The Trigeminal Nerve, often referred to as “The Dentist’s Nerve” is the largest proprioceptive input nerve in the body. In fact, after amplification in the Reticular Activating System it accounts for over 50% of total input to the brain from the entire body.
Common names include Atypical Facial Pain, Atypical Facial Neuralgia, atypical facial neuralgia, Chronic Idiopathic Facial Pain and Psychogenic facial pain. Regardless of what it is called the most commonly used approaches in by neurologist is medications.
It is very similar to Phantom tooth pain also called psychogenic toothache, atypical odontalgia or persistent dentoalveolar pain disorder.
The definition of these disorders usually include the statement “pain with no demonstrable cause which is perceived to be coming from a tooth or multiple teeth, and is not relieved by standard treatments to alleviate dental pain.” (source wikipedia)
These problems are often autonomically controlled pain syndromes and are often receptive to Sphenopalatine Ganglion Blocks (SPG Blocks) The pain can also be referred myofascial pain that were missed on diagnosis (often due to not being considered as a possible diagnosis).
Physiologic Dentistry can sometimes resolve Atypical Facial Pain or Atypical Odontalgia by use of ULF-TENS and treatment of underlying functional problems.
Nerve Blocks used as part of the diagnostic process can sometimes eliminat the pain.