Neurophysiological Characteristics of Orofacial Pain in Patients Attending Private Dental Clinics in Western Libya.
DOI:
https://doi.org/10.54361/LJMR.20.1.30Keywords:
Orofacial Pain, Neurophysiology, Trigeminal System, Pain, Dental PracticeAbstract
In private dental clinics in western Libya, dentists frequently encounter patients with orofacial pain that cannot be explained by obvious dental pathology. A retrospective observational study was conducted through the review of archived clinical records of adult patients presenting with orofacial pain between January 2023 and October 2025. Data from 212 eligible cases were analyzed, including demographic variables, pain localization, duration, neurophysiological indicators, and pain mechanism classification. Orofacial pain was categorized as nociceptive, neuropathic, neurovascular, or mixed based on documented clinical assessment. Descriptive statistical analysis was performed using SPSS. The mean age of patients was 42.7 ± 13.6 years, with females comprising 53.8% of the study population. Dental and periodontal pain was the most common presentation (43.4%), followed by temporomandibular joint-related pain (22.6%) and masticatory muscle pain (17.0%). Pain duration exceeded one month in 73.6% of cases, with 32.1% of patients experiencing symptoms for longer than six months. Nociceptive pain was identified in 50.9% of patients, while mixed pain mechanisms accounted for 23.6%, neuropathic pain for 17.9%, and neurovascular pain for 7.5%. Neurophysiological indicators included hyperalgesia in 38.7% of cases, referred pain in 25.5%, allodynia in 21.7%, and persistent pain without identifiable local pathology in 18.9% of patients.The findings demonstrate that a substantial proportion of orofacial pain cases in dental practice involve non-nociceptive or mixed neurophysiological mechanisms and are frequently associated with prolonged pain duration and sensitization-related features. These results underscore the limitations of symptom-based diagnostic approaches and highlight the importance of integrating mechanism-based, neurophysiologically informed assessment strategies into routine dental practice to improve diagnostic accuracy and patient outcomes.
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References
1. Sessle BJ. Peripheral and central mechanisms of orofacial pain and their clinical correlates. Minerva Anestesiol. 2011 Mar;77(3):233-46.
2. Borsook D, Burstein R, Yamamura H. The neurobiology of pain: Implications for clinical dentistry. J Oral Rehabil. 2014 Feb;41(2):87-99. doi: 10.1111/joor.12130.
3. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-S15. doi: 10.1016/j.pain.2010.09.030
4. Orofacial Pain Classification Committee. International classification of orofacial pain, 1st edition (ICOP). Cephalalgia. 2020 Feb;40(2):129-221. doi: 10.1177/0333102419893823.
5. Macfarlane TV, Beasley M, Macfarlane GJ. The epidemiology of orofacial pain. Pain. 2018 Sep;159(9):1691-1697. doi: 10.1097/j.pain.0000000000001274.
6. Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009 May;10(5):447-85. doi: 10.1016/j.jpain.2008.12.001.
7. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 8th ed. St. Louis: Elsevier; 2020.
8. Benoliel R, Eliav E. Neuropathic orofacial pain. Oral Maxillofac Surg Clin North Am. 2008 May;20(2):237-54. doi: 10.1016/j.coms.2007.12.002.
9. Renton T. Dental (odontogenic) pain. Rev Pain. 2011 Mar;5(1):2-7. doi: 10.1177/204946371100500102.
10. Sharav Y, Benoliel R. Orofacial Pain and Headache. 2nd ed. Edinburgh: Elsevier; 2015.
11. Ohrbach R, Dworkin SF. The evolution of temporomandibular disorder diagnosis: Past, present, future. J Dent Res. 2016 Oct;95(10):1093-101. doi: 10.1177/0022034516653922.
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Copyright (c) 2026 Sarah Yousuf Alhameedi, Tebra Ramadan Abdulsalam, Salwa Alwafi Abukhedir (Author)
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