Pattern of Presentations of Non-odontogenic Paininoral Medicine Clinic of Lagos University Teaching Hospital (Luth)

Background: Many patients visit dentists as a result of pain. It may have non-odontogenic causes such as lesions of vascular, neurologic/psychological, muscular, bone structures or referred from surrounding structures, or odontogenic, in which case the cause of the pain is the tooth and/or tooth supporting structures. Non odontogenic pain is often challenging to diagnose with consequent inappropriate treatment, leading to frustration of the patients and loss of confidence in the managing physician. Hence, attention on the pattern of distribution of these groups of facial pain would assist in their management.
Aims: To describe the pattern of presentation of non-odontogenic pain among patients who attend oral medicine clinic in LUTH
Methodology: A retrospective review of all cases of non odontogenic pain seen in oral medicine clinic of Lagos University Teaching Hospital (LUTH) between May 2010 and May 2011 was done using the clinic records and patients’ case notes. The recorded parameter includes patients' age, sex and the clinical diagnosis. The results were analysed with SPSS software
Results: A total number of 221 patients were seen, 144 (65%) were diagnosed with one form of non-odontogenic pain. The age distribution of subjects with non odontogenic pain ranged from 15 to 85 yrs (45yr+13.8) with the peak age of occurrence at 51-55yrs. On the other hand, those with odontogenic pain were most prevalent at the peak age of 21-40yr, mean age of 37.3+13.6. Female predilection was observed in all subjects. Dentine hypersensitivity, pulpitis and periodontits were some of the odontogenic pain diagnosed while the various non odontogenic pain diagnosed includes burning mouth 34(23.6%), Aphthous ulceration 28(19.4%), Trigeminal neuralgia 16(11.1%), Candidiasis 11(7.4%), Lichen planus 7(4.6%), Erythemamultiforme 7(4.6%), and Herpes zoster 3(1.9%). Others include mucous membrane pemphigoid and traumatic ulcer.
Conclusion: Non-odontogenicpain is relatively common presentations in oral medicine. Burning mouth sensation due to herbal toothpaste use was the most prevalent.