Temporomandibular disorders and orofacial neuropathic pain in children and adolescents: a systematic review

Abstract

Pediatric orofacial pain (OFP) is a blanket term referring to the pain of soft and hard tissue in the face, neck and headaches affecting subjects younger than 18. OFP encompasses pain due to various causes, i.e., (i) Temporomandibular Disorders (TMD), (ii) Headache, and (iii) Neuropathies. This review aims to provide an overview of these three causes of OFP. The inclusion criteria are: (1) articles in English; (2) human studies; (3) clinical trials; (4) systematic review. Data from the included studies using a customized data extraction on a Microsoft Excel sheet. PubMed, Web of Science and Lilacs were systematically searched. The time window considered for the electronic search was from 01 January 1950 to 21 October 2022. A total of 3399 articles published were found from electronic searches. Finally, six full-text articles satisfied the inclusion criteria. The included studies have been published over the past 27 years (1993 to 2020). The studies analyzed were conducted in various parts of the world: USA, Argentina, Canada, South America (Brazil), and India. A total of 308 subjects were analyzed. TMD, headache, and neuropathies are among the leading causes of orofacial pain. Lifestyle changes and psychological approaches could be curative. However, some patients need pharmacotherapy. Regarding the inadequate treatment of pain after hospital discharge due to the difficulty of following the scheduled intervals prescribed, remote monitoring through telemedicine tools could be a solution in the future. Several conditions present with pain in children and adolescents; in most of them, pain is the most prominent symptom. This review found that one of the most critical causes of OFP is temporomandibular dysfunction. Treatment is founded on a multidisciplinary approach.