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Differentiation of orofacial pain related to Lyme disease from other dental & facial pain disorders

  [ 23 votes ]   [ Discuss This Article ]
By Heir GM • www.ProHealth.com • April 25, 1997


The diagnostic process for the orofacial pain patient is often
perplexing. Compounding the process of solving a diagnostic
mystery is the multiplicity of etiologic factors. The
propensity for Lyme disease to present with symptoms mimicking
dental and temporomandibular disorders makes the task even
more complex. It is hoped that the reader is cognizant of the
fact that a pathologic process of dental structures--the teeth
and their attachments to the mandible and maxilla, the
temporomandibular joints, masticatory musculature, and
vascular supply and sensory innervation of the oromandibular
anatomy--may also be the source of facial pain. Although
unique, similar complaints may also be manifestations of other
causes, including pain associated with Lyme disease. The
informed and fastidious clinician does not overlook these
possibilities when evaluating the headache and facial pain
patient. The clinician should be equipped with the knowledge
and minimal armamentarium to evaluate the patient
appropriately. To paraphrase from Sherlock Holmes, we must
first eliminate the impossible, whatever is left is the truth,
no matter how unlikely. A differential diagnosis must be
achieved based on clinical experience, unbiased observations,
and probability.




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