[Diagnosis and treatment of orofacial pain].

Management of orofacial pain should address factors that contribute to the continuation of the pain complaint. This requires elimination of etiologic factors, modification of nociceptive mechanisms, and support of adaptive mechanisms. In addition, methods that help the patient to cope with (remaining) complaints should be applied. A specific diagnosis of the pain problem is the basis for successful management. From the history and clinical examination it should become clear whether the pain problem is acute or chronic, whether its characteristics suggest a somatic or neuropathic basis, and whether the experienced pain is primary or secondary (i.e., hyperalgesia, referred pain). It is important to regard pain as a multidimensional phenomenon, in which psychosocial factors are involved. It is the responsibility of the dentist to judge as early as possible whether he/she is capable of managing the pain problem, or further consultation or referral is necessary for diagnosis and/or management.