Nerve Disorders

TMJ and Orofacial Pain Clinic in Mumbai

The human nervous system is divided into two general parts: the central nervous system, comprising the brain and spinal cord, and the peripheral nervous system, including nerves that go to the limbs, trunk, face and all outlying areas of the body. Damage to nerves of the peripheral or central nervous system can cause abnormal pain signals to be sent to the brain, which may result in the chronic pain condition known as neuropathic pain.

Neuropathic pain may manifest as continuous or episodic, with episodic attacks described as an electric shock and continuous attacks often experienced as feelings of prolonged aching, burning, sensitivity or coldness. Neuropathic orofacial pain conditions refer to those with symptoms that primarily affect a patient's mouth and face.

The main nerve that supplies the mouth and face is the trigeminal nerve. The trigeminal nerve has three branches: ophthalmic, maxillary and mandibular. The opthalmic/ upper branch is responsible for sensations for the scalp, forehead and front of the head. The middle/ maxillary branch is responsible for sensations in the cheek, upper jaw, top lip, top teeth and gums, and side of the nose. The lower/ mandibular branch is responsible for sensations of the lower jaw, lower teeth and gums, and bottom lip.

The trigeminal nerve may be injured during relatively common and innocuous dental procedures like extractions, teeth cleaning, root canal treatment and various oral surgical procedures. Major trauma to the nerves may occur during facial reconstructive surgery, jaw fractures, road accidents, etc. resulting in long term complex facial pain.

Other conditions responsible for nerve pain include: tumors, multiple sclerosis, vascular aberrations, auto-immune disease, chronic infections, diabetes mellitus, nutritional deficiency, etc.

Very often there is no discernible cause for the neuropathic pain and in that case it is termed as 'idiopathic'.

  • Tingling in mouth / face
  • Burning in mouth / face
  • Numbness
  • Prickling / weird / odd sensation
  • Numb with severe pain
  • Electrical sensation
  • Trigeminal Neuralgia
  • Burning Mouth Syndrome
  • Atypical Odontalgia
  • Post - Herpetic Neuralgia
  • Peripheral Post Traumatic Trigeminal Neuropathy
  • Complex Regional Pain Syndrome

Diagnosis And Treatment of Orofacial Pain

Various orofacial neuropathies derive from a number of causes. As with any diagnostic process the orofacial pain specialist in Mumbai will take a complete symptom and medical history, perform a physical exam and order necessary tests and scans like MRI/MRA, CT, X-Rays, etc.

Management of these conditions depends on the nature and cause of the disease and include the following

  • Medications like antiepileptics, multi-vitamins, anti-oxidants, etc.
  • Local application of medication gels or injections as indicated
  • Surgery where appropriate
  • Treatment of underlying disorders