Orofacial pain of cardiac origin: hypothesis and review of the literature

Resumo

Introduction: It is known that pain can be referred to orofacial structures from sources far from craniofacial structures. Objective: Demonstrate that many orofacial structures rather than the teeth can be affected by pain referred from cardiac structures Methodology: The sets of words Orofacial pain + Cardiac structures, Orofacial referred pain; Orofacial pain + Cardiac structures + Convergence mechanism, were entered into the Google electronic site. Results: A total of 24 articles written in English and related to orofacial pain, referred pain and convergence mechanisms were retrieved. 22 articles were published between 2000-2016 and 2 articles were published before the year 2000. All papers were summarized in order to gather information about different subjects related to orofacial pain referred from cardiac structures. Final considerations: Based on the review of the literature it is concluded that the teeth are not so frequently affected with orofacial pain of cardiac origin as compared to other anatomic orofacial locations. Pain is most frequently referred to the throat, lower and upper jaw, temporomandibular joints and other structures; Intensity of pain and increased sensitization is considered by many researchers as one mechanism which facilitates the development of referred pain; the most common mechanism of referred cardiac pain is convergence of nociceptive signals and probably amplification in the subnucleus caudalis of the fifth cranial nerve. Fibers of the vagus nerve are thought to carry cardiac nociceptive signals to the Central Nervous System.

Descriptors: Orofacial pain. Preventive dentistry. Public health dentistry. Referred pain.