Bell's orofacial pains: the clinical management of orofacial pain, 6th edition (2005)
Author: Jeffrey P. Okeson
Publisher: Quintessence Publishing Co. Ltd, New Malden, Surrey, UK
Price: £47.00
ISBN: 0-86715-439-X
Orofacial pain is one the main reasons for patients to seek treatment. Pain in the face and mouth has a significant psychological meaning since a good interplay of orofacial structures is essential for correct jaw function, communication and body image. Unfortunately, diagnosis and treatment of orofacial pain is not an easy task. This textbook represents a good start for those interested in orofacial pain conditions. It is an extended revision of Dr Welden Bell's classic text, reporting the latest findings related to pain supported by an updated text including a comprehensive list of references. The clinician is guided throughout the diagnostic process with the analysis of the underlying neural mechanisms encompassing peripheral and central sensitization, the pain-modulatory system, and the genetic and molecular processes. In addition, the description of 35 relevant clinical cases helps the practising clinician to better understand the flow chart for correct diagnosis and effective treatment of orofacial pain conditions. The book presents a complex and thorough classification system including both the physical conditions (Axis I), with somatic pain and the complicated area of neuropathic pain, and the psychological conditions (Axis II). Each disease is described in detail taking into account the differential diagnosis and the therapeutic considerations. Special emphasis has been given to the utility of injection techniques of local anaesthetic for the diagnosis and management orofacial pain.
The text is divided into three major sections. The first presents the nature of pain, the anatomy and the function of the trigeminal system, the ways by which the nociceptive impulse arrives at the central nervous system, and the neurophysiological mechanisms underlying the processing and modulation of pain in the orofacial region. This concept represents, the basis for understanding projected pain, referred pain, the co-contraction of jaw musculature, the pain molulatory mechanisms and, eventually, the management of pain conditions. The second section describes the classification of various clinical and psychological aspects of orofacial pain conditions. The diagnostic process is described and the importance of history, examination procedures and differential diagnosis are stressed. The basic guidelines for the management of orofacial pain conditions are reported, including pharmacological, physical, and psychological therapies, and management by interocclusal appliances. The third section deals thoroughly with each orofacial pain disorder and underlines the differential diagnosis and management options for each condition. It describes a wide range of diseases, including mucogingival, dental, muscular, temporomandibular joint, visceral, vascular, neurovascular and neuropathic pain.
In conclusion, this is a useful reference book for clinical practitioners looking for a basic understanding of pain mechanisms and clinical approaches to orofacial pain problems. It is easy to read, though it is sometimes redundant as the same concept is repeated in different sections of the book.
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