Orofacial pain considerations in autoimmune disorders: narrative review

Abstract

Background and Objective: Autoimmune diseases (AD) affect significant proportion of patients worldwide and are major cause of morbidity and mortality. Several countries including the U.S. have reported a surge in the prevalence of AD in the past decade. Healthcare professionals including oral healthcare professionals (OHP) may frequently encounter patients with AD. The objective of the narrative review is to summarize the orofacial pain conditions and oral manifestations in key rheumatologic diseases and other systemic AD. Methods: Comprehensive search was performed on the scientific research data base and all the literature reviewed for orofacial manifestations related to AD. Key Content and Findings: Orofacial manifestations are common in the several AD and may constitute the preliminary signs of onset. Orofacial pain and orofacial manifestations may affect extraoral or intraoral sites. Orofacial pain conditions affecting extraoral facial sites include temporomandibular disorders (TMD), neuropathic pain (NP), headaches. Intra oral signs and symptoms include xerostomia, oral lesions, periodontal disease and others. The review also discusses the prevalence, salient clinical features, diagnosis, dental considerations related to orofacial region and treatments of important AD. Conclusions: The identification of early signs and symptoms while performing comprehensive intraoral and extraoral examination by OHP can help in timely referrals and diagnosis. It also facilitates interdisciplinary collaboration between physicians, rheumatologists and OHP to provide comprehensive care to patients with AD. Understanding the underlying AD can enable comprehensive treatment planning, better pain management strategies and improve prognostic outcomes.