Refractory craniofacial pain: is there a role of periodontal disease as a comorbidity?

OBJECTIVE To evaluate the influence of the periodontal disease (PD), a chronic infection, in patients with chronic craniofacial pain complaints. METHOD Twenty patients with chronic craniofacial pain and PD (CFP group) and 20 patients with PD (PD group) were assessed before and after periodontal treatment (baseline, 30 and 180 days after treatment). The parameters evaluated were: plaque index, bleeding index, clinical probe insertion, Visual Analogic Scale (VAS) for pain intensity and Numerical Rating Scale (NRS) and Verbal Rating Scale (VRS) for the 'chief complaint'. RESULTS After 180 days PD was controlled in both groups (p<0.001); the VAS decreased in CFP group (p<0.001); 'chief complaint' improved (p=0.005 and p=0.027, respectively in CFP and PD group). VRS showed improvement between the groups in 30 (p=0.004) and 180 days (p=0.001). CONCLUSION These results suggest a possible influence of periodontal disease, as a comorbidity, in refractory craniofacial pain patients and in their pain levels.