Journal of Dental Research, Vol 66, 962-981, Copyright © 1987 by International & American Associations for Dental Research Online Journals

ARTICLES

The neurobiology of facial and dental pain: present knowledge, future directions

B. J. Sessle

This review outlines recent research which has identified critical neural elements and mechanisms concerned with the transmission of sensory information related to oral-facial pain, and which has also revealed some of the pathways and processes by which pain transmission can be modulated. The review highlights recent advances in neurobiological research that have contributed to our understanding of pain, how acute and chronic pain conditions can develop, and how pain can be controlled therapeutically. Each section of the review also identifies gaps in knowledge that still exist as well as research approaches that might be taken to clarify even further the mechanisms underlying acute and chronic oral-facial pain. The properties of the sense organs responding to a noxious oral-facial stimulus are first considered. This section is followed by a review of the sensory pathways and mechanisms by which the sensory information is relayed in nociceptive neurones in the brainstem and then transmitted to local reflex centers and to higher brain centers involved in the various aspects of the pain experience--namely, the sensory-discriminative, affective (emotional), cognitive, and motivational dimensions of pain. Reflex and behavioral responses to noxious oral-facial stimuli are also considered. The next section provides an extensive review of how these responses and the activity of the nociceptive neurones are modulated by higher brain center influences and by stimulation of, or alterations (e.g., by trauma) to, other sensory inputs to the brain. The neurochemical processes, involved in these modulatory mechanisms are also considered, with special emphasis on the role of neuropeptides and other neurochemicals recently shown to be involved in pain transmission and its control. The final section deals with recent findings of peripheral and central neural mechanisms underlying pain from the dental pulp.

This article has been cited by other articles:

				H. Forssell, O. Tenovuo, P. Silvoniemi, and S. K. Jaaskelainen Differences and similarities between atypical facial pain and trigeminal neuropathic pain Neurology, October 2, 2007; 69(14): 1451 - 1459. [Abstract] [Full Text] [PDF]

				T. Tanimoto, M. Takeda, T. Nishikawa, and S. Matsumoto The Role of 5-Hydroxytryptamine3 Receptors in the Vagal Afferent Activation-Induced Inhibition of the First Cervical Dorsal Horn Spinal Neurons Projected from Tooth Pulp in the Rat J. Pharmacol. Exp. Ther., November 1, 2004; 311(2): 803 - 810. [Abstract] [Full Text] [PDF]

				Y.-C. Liang, C.-C. Huang, K.-S. Hsu, and T. Takahashi Cannabinoid-induced presynaptic inhibition at the primary afferent trigeminal synapse of juvenile rat brainstem slices J. Physiol., February 15, 2004; 555(1): 85 - 96. [Abstract] [Full Text] [PDF]

				A. Woda Pain in the Trigeminal System: from Orofacial Nociception to Neural Network Modeling J. Dent. Res., October 1, 2003; 82(10): 764 - 768. [Full Text] [PDF]

				G. Cruccu, M. Leandri, G.D. Iannetti, A. Mascia, A. Romaniello, A. Truini, F. Galeotti, and M. Manfredi Small-fiber dysfunction in trigeminal neuralgia: Carbamazepine effect on laser-evoked potentials Neurology, June 26, 2001; 56(12): 1722 - 1726. [Abstract] [Full Text] [PDF]

				S. J. Park, C. Y. Chiang, J. W. Hu, and B. J. Sessle Neuroplasticity Induced by Tooth Pulp Stimulation in Trigeminal Subnucleus Oralis Involves NMDA Receptor Mechanisms J Neurophysiol, May 1, 2001; 85(5): 1836 - 1846. [Abstract] [Full Text] [PDF]

				H. Hirata, S. Takeshita, J. W. Hu, and D. A. Bereiter Cornea-Responsive Medullary Dorsal Horn Neurons: Modulation by Local Opioids and Projections to Thalamus and Brain Stem J Neurophysiol, August 1, 2000; 84(2): 1050 - 1061. [Abstract] [Full Text] [PDF]

				X.-M. Wang, K.-M. Zhang, L. O. Long, C. A. Flores, and S. S. Mokha Endomorphin-1 and Endomorphin-2 Modulate Responses of Trigeminal Neurons Evoked by N-Methyl-D-Aspartic Acid and Somatosensory Stimuli J Neurophysiol, June 1, 2000; 83(6): 3570 - 3574. [Abstract] [Full Text] [PDF]

				H. Hirata, J. W. Hu, and D. A. Bereiter Responses of Medullary Dorsal Horn Neurons to Corneal Stimulation by CO2 Pulses in the Rat J Neurophysiol, November 1, 1999; 82(5): 2092 - 2107. [Abstract] [Full Text] [PDF]

				C. Y. Chiang, S. J. Park, C. L. Kwan, J. W. Hu, and B. J. Sessle NMDA Receptor Mechanisms Contribute to Neuroplasticity Induced in Caudalis Nociceptive Neurons by Tooth Pulp Stimulation J Neurophysiol, November 1, 1998; 80(5): 2621 - 2631. [Abstract] [Full Text] [PDF]

				K.-M. Zhang, X.-M. Wang, A. M. Peterson, W.-Y. Chen, and S. S. Mokha alpha 2-Adrenoceptors Modulate NMDA-Evoked Responses of Neurons in Superficial and Deeper Dorsal Horn of the Medulla J Neurophysiol, October 1, 1998; 80(4): 2210 - 2214. [Abstract] [Full Text] [PDF]

				K. Iwata, Y. Tsuboi, and R. Sumino Primary Somatosensory Cortical Neuronal Activity During Monkey's Detection of Perceived Change in Tooth-Pulp Stimulus Intensity J Neurophysiol, April 1, 1998; 79(4): 1717 - 1725. [Abstract] [Full Text] [PDF]

				I. D. Meng, J. W. Hu, A. P. Benetti, and D. A. Bereiter Encoding of Corneal Input in Two Distinct Regions of the Spinal Trigeminal Nucleus in the Rat: Cutaneous Receptive Field Properties, Responses to Thermal and Chemical Stimulation, Modulation by Diffuse Noxious Inhibitory Controls, and Projections to the Parabrachial Area J Neurophysiol, January 1, 1997; 77(1): 43 - 56. [Abstract] [Full Text] [PDF]