Recognition and management of headache

Pain of all types continues to cause substantial burdens to society because of high health care costs and decreased productivity. Dental patients may present with facial pain (often subjectively defined as pain below the ala-tragus line) associated with headache (subjectively defined as pain above the ala-tragus line), both of which are often poorly diagnosed and treated. People with ongoing pain lasting for more than 3-6 months (chronic pain) may experience multiple types of pains in the head and neck region, including headache, facial pain or even global head pain (pain throughout the head, from the neck up). Some pain problems do not follow strict anatomic boundaries, and the pain may spread into adjacent regions, which complicates diagnosis. A better understanding and appreciation of headaches and facial pain can lead to improved outcomes and better overall management. This article reviews frequently occurring headache disorders that should be considered in the differential diagnosis of pain seen in the dental office.