Orofacial pain in patients with sickle cell disease

The potential danger of low oxygen tension to patients with sickle cell disease is widely known. However, less well known is the phenomenon of patients with sickle cell disease presenting with toothache in the absence of any dental pathology. This study investigated the experience of orofacial pain in three matched groups, comprising patients with sickle cell disease, sickle cell trait and patients with no known blood dyscrasia. There were no differences in pain experience between those groups with sickle cell trait and no known blood dyscrasia. The sickle cell disease patients experienced significantly more orofacial pain in the same 12-month period than the other groups. The pain was also more frequent and of longer duration. In two-thirds of those sickle cell disease patients who experienced toothache, no dental pathology was found, in direct contrast to patients with trait or no known blood dyscrasia. Sickling of blood cells within the dental pulp in a sickle cell crisis may result in pain within teeth. These patients may then present as experiencing toothache in the absence of any dental pathology. General dental practitioners should be aware of this phenomenon when providing care for these susceptible patients.