Symptom Persistence Across Selected Orofacial Conditions: Toward a Chronic Explanatory Profile

Although diagnostically heterogeneous, several orofacial conditions share a problem: symptoms persist when the original source is absent, has resolved, or is no longer sufficient to account for the persisting burden.

To compare burning mouth syndrome, persistent dentoalveolar pain, persistent idiopathic facial pain, occlusal dysesthesia, chronic myogenous orofacial pain and chronic joint-related temporomandibular disorder in terms of their chronic explanatory profile: the pattern of factors that may help account for persistence once current peripheral findings are insufficient.

This theory-driven narrative review selected publications across classification, consensus, review and empirical literature addressing diagnostic definition, peripheral or somatosensory findings, central or sensory processing, psychological modulation, behavioural factors, clinical management and persistence. The synthesis compared the retained conditions across shared maintenance domains rather than prevalence.

The retained conditions remained clinically distinct but could be organized around a shared persistence problem. Shared maintenance domains included insufficient current peripheral explanation, altered sensory or central processing, attentional and affective salience, behavioural responses and clinical embedding. Evidence levels differed across conditions and mechanisms. Occlusal dysesthesia was especially informative because persistence may concern a perceptual symptom rather than pain amplification. Myogenous orofacial pain and joint-related temporomandibular disorder served as contrast conditions because muscle and joint anchors may remain clinically meaningful.

The chronic explanatory profile is proposed as a hypothesis-generating account of maintenance domains, not a new classification, etiological explanation or single mechanism. It identifies domains through which persistent orofacial symptoms can be compared, operationalized and studied as a basis for future mechanistic research.