Orofacial pain resulting from ill-fitting dentures

The patient who presents to the physician with a history of facial pain can be a diagnostic challenge. The etiology can be elusive, and this problem is compounded by the subjective nature and the often multi-factorial causes of facial pain. The differential diagnoses to be considered include both local and systemic disorders such as neuropathy, myofascial pain, dentoalveolar pathoses, and psychological disturbances, among others. This paper presents the case of a patient with a history of left auricular pain that was managed for over 12 years with drug therapy with only limited success. A thorough head and neck evaluation revealed probable myofascial pain with a poorly occluding set of complete dentures as a potential etiology. Fabrication of a new set of dentures and modification of the patient's denture-wearing habits has produced an almost complete remission of the pain. This case demonstrates the importance of a dental consultation to rule out a possible oral-musculoskeletal and/or dental etiology in the management of the patient with facial pain.