Sickle cell disorder and orofacial pain in Jamaican patients

The aim of this study was to investigate the prevalence of orofacial pain in a large group of sickle cell disorder (SCD) sufferers.

In 1996, 51 Jamaican adults and teenagers with SCD and 51 matched subjects (non-SCD) without any sickle cell problems were questioned about their experience of pain in the maxilla or mandible, and pain in their teeth. The subjects, aged 13 to 45 years, had oral examinations and the state of the teeth was recorded together with the presence or absence of deep periodontal pockets, vertical or horizontal mobility, sepsis, trauma and severe erosion.

Mandibular or maxillary pain during the previous 12 months was reported by 49% of those with SCD and only 8% of the non-SCD subjects. Among the SCD group reporting this pain, 68% were found to have no dental problems which could have caused the pain. Dental disease accounted for the facial pain in all non-SCD subjects. Headaches were experienced by 77% of the SCD group and only 47% of the non-SCD group. Experience of toothache during the previous year was reported by 67% of the SCD group and 57% of the non-SCD. In half of these SCD subjects there was no obvious dental pathology to account for the dental pain but none of the controls had dental pain in the absence of dental pathology.

People who suffer from sickle cell disorders are likely to suffer orofacial and dental pain in the absence of dental pathology and this is probably because of sickling crises within the microcirculation of the facial bones and dental pulps and small areas of necrosis in the bone marrow.