Use of topical medication in orofacial neuropathic pain: a retrospective study

Objective: The objective of this study was to evaluate the effect of topical medications as a single treatment or in combination with systemic medications in the treatment of orofacial neuropathic pain conditions. Study design: A retrospective chart review of 39 patients treated for orofacial neuropathic pain at the Orofacial Pain Clinic in the New Jersey Dental School was performed. In line with the treatment selection, the subjects were divided into 3 groups: topical medications only (n = 12), systemic medications only (n = 10), and a combination of both (n = 17). Results: The starting pain level as expressed in pain Visual Analog Scale for the 3 groups was significantly different. The combined treatment group baseline pain level (7.5 ± 0.403 SEM; P = .0015) and the systemic treatment only group pain level (8.6 ± 0.611 SEM; P = .0375) was significantly elevated compared to the topical only group (6.1 ± 0.716 SEM; P = .1057). Following treatment, pain level was significantly reduced in all 3 groups. The combined group had the highest pain relief (52.0 ± 6.676 SEM % reduction; P < .0001) followed by the systemic-only group (40.6 ± 9.727 SEM % reduction; P = .0029) and the topicals-only group (40.9 ± 10.775 SEM% reduction; P = .0048). The time taken for the topical treatment only to act was significantly shorter (3 weeks ± 0.479 SEM; P = .0015) when compared with the systemic-only (4 weeks ± 0.772 SEM; P = .3629) and the combined group (5.5 weeks ± 0.912 SEM; P = .1738). Conclusion: Topical medication as single treatment or in combination with systemic medications can reduce orofacial neuropathic pain severity. Further prospective research should be performed to validate this treatment option.