Department of Oral Health Sciences, Catholic University, Leuven, Belgium
Prof. Antoon De Laat is responsible for the Clinic for Temporomandibular Disorders and for teaching oral physiology and pathophysiology at the Department of Oral Health Sciences of the Catholic University Leuven, Belgium. He deals with temporomandibular disorders and orofacial pain on a full-time basis. His scientific work led to over 200 papers and abstracts. He lectured all over Europe, North and South-America, the Middle and Far East. Prof. De Laat was Associate Editor of the Journal of Orofacial Pain, the European Journal of Oral Sciences and the European Journal of Pain. He is Past-President of the IADR/Neuroscience group, the European Academy of Craniomandibular Disorders, the Belgian Pain Society, and founding Chair of the Special Interest Group on Orofacial Pain of the International Association for the Study of Pain (IASP), where he also served on the Council and as chair of the Research Committee. He is Curator of the Society of Oral Physiology and President of the Leuven Dental Alumni Society. His research interests are trigeminal neurophysiology, jaw reflexes, orofacial pain and quantitative sensory testing. In 2009, he received a Doctorate h.c. at the Aalborg University, Denmark. From 2011 to 2018, he was Chairman of the Dental Department of the Univ. Hospitals KULeuven.
Title 1: From Toothache to Orofacial Pain – What Did We (Have to) Learn?
Abstract 1: While during the previous century the dentist was more focused on acute pain and its intra-oral causes, the scope of our field widened over the past decades, also including more chronic pains. Consequently, the role of dentistry in the differential diagnosis of chronic orofacial pain became more important. This development paralleled the impressive progress made in the field of understanding pain in general, and the important role that dental scientists and clinicians had in this evolution. One example: from a more biomechanical thinking regarding the etiology of temporomandibular disorders, a more in-depth knowledge of the neurophysiology of the masticatory system and of the implementation of the biopsychosocial model of pain deemed necessary.
The present lecture will provide an overview of this period and the consequences it had for our profession. Indeed, along with the expanding scope of our field came the responsibility to strengthen our knowledge on pain physiology and on medical topics in general. Similarly, teachers should realize that if the future of dentistry will shift away from the technical precision and handicraft into more medical management of our patients, also our teaching and curricula need to modernize. In this way, and based upon the important realizations of our profession interacting with other medical specialists, a continuous improvement can be provided in the way we manage and treat our patients.
Title 2: Typical and Atypical Facial Pain
Abstract 2: Traditionally, dentists were highly trained for the diagnosis and management of acute pain and its intraoral causes. However, several kinds of pain in and around the oral cavity can interfere with a clear diagnosis of dental or periodontal pain. Consequently, dentists should be trained in differentially diagnosing pain that may mimic dental pain, or occur in the same region.
As a typical example, temporomandibular disorders with their myogenous or arthrogenous pain, are considered the responsibility of the dentist. Happily, over the last decades an impressive progress has been made in formulating Research and Clinical Criteria for a reliable diagnosis of musculoskeletal pain of the masticatory system, as well as its evidence-based management. Sometimes muscle and joint pain of the jaw system constitute part of a more generalized musculoskeletal condition that needs to be managed in cooperation with other disciplines.
Another important differential diagnosis with toothache and dental pain, is the group of neuralgia’s and neuropathic pain syndromes. Here patients may present first to the dentist and it is crucial to orientate them correctly from the start. Regarding trigeminal neuropathic pains, new developments have necessitated more focused intention: e.g. the underlying pathophysiology of glossodynia/burning mouth syndrome tends to be neuropathic. In addition, potentially as a result of increased alveolar implant-surgery, post-traumatic trigeminal neuropathy presents more frequently and these difficult chronic pains need an appropriate approach.
The current presentation will try to bring an update on some aspects of the abovementioned topics.