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In patients with persistent idiopathic dentoalveolar pain, using Botulinum neurotoxin-A leads to remarkable improvement in pain and functional outcomes such as reduced discomfort during chewing, swallowing, and talking.
A recent case series involving 9 patients suffering from persistent idiopathic dentoalveolar pain (PIDP) suggested that botulinum neurotoxin-A (BONT-A) could offer prominent relief for this challenging condition. PIDP, known for its persistent pain and emotional toll, is typically tackled with symptom-based treatments, but these often prove inefficient.
In this study, all participants (mean age 56 ± 15 years) had previously used systemic drugs with limited success. Each patient received injections of BONT-A (100 U diluted with saline), with doses ranging from 20U to 50U across 3 intraoral and/or extraoral sites. If the degree of pain remained above 3 on the Numerical Rating Scale (NRS), further 50U injections were given monthly for up to 3 months. Pain level and attributes were measured at baseline and after 1, 2, and 3 months.
The results were promising. The degree of pain dropped from a baseline NRS of 6 (range 4-10) to NRS 4 (range 0–8) at 1 month, NRS 2 (range 0–8) at 2 months, and maintained at NRS 2 (range 0–8) at 3 months. The latency prior to analgesic effect was a minimum of 5-10 days after injection. Minor side effects, such as mild sickness and muscular hypotonia, were observed. However, there were no serious adverse reactions. Functional improvements, including reduced discomfort during chewing, swallowing, and talking were also documented.
These findings indicate that BONT-A could serve as a valuable alternative therapy for addressing PIDP, offering substantial pain relief and boosting the quality of life for those who have not responded to traditional therapies. While the exact mechanism of action remains unclear, BONT-A’s potential in handling PIDP is a noteworthy development in pain management. This study supports the use of BONT-A as a viable option for PIDP patients, offering a novel approach for pain amelioration in this difficult-to-treat condition.
Clinical Oral Investigations
Efficacy of botulinum neurotoxin A in persistent idiopathic dentoalveolar pain: a case series
Katia Rupel et al.
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