A patient with sickle cell disease may suffer non-dental orofacial pain. The nature and location of the pain should be documented and monitored over time.
Mechanisms:
(1) vaso-occlusion with bone infarcts
(2) erythroblastic hyperplasia with loss of trabeculae leading to decreased radiodensity of bone
Some causes of non-dental oro-facial pain:
(1) infarction of the mandible with or without
(1a) osteomyelitis
(1b) mental nerve neuropathy
(2) temporomandibular joint disorders with avascular necrosis and arthritis
(3) changes in maxillary and zygomatic bones
(3a) infarcts
(3b) distortion of bone secondary to bone marrow expansion
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