Pharmacologic advances in orofacial pain: from molecules to medicine.
The management of chronic orofacial pain often follows a pattern of claims of efficacy based on clinical observations superseded by equivocal findings of effectiveness or belated recognition of toxicity. While therapeutic innovation spurred by genomics and proteomics is likely to result in new drugs for pain, inflammation, and neuropathic pain, the process of drug development and approval takes five to ten years and is often unsuccessful. Therapeutic strategies for improving treatment for chronic orofacial pain are proposed, but recognition of impediments to changing clinical practices suggest the need for interim measures. Greater understanding of the molecular and genetic events that contribute to pain chronicity and interindividual variations in pain responsiveness may eventually result in individualized molecular pain medicine to prevent and treat chronic orofacial pain.
Dionne
R A
RA
National Institute of Dental and Craniofacial Research, NIH, USA. dionnera@yahoo.com
D000700:Analgesics / Q000138:chemical synthesis / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000138:chemical synthesis / Q000627:therapeutic use; D002908:Chronic Disease; D017277:Drug Approval; D015195:Drug Design; D005157:Facial Pain / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D008967:Molecular Biology; D009473:Neuronal Plasticity / Q000187:drug effects; D018689:Sensory System Agents / Q000138:chemical synthesis / Q000627:therapeutic use
D000700:Analgesics; D000701:Analgesics, Opioid; D000893:Anti-Inflammatory Agents; D018689:Sensory System Agents