Use of compounded topical medications for treatment of orofacial pain: a narrative review

Background and Objective:

‍Orofacial pain is a frequent form of pain perceived in the face and/or oral cavity. It may be caused by diseases or disorders of regional structures, dysfunction of the nervous system, or through referral from distant sources. The objective of the narrative review is to describe the classifications of orofacial pain, potential targets for pharmacotherapeutic treatment and discusses the novel topical administration of already approved medications for management. Actual cases will be presented illustrating administration and efficacy.

Methods:

‍Electronic databases (PubMed, Embase, Ovid Medline, Google scholar, Scopus, Cochrane library) were searched using keywords “Topical medications” and “Orofacial Pain” from 1^st January 1974 to 30^th November 2021. A total of 280 articles were identified and relevant 105 articles were included in the review.

Key Content and Findings:

‍The multifactorial etiology of orofacial pain requires an accurate diagnosis in order to appropriately treat. Treatment of orofacial pain typically includes pharmacotherapy, which can only be effective if the source of pain is clearly identified. In most cases of orofacial pain, primary treatment includes pharmacotherapy. The pharmacotherapeutic agents required to treat the majority of orofacial pain disorders are associated with significant side effects, interactions, and complications. Administration of medications topically avoids many, if not all side effects. Topical administration of approved medications for neuropathic and musculoskeletal pain offers a unique delivery system that can improve the quality of life while avoiding systemic side effects.

Conclusions:

‍Topical medications offer safe and effective strategy for management of neuropathic and musculoskeletal orofacial pain while avoiding significant side effects. Topical administration is especially useful for the medically complex, compromised, or elderly patients with comorbid medical conditions or those using other medications which may contraindicate the systemic administration of otherwise appropriate pharmacotherapeutics.

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