Orofacial pain crisis is a frequently overlooked aspect of sickle cell anaemia

Charles and colleagues provide valuable insights into acute painful crisis in sickle cell disease (SCD).1 As dentists from India, an SCD “hotspot,” we emphasise the importance of recognising orofacial pain as part of this crisis.Nearly 49% of patients with SCD experience orofacial pain.2 Non-specific generalised pain has been reported to affect various areas of maxilla and mandible, including teeth (“sickle cell toothache”) and mental neuropathy (“numb chin syndrome”).34 This pain is linked to multiple episodes of vaso-occlusive events affecting the oro-maxillofacial structures with the risk of headaches and jaw pain being nine times higher in people with SCD than those without.56Other complications include mandibular neuropathy, temporomandibular joint arthritis, fibrous ankylosis, and osteomyelitis. Osteomyelitis of the jaws secondary to SCD, although rare with an incidence of 3-5%, typically occurs in the posterior region of the mandible owing to the single homolateral vascularisation provided by the inferior alveolar artery and the periosteal…
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