Orofacial neuropathy and pain in cancer patients

The orofacial region, which includes the lower half of the face and the oral cavity, commonly causes oncologic patients to seek medical attention for pain. Orofacial pain is unique because its potential influence is much wider than pain in other regions of the body. Orofacial pain impairs: (1) orofacial functions such as eating, drinking, speaking, and facial expression; (2) quality of life; and (3) the ability to maintain adequate oral hygiene, which might result in the deterioration of oral health (teeth and gums) and halitosis. These difficulties may have a significant medical, nutritional, functional, or social-psychological impact in the cancer patient, especially during periods of cytotoxic chemotherapy-related neutropenia. The debilitating effects of orofacial pain may limit the administration of anticancer chemotherapy or cause other treatment modifications (e.g., percutaneous endoscopic gastrostomy for feeding). Furthermore, orofacial neuropathies manifesting as parasthesia may cause aspiration of oral intakes, with adverse consequences.