Chronic Post-Surgical Pain following Dental Surgeries- Mechanisms, Risks, and Multimodal Management

Session Title: Chronic Post-Surgical Pain following Dental Surgeries- Mechanisms, Risks, and Multimodal Management

Topic: CLINICAL SCIENCE

Description of Workshop: Chronic post-surgical pain (CPSP) is increasingly recognized as a significant long-term complication following a wide range of surgical procedures, with an estimated 10% of patients developing persistent pain after surgery. Although this phenomenon has been extensively studied in major surgeries such as mastectomies, limb amputations, thoracotomies, its occurrence following dental and maxillofacial surgeries — including extractions, endodontics, root canal surgeries, dental implants, orthognathic surgeries and temporomandibular joint (TMJ) surgery — remains underreported and underrecognized within both dentistry and pain medicine.
Studies suggest that CPSP occurs in 4–5% of patients undergoing dental surgeries, with prevalence rates substantially higher in some procedures: up to 10% of patients develop chronic neuropathic pain after orthognathic surgery; 77.3% of patients experience CPSP following TMJ total joint replacement, with 25% reporting severe persistent pain; 8.5–36% develop altered sensation after implant surgery; and up to 10% experience neuropathic pain after dental extractions, often linked trigeminal nerve injury.
These pain syndromes can manifest as burning, tingling, allodynia, or deep aching sensations, leading to significant functional impairment, psychosocial distress, and reduced quality of life. Psychological aspects such as state anxiety, depression, and catastrophizing are predictive of poor outcomes, including CPSP and protracted opioid use - these risk factors are measurable and modifiable. Without timely recognition and intervention, CPSP may result in unnecessary repeat procedures, long-term sensitization, disability, and opioid misuse.
This workshop aims to bridge a critical gap by placing CPSP following dental and maxillofacial surgeries at the forefront of the pain science agenda. Participants will gain an evidence-based framework for understanding, preventing, and managing this underrecognized condition. The session will explore:
• Mechanisms underlying acute postoperative pain and its transition to chronicity.
• Pathophysiological processes, including peripheral nerve injury, central sensitization, and neuroplastic changes.
• Clinical characteristics and phenotypic presentation of orofacial CPSP
• Risk factors such as surgical technique and patient-specific characteristics (e.g., anxiety, pain catastrophizing, preoperative pain).
• Multimodal management strategies, including pharmacological (e.g., anticonvulsants, antidepressants, topical agents), non-pharmacological approaches (e.g., cognitive behavioral therapy), and emerging interventional options (e.g., nerve blocks, nerve stimulation, botulinum toxin injections, and surgical interventions).
Interactive case discussions with oral and maxillofacial surgeon, orofacial pain specialists and pain psychologist will offer participants practical tools and real-world clinical scenarios to improve their ability to recognize and treat this often-overlooked pain condition. The workshop will also highlight the importance of interdisciplinary collaboration — between dentists, oral and maxillofacial surgeons, pain physicians, neuroscientists, and psychologists — to provide comprehensive, patient-centered care.
Given the global rise in elective dental surgeries and the high surgical volumes worldwide, the prevalence of CPSP is expected to increase. By increasing awareness and clinical competence around CPSP in dental contexts, this workshop aligns with IASP’s mission to reduce the global burden of pain and foster integrative pain education across specialties. Participants will leave with enhanced knowledge and evidence-based strategies to improve outcomes for patients experiencing CPSP after dental and maxillofacial surgery.

Speakers