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| == Abstract ==
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| [[File:FOSMN 1.jpeg|left|366x366px]]
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| In the section "Are we sure to know everything?" from Masticationpedia, the narrative explores the complexities in diagnosing orofacial disorders, especially in differentiating them from severe organic diseases. It presents a clinical case of a 40-year-old patient initially referred from Gastroenterology due to unexplained organic food wasting, who was later diagnosed with facial onset sensory and motor neuronopathy (FOSMN), a type of trigeminal degenerative neuropathy. This patient had a history of maxillofacial surgery for a unilateral crossbite, but her symptoms did not initially appear related to this surgery.
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| The case emphasizes the importance of considering orofacial pain and headache centers for patients with initial unilateral sensory disturbances, which may progress to bilateral trigeminal neuropathy. It highlights the critical need for early and accurate diagnosis, despite the lack of effective therapies for this condition, to manage patient expectations and rule out treatable causes.
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| The chapter critiques current medical education and diagnostic approaches, noting the heavy reliance on established protocols and the resulting diagnostic errors. Over 90% of surveyed dentistry professors acknowledged significant diagnostic inaccuracies, particularly for conditions like oral mucosal lesions and temporomandibular joint disorders (TMDs). The recent recognition of orofacial pain as a specialty by the American Dental Association is seen as a positive development, promoting expertise and improved treatment options, favoring conservative and reversible interventions over invasive ones.
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| The patient's journey through the healthcare system highlights the need for a multidisciplinary approach to diagnosis and treatment. Initial misdiagnoses and the eventual identification of a rare neurological disorder illustrate the limitations of current diagnostic paradigms. The chapter calls for reevaluating training and protocols used in diagnosing TMDs and related conditions, advocating for a nuanced and patient-centered approach in both dental and medical fields. This case underscores the necessity for ongoing education, research, and interdisciplinary cooperation to improve outcomes for patients with complex orofacial conditions.
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| | autore = Gianni Frisardi | | | autore = Gianni Frisardi |
| | autore2 = | | | autore2 = |