Emerging results from clinical and basic research indicate that persistent pain results in changes in the central nervous system. These changes may help explain chronic orofacial pain and lead to new therapies. The authors review data that support the use of tricyclic antidepressants for neurogenic or atypical pain, and benzodiazepines for musculoskeletal pain. Dentists must weigh the benefits of the chronic administration of a drug for the management of temporomandibular disorders against the equivocal scientific support for the use of many drug classes and the potential for serious toxicity with prolonged administration.

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