A Case Report of a Patient Complaining of Itch Sensation in the Maxillary Molar Gingiva Likely Related to the Myofascial Pain in the Masticatory Muscles

Patient: The patient was a 36-year-old female who visited a private dental clinic with the complaints of uncomfortable feeling in the gingival area of left maxillary molar region and itch sensation in the left side head, neck and shoulder regions. Since her uncomfortable feeling of the gingival area did not improve after the pulpectomy of the maxillary left side second molar, she visited our hospital. Root canal treatment of the left maxillary molars was carried out under the diagnosis of the periapical periodontitis based on the X-ray and cone beam CT findings. However, percussion pain of the concerned tooth and itch sensation of the left side maxillary molar region continued. She said that shoulder stiffness accompanied with the itch sensation of gingiva and simultaneously aggravated and continued for a couple of days. Additionally, she complained tenderness at left masseter, temporalis and sternocleidomastoid muscles and the itch sensation could be evoked by continuous press of those tender points, similarly with the refereed pain from myofascial trigger point.<br>From the above findings, the itch sensation was considered as a related symptom of her myofascial pain conditions. Thus, we instructed her physical therapies such as muscle massage and hot pack to alleviate myofascial pain. Furthermore, since she was aware of having nocturnal bruxism habit, she was also instructed to wear stabilization splint at night. As the results, her myofascial pain improved and consequently the percussion pain of left side second molar and the itch sensation of maxillary molar gingival region disappeared as well.<br>Discussion: In addition to the myofascial toothache, it was possible to consider that itch sensation appears at distant parts of body as a related symptom of myofascial pain conditions.<br>Conclusion: We experienced the patient case who complained itch sensation of gingiva likely appeared as a related symptom of myofascial pain.