Practice abstract


British Dental Journal 204, 187 - 189 (2008)
Published online: 23 February 2008 | doi:10.1038/bdj.2008.101

Subject Categories: Case reports | Facial pain

Vagus nerve pain referred to the craniofacial region. A case report and literature review with implications for referred cardiac pain

D. E. Myers1

  • Neck, tooth and jaw pain can occur with or without chest pain in angina pectoris and myocardial infarction.
  • The mechanism of this referred pain has not been established and is puzzling.
  • Stimulation of a branch of the left vagus nerve from the heart can cause tooth, neck and jaw pain.
  • This mechanism can help the dental provider to explain the cardiac significance of activity related jaw pain to patients.


The pain of angina pectoris and myocardial infarction is sometimes referred to the head and neck region. The mechanism for this effect remains obscure. A case is presented here that reports that electrical stimulation of a cardiac branch of the left vagus nerve in humans can cause referred craniofacial pain. This leads to the hypothesis that the vagus nerve plays a role in mediating this pain. A review of the clinical and physiologic literature supports this hypothesis.

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  1. Department of Oral Diagnosis, Dental Associates, Ltd. Of Wisconsin, 11711 W. Burleigh St., Wauwatosa, WI 53222, USA

Correspondence to: D. E. Myers1 e-mail: dnaanddan@yahoo.com



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