Sir, dental surgeons may be the first health care professional to which a patient with undiagnosed temporal arteritis may present.

Although the classical presentation of this condition is with temporal headache and tenderness with associated systemic symptoms, atypical facial pain may also be a feature.

As maxillofacial surgeons, we are often involved in the investigation of temporal arteritis by performing temporal artery biopsy.

In our clinical practice, we have seen several cases initially presenting with atypical facial pain from presumed maxillary teeth, and these patients had primarily visited their dentist.

It is often the high risk cases with impending ischaemic complications that frequently have significant orofacial pain resulting from jaw or tongue claudication. In a recent review of 390 reported cases from 81 studies, 31% presented with a history of jaw claudication and pain.1

As an acute vasculitis, ciliary and retinal arteries may also be affected, a delay in diagnosis can lead to acute blindness which can occur in up to 20% of patients.

For this reason, dental surgeons should have a high index of suspicion and consider this in their differential diagnosis in the older patient presenting with facial pain, particularly with tenderness over the temporal region.2 Prompt referral is indicated in these cases.

Figure 1
figure 1

Patients often present with a palpable, thickened and tender temporal artery (marked on this patient)

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