Congenital Insensitivity to Pain-Boon or Bane??? A Case Report with Dental Implications

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It interferes with the daily activity of a person's life. Congenital insensitivity to pain with anhidrosis (CIPA) is a rare, hereditary, autosomal recessive disorder resulting from the mutation of the neurotrophic tyrosine receptor kinase 1 gene (NTRK1). Insensitivity to pain results from loss of nociceptive afferents, while anhidrosis is caused by loss of innervation to the sweat glands. Insensitivity to pain and mental retardation lead to self-inflicted injuries to fingers, lips, and tongue, corneal lacerations, painless bony fractures, joint deformities with consequent chronic osteomyelitis and septic arthritis. Early diagnosis and specific dental management of patients with congenital insensitivity to pain are important for prevention of the characteristic oral and dental problems accompanying this disorder.