Unexplained orofacial pain - is an early diagnosis possible?

V R Aggarwal, J McBeth, J M Zakrzewska, G J Macfarlane
British Dental Journal 2008 August 9, 205 (3): E6; discussion 140-1
Aim To identify distinct characteristics of unexplained orofacial pain that could be used by dental practitioners in making an early diagnosis.Methods Subjects reporting orofacial pain in a postal questionnaire-based cross-sectional survey were invited for clinical examination. The interviewer was blinded to the questionnaire responses of the subjects. A diagnosis was made following the examination and subjects were assigned into two groups: unexplained pain and dental pain. The questionnaire responses of subjects who had consulted a healthcare professional within these two groups were then compared with particular attention to demographics, orofacial pain characteristics, consultation behaviour and relationship with other unexplained syndromes.Results Subjects who had consulted for their pain and were assigned to the unexplained orofacial pain group were significantly (p <0.05) more likely to report the following characteristics: pain descriptors (nagging, aching, tingling), pain pattern (worse with stress), site (poorly localised), duration (persistent/chronic), high disability, multiple consultations and co-morbidities (teeth grinding, reporting of other unexplained syndromes).Conclusion This study has shown that unexplained orofacial pain has distinct characteristics that differentiate it from other common dental conditions. This provides a good evidence base which can reduce uncertainty among dental practitioners, allowing them to make an early diagnosis.

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