Leave no one behind: easy and valid assessment of orofacial pain

Abstract

In 2021, WHO adopted a historic resolution, WHA74·5, on the urgent need for global oral health improvement.1WHOOral Health.https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_R5-en.pdfDate: May 31, 2021Date accessed: November 2, 2021Google Scholar The seriousness of this need resides in the high prevalence of untreated oral conditions, most notably tooth decay and gum disease, which affect the general health and quality of life of around 3·5 billion individuals worldwide.2Peres MA Macpherson LMD Weyant RJ et al.Oral diseases: a global public health challenge.Lancet. 2019; 394: 249-260Summary Full Text Full Text PDF PubMed Scopus (649) Google Scholar In the resolution, a request is formulated to develop a global oral health strategy and to translate this strategy into a comprehensive global action plan for public oral health, with specific, measurable, and realistic targets. Although the WHA74·5 resolution is highly relevant, an important aspect has been mentioned only in passing—namely that poor oral health commonly leads to orofacial pain, which is the most common reason for visits to dental practitioners worldwide.3John MT Sekulić S Bekes K et al.Why patients visit dentists - a study in all World Health Organization regions.J Evid Based Dent Pract. 2020; 20101459Crossref PubMed Scopus (21) Google Scholar Data that need to be collected as part of the evidence-based decision-making process on oral health must therefore also include orofacial pain complaints, with the ultimate goal to enable orofacial pain relief around the globe. Estimates from high-income countries show that orofacial pain is reported by about 10% of those aged 18 years and older.4Lövgren A Häggman-Henrikson B Visscher CM Lobbezoo F Marklund S Wänman A Temporomandibular pain and jaw dysfunction at different ages covering the lifespan—a population based study.Eur J Pain. 2016; 20: 532-540Crossref PubMed Scopus (88) Google Scholar However, population estimates are not readily available from low-income countries. To that end, patient-reported outcomes are essential for the adequate and valid assessment of orofacial pain at both individual and population levels.5Häggman-Henrikson B Lobbezoo F Durham J Peck C List T The voice of the patient in orofacial pain management.J Evid Based Dent Pract. 2021; (published online Oct 29.)https://doi.org/10.1016/j.jebdp.2021.101648Crossref Scopus (4) Google Scholar The International Network for Orofacial Pain and Related Disorders Methodology (INfORM) of the International Association for Dental Research has been one of the driving forces behind the development and implementation of a comprehensive set of patient-reported outcomes for the assessment of orofacial pain. However, as a prerequisite for the desired global implementation, including in low-income countries and disadvantaged communities, easy to use patient-reported outcomes need to be further developed and tested. Apart from having good psychometric properties, these patient-reported outcomes need to be brief, easy to translate, and culturally adaptable so that, as the WHA74·5 resolution states, “no one is left behind.”1WHOOral Health.https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_R5-en.pdfDate: May 31, 2021Date accessed: November 2, 2021Google Scholar Fortunately, INfORM has already done some of the groundwork to facilitate this process. For example, brief screening tools have been developed and proposed for implementation, such as a three-item self-report screening tool for orofacial pain.4Lövgren A Häggman-Henrikson B Visscher CM Lobbezoo F Marklund S Wänman A Temporomandibular pain and jaw dysfunction at different ages covering the lifespan—a population based study.Eur J Pain. 2016; 20: 532-540Crossref PubMed Scopus (88) Google Scholar In addition, a working group within INfORM has developed a short clinical assessment tool for orofacial pain diagnostics that is near completion and will soon be ready for dissemination. Ultimately, orofacial pain assessment is a necessary step towards the development and implementation of appropriate best-buy interventions that address this major driver of need for oral health care worldwide. FL has received research grants from SomnoMed, Sunstar Suisse, Vivisol-Resmed, Health Holland, and Airway Management, unrelated to this work; is an unsalaried member of the Academic Advisory Board of Sunstar Suisse for GrindCare; and is a past-president of the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) of the International Association for Dental Research. GA has received research grants from SomnoMed, Sunstar Suisse, Vivisol-Resmed, and Health Holland, unrelated to this work. FPK has received research grants from the American Academy of Orofacial Pain and the Scan Design Foundation, unrelated to this work, and is secretary, treasurer, and co-chair of the Early Career Researchers Committee of INfORM. MK is president of INfORM. BH-H is vice-president of INfORM. MT has received research grants from Sunstar Suisse and Health Holland, unrelated to this work. AFD declares no competing interests.