Role of the dentist in the management of orofacial pain.

Abstract

Pain is defined by the International Association for the Study of Pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms as such [1]. Although acute pain has the benefit of protection and healing, chronic pain has less value and can become one of the most powerful distressing experiences of the human spirit. Chronic pain is a major healthcare problem costing the USA approximately US$635 billion each year in medical treatment and lost productivity [2]. In a cross-sectional internet-based survey of more than 35,000 individuals, the prevalence of chronic pain, defined as chronic, recurrent or long-lasting pain, lasting for at least 6 months, was 30.7%. The prevalence was higher for females (34.3%) than males (26.7%) and increased with age. Half of respondents with chronic pain experienced daily pain and 32% of them reported their average pain intensity as severe (≥7 on a scale ranging from 0 to 10) [3]. In a screening interview in 15 European countries and Israel, 19% of 46,394 respondents reported suffering with pain for 6 months or longer and had experienced pain in the last month and several times during the last week. Of these respondents, 46% reported their pain as constant [4]. In another study, 90% of the individuals with chronic pain localized their pain to the musculoskeletal structures [5]. Similar findings are reported when only the orofacial regions are considered. Macfarlane et al. [6] found the overall prevalence of orofacial pain (OFP) in the general population to be 26%. According to specific anatomic sites, this study found the prevalence of pain complaints as follows: 6% pain in the jaw joints, 6% in front of the ears, 10% in and around the temples and 12% in the periorbital region. Professional consultation with a dentist or physician was only sought by 46% of the participants with OFP. Furthermore, 17% reported work absenteeism or were disabled from undertaking normal activities because of pain. In another survey of 45,711 American households, 22% of the respondents reported having experienced at least one of five types of OFP in the past 6 months. The most common was tooth pain at 12.2% followed by t emporomandibular joint pain in 5.3% [7].