Prevalence Of Orofacial Pain Research Articles

Correlation Between Orofacial Pain and Sensory and Autonomic Neuropathies.

Orofacial Pain (OFP) affects 15% of the general population. OFP conditions can be myofascial, also known as temporomandibular disorders (TMDs) or neuropathic. The underlying pathophysiology in several chronic OFP conditions, is unknown. Small fiber neuropathy (SFN) is a disorder of thinly myelinated A-delta and non-myelinated C-fibers and can manifest as sensory and autonomic neuropathies. SFN has been demonstrated in some OFP conditions. Our study aims to assess the presence of OFP in patients with sensory and autonomic neuropathies and assess the correlation between OFP, skin biopsy and autonomic dysfunction. This is a retrospective study (2018-2020) of patients from the SFN registry, Massachusetts General Hospital, Boston, USA, for the presence of OFP. All patients were included. Primary outcome: Prevalence of OFP in patients with chronic neuropathies. Secondary outcomes: Correlation between OFP and skin biopsy, dysautonomia, headaches, chronic nociceptive pain, psychological conditions, and patient factors, such as mean age and BMI. Charts of 450 patients with sensory and autonomic neuropathies were reviewed. 22.67% (n=102) had OFP. The mean (range) age at biopsy in patients with OFP was 48.36 (20-81) years, female: male ratio 3.25:1. More OFP patients had negative skin biopsy results (p value<0.05) than those with sensory neuropathies. Patients with OFP had significantly higher prevalence of psychological conditions (p value 0.000), and higher BMI >30 (p value 0.025). Dysautonomia was significantly higher in patients with TMDs when compared to the ones without TMDs (p value 0.030). There was no significant difference in mean age, gender predilection, presence of headaches, peripheral neuropathies, and nociceptive pain between patients with and without OFP. OFP and sensory neuropathies can be overlapping conditions. Patients presenting with concomitant TMD and dysautonomia can be further tested for SFN. This can further help us understand a correlation if any, between idiopathic TMD/OFP conditions and SFN and further our understanding of the pathophysiology of these conditions.

Headache diagnoses in patients with orofacial pain at a specialized pain center

Background. Headache and orofacial pain (OFP) are widespread at specialized pain centers. However, reliable data on their prevalence and co-occurrence are lacking, and prevalence of OFP in headache patients seems to be underestimated. The aim of this study was to evaluate the types of headache in patients with OFP and types of OFP in patients with headache.Methods. We enrolled patients presenting with headache and/or OFP. Patients were examined by an experienced headache and pain specialist who questioned the patients about the presence of OFP. Depression was assessed with the Beck Depression Inventory (BDI-II), anxiety – with the Beck Anxiety Inventory (BAI). Bruxism was evaluated based on subject self-report.Results. We recruited 310 patients: 177 (57%) patients with headache, 28 (9%) patients with OFP and 105 (34%) patients presenting with both types of pain. The prevalence of OFP in headache patients was 37.2%. Migraine was the most prevalent type of headache, while painful temporomandibular disorder (TMD) – the most prevalent form of OFP. Patients with PFP presented with a high prevalence of sleep and awake bruxism.Conclusion. Migraine and pain-related TMD are the most prevalent diagnoses in a specialized pain center. OKI and OKI ACT are soluble forms of ketoprofen and reach peak concentration in 15 minutes. This enables faster onset of action compared to conventional NSAIDs and better tolerability. OKI and OKI ACT are recommended in the acute treatment of migraine with comorbid painful TMD.

Involvement of dopaminergic system in the dentate gyrus of the hippocampus in modulating the orofacial pain-related behaviors in the rats.

Chemical stimulation of the lateral hypothalamus (LH) induces analgesia by forming neural circuitries with multiple brain regions. The involvement of hippocampal dopaminergic receptors in the LH stimulation-induced antinociception in specific pain models in animals has been documented. However, because the neural circuitries involved in the mediation of orofacial pain are not the same as those that mediate the other types of pain, the present study aims to detect the role of dopamine receptors within the dentate gyrus (DG) in the antinociceptive responses induced by LH stimulation in an animal model of orofacial pain. Male Wistar rats (220-250 g) were implanted with two separate cannulae into the LH and DG on the same side. D1- or D2-like dopamine receptor antagonist, SCH23390, or sulpiride (0.25, 1, and 4 μg) were microinjected into the DG, five minutes before intra-LH injection of carbachol (250 nM). The animals were then injected with formalin 1% (50 μL; sc) into the upper lip lateral to the nose and subjected to the orofacial formalin test. Intra-DG administration of SCH23390 or sulpiride attenuated the antinociceptive responses induced by intra-LH microinjection of carbachol during the orofacial formalin test. The findings of the current study suggest that chemical stimulation of the LH modulates orofacial pain, possibly through activation of the DG dopaminergic neurons. Due to the high incidence and prevalence of orofacial pain in the general population, understanding how such neuronal circuitry modulates nociceptive processing will advance the search for novel therapeutics.

Prevalence of orofacial pain and temporomandibular disorder among violin and viola players: a pilot study

Prevalence of orofacial pain and temporomandibular disorder was evaluated among violin and viola players, having as control group other string players (cello and double base players). We found a high prevalence and more severity on violin /viola players. We also found that it is not related to the number of hours performing the instruments. Violin and viola players are more prone to headache and more aware of their parafunctional behavior.

Characteristics and prevalence of orofacial pain as an initial symptom of oral and oropharyngeal cancer and its impact on the patient's functionality and quality of life

To evaluate the prevalence and characteristics of orofacial pain in oral and oropharyngeal cancer (OOC), at diagnosis. a) Study group (SG; n = 74) patients with cancer were divided into 2 subgroups: oral cancer (OC) and oropharyngeal cancer (OPC); b) control group (CG; n = 74) patients within dental care. An Orofacial Pain Assessment, verbal descriptive scale, Helkimo dysfunction index, Quality of Life questionnaire, and Karnofsky performance status (KPS) was used for evaluation. The mean age was 58.46 years (79.7% male) in SG, 58.61 years (20.3% male) in CG. The pain within the SG was indicated by the following: prevalence = 91.9% (21.6% in stages 0, I, or II; 70.3% in III or IV); reason for seeking care = 50.1%; main complaint = 55.4%; most important issue in the past 7 days = 74.3%; breakthrough-like pain = 64.9%; main features: chewing or swallowing as triggering factors, wake up patient, variable duration, independent of daytime, multiple descriptors, and earache. The following indexes were worse within the SG: clinical dysfunction, quality of life, and KPS. In addition, the OC subgroup reported toothache-like pain and burning; whereas the OPC subgroup reported heavy swallowing as triggering factor, throat as location, and a bilateral earache. At diagnosis, orofacial pain, including breakthrough-like pain, was prevalent in patients with OOC, and the pattern was heterogeneous. Predominantly, the pain was moderate to severe, related to stage of cancer, and already compromising the patients' quality of life and functionality.

Involvement of Dopaminergic System in the Dentate Gyrus of the Hippocampus in Modulating the Orofacial Pain-Related Behaviors in the Rats

Chemical stimulation of the lateral hypothalamus (LH) induces analgesia by formation neural circuitries with multiple brain regions. The involvement of hippocampal dopaminergic receptors in the LH stimulation-induced antinociception in certain animal models of pain has been documented, however, considering the fact that the neural circuitries involved in the mediation of orofacial pain are not the same as those that mediate the other types of pain, the present study aims to detect the role of dopamine receptors within the dentate gyrus (DG) in the antinociceptive responses induced by LH stimulation in an animal model of orofacial pain. Male Wistar rats (220-250 g) were implanted with two separate cannulae into the LH and DG on the same side. D1- or D2-like dopamine receptor antagonist, SCH23390 or Sulpiride (0.25, 1, and 4 μg) were microinjected into the DG, five minutes prior to intra-LH injection of carbachol (250 nM). The animals were then injected with formalin 1% (50 μl; sc) into the upper lip lateral to the nose and subjected to the orofacial formalin test. Intra-DG administration of SCH23390 or Sulpiride attenuated the antinociceptive responses induced by intra-LH microinjection of carbachol during orofacial formalin test. The findings of the current study suggest that chemical stimulation of the LH modulates the orofacial pain possibly through activation of the DG dopaminergic neurons. Due to the high incidence and prevalence of orofacial pain in the general population, understanding how such neuronal circuitry modulates nociceptive processing will advance the search for novel therapeutics.

Impact of orofacial pain on the quality of life of students

Introduction. The aim of the study was to determine the prevalence of orofacial pain in students and the impact of pain on their quality of life and everyday professional obligations. Material and Methods. A cross-sectional study included 319 respondents of both genders. Two questionnaires were used in this study; one that we specifically designed to detect orofacial pain among students and the Oral Impacts on Daily Performance questionnaire. Results. Of the total number of examinees, 101 (32%) reported that they had previously experienced pain in the orofacial region. Using the logistic regression analysis, we found that gender was an important predictor of pain and that female students had a 1.8 times higher risk for developing pain (p &lt; 0.05). The highest prevalence of pain in our subjects was in the temporal region (7%; confidence interval 4%; 9%) and the region around the eye (6%; confidence interval 4%; 9%). Namely, in 65 (64.4%) students who had pain in the orofacial region, it had an impact on the quality of life and daily activities. The most prominent was the impact of the orofacial pain on the performance of their activities at the faculty. Orofacial pain has a significant impact on the psychosocial sphere, emotional and social contacts (12.3%; 14.1%). The temporomandibular joint pain and the pain when opening the mouth showed the least impact on the quality of life (p &lt; 0.05). Conclusion. Orofacial pain is a condition that affects daily activities of students at the faculty, as well as their emotional and social life.

Prevalence of orofacial Pain among working adults - A Retrospective Study

Orofacial pain can be defined as a discipline of dentistry that deals with the diagnosis and management of different types of pain pertaining to the orofacial region such as the trigeminal neuralgia, atypical facial pain, postherpetic neuralgia, etc. The aim of the current study is to determine the prevalence of Orofacial Pain among working adults. The retrospective study involved the analysis of the case sheets of the patients with orofacial pain in the stipulated time frame and assessment based on the following parameters: age, gender, the type of orofacial pain, working status—statistical analysis calculated by chi-square test. A p-value &lt;0.05 was considered significant. The prevalence of orofacial pain was 0.08% with a female - to - the male ratio of 1.06: 1 and working adults to non-working adults ratio of 1.36: 1. Trigeminal neuralgia shows a male-female ratio of 1.18: 1 and higher prevalence of Atypical facial pain in females (15.15%). According to our study, it can be concluded that orofacial pain was more prevalent in females. The prevalence of Trigeminal Neuralgia was higher in males and Atypical facial pain was the most prevalent type in females.

Evaluation of orofacial pain and psychological comorbidities in health sciences university students

Introduction: Orofacial pain (OP) is a common public health problem among the general population however, its distribution among the young population like students has not been evaluated so far. The objectives of this study were to investigate the self-reported prevalence, and characteristics of OP, and to evaluate its association with psychological comorbidities such as anxiety and depression. Materials and Methods: A questionnaire-based study was conducted on students studying health sciences programs at SEGi University, Malaysia. A well-designed, structured questionnaire was utilized to assess the prevalence and characteristics of OP. Hospital Anxiety and Depression (HAD) scale was used to evaluate the psychological status of the students. The collected data was subject to statistical analysis by using the SPSS version 22 software. Results: Overall 494 university students had participated in the study of which, 78% (n = 375) of students had suffered from OP and it was significantly higher among the female students (p &lt; 0.03). Headache was the most common type of OP (66.2%) followed by pain in temple region (47.2%), in and around eyes (29.1%), facial region (23.3%), and tooth/gingival pain (20.9%). The association between the prevalence of OP and anxiety was statistically significant (p &lt; 0.019). About 35.4% of the health sciences students had first OP episode started three months ago, 4.2% had daily pain, 14.3% suffered from continuous pain, and only 14% of the students had consulted professionals and 36.1% of them took medication. Conclusion: A significantly higher prevalence of self-reported OP was evident among the health sciences university students and students with different types of OP had higher anxiety and depression scores. Early recognition of OP symptoms and associated comorbidities must be considered for the prevention and successful management of these conditions to circumvent its negative academic impact on the students.

Prevalence of orofacial pain in wind instrument players

BACKGROUND AND OBJECTIVES: This cross-sectional observational study was conducted due to the uncertainties that still exist about the role of playing wind instruments in musculoskeletal complaints. Therefore, the objective was to assess the prevalence of temporomandibular dysfunction and associated factors in wind instrument players. METHODS: Wind instrument players from the School of Music of Fine Arts of Paraná were evaluated for nine-months. Axes I and II of the Research Diagnostic Criteria for Temporomandibular Disorders was used to obtain the variables of interest. The statistical analyses were performed using the SPSS 2.0 software, using the Fishers Exact test, with a significance level of 5%. RESULTS: Thirty-five musicians were examined, 85.7% were male, and 14.3% were female. The temporomandibular dysfunction prevalence was 51.4% being more commonly found in the group II (disc displacements) 34.2%. This result was statistically meaningful when associated with females (p=0,052). Group I disorders (muscle disorders) were diagnosed in 5 patients (14.2%) and group III disorders (joint disorders) were diagnosed in 3 patients (8.5%). Gender also influenced the presence of chronic pain, being more frequent in females (p=0.019). CONCLUSION: In this research, we found a high prevalence of individuals affected by temporomandibular dysfunction. Therefore, studies with expanded samples are necessary, as well as educational and preventive measures. Temporomandibular dysfunction specialists should devote more attention to this group of people.

Orofacial Pain During Rest and Chewing in Dementia Patients Admitted to Acute Hospital Wards: Validity Testing of the Orofacial Pain Scale for Non-Verbal Individuals.

To assess the validity of the resting and chewing components of the recently developed observational diagnostic tool, the Orofacial Pain Scale for Non-Verbal Individuals (OPS-NVI). This cross-sectional observational study was carried out in two UK hospitals. A total of 56 participants with dementia who were admitted to the acute hospital were observed for 3 minutes during rest and during chewing, and the OPS-NVI was used to identify orofacial pain. Afterwards, the participants were asked about the presence of orofacial pain using self-report pain scales. The sensitivity, specificity, and area under the receiver operating curve (AUROC) of the OPS-NVI were calculated for each activity. Spearman coefficient was calculated to assess the correlation between the number of positively scored behavior items of the OPS-NVI and the presence of orofacial pain according to self-report. According to the OPS-NVI, orofacial pain was present in 5.4% of participants during rest and in 9.1% during chewing. According to self-report, the prevalence of orofacial pain was 5.4% during rest and 10.7% during chewing. The specificity of the OPS-NVI was 98.1% to 100%, the sensitivity was 66.7% to 83.3%, and the AUROC was 0.824 to 0.917. The predictive validity showed a strong correlation (0.633 to 0.930, P < .001) between the number of positive behavior items and the self-reported presence of orofacial pain. The resting and chewing components of the OPS-NVI showed promising concurrent and predictive validity. Nevertheless, further validation is required and highly recommended.

Oral health and orofacial pain in people with dementia admitted to acute hospital wards: observational cohort study

BackgroundOrofacial pain in people with dementia is difficult to detect, and often under-treated. Our aim was to investigate the prevalence of orofacial pain in people with dementia in acute hospitals in the UK. Secondary aims were to examine oral health status and explore associations between orofacial pain and oral health factors.MethodsThis cross-sectional observational study was carried out in two UK hospitals. Using the Orofacial Pain Scale in Non-Verbal Individuals (OPS-NVI) to identify orofacial pain, 101 participants with dementia, admitted to acute medical wards, were observed for at least 3 min during rest and chewing. Verbal participants were then asked about presence of orofacial pain, using self-report pain scales. Finally, a brief oral assessment was performed.ResultsOrofacial pain, assessed with the OPS-NVI, was present in 11.9% (95% C.I. 5.9, 18.8) of participants at rest and 21.9% (95% C.I. 14.6, 31.3) whilst chewing. Participants who were no longer able to self-report pain were significantly more likely to experience orofacial pain. Oral health in both dentate and edentate participants was poor. Brush frequency, indication of chewing quality, consistency of the food, presence of extra-oral abnormalities, person who performed mouth care, and oral hygiene in dentate participants were significant predictors for the presence of orofacial pain.ConclusionImproving oral care in acute hospital patients with dementia, particularly those who cannot self-report pain, may significantly reduce pain and suffering in this population.

Burden of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom.

Little is known about the burden and impact of orofacial pain in deprived areas, and whether it mediates the relationship between socioeconomic position and impacts on daily life. We analysed data from a representative sample of 2168 adults, aged 16 to 65 years, from the East London Oral Health Inequality study. Participants completed a validated questionnaire on demographics, socioeconomic position (area deprivation), orofacial pain (by anatomical site) in the past month, and impacts related to oral conditions on daily life. Negative binomial regression models with robust variance estimator were fitted. The prevalence of orofacial pain was high (30.2%). The most common subset of orofacial pain was intraoral pain (27.5%). The prevalence of pain related to temporomandibular disorders was 6.8%. The most common subsets of intraoral pain were tooth (20.4%) and gingival (11.4%) pain. Orofacial pain, its subsets (intraoral and temporomandibular disorder-related pain), and intraoral pain subsets (tooth and gingival pain) consistently showed associations with all dimensions of impacts on daily life that were highly statistically significant: functional limitation, psychological discomfort, disabilities, and handicap. Socioeconomic inequalities were present in orofacial pain and some dimensions of impacts on daily life. Orofacial pain did not mediate the relationship between area deprivation and impacts on daily life. Our study demonstrated a substantial burden and impact of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom. To address this burden, interventions that lie within the remit of health services are needed to improve access to dental care for adults with orofacial pain.

Studies on a novel regimen for management of orofacial pain and morphine tolerance

Background/purposeThe prevalence of orofacial pain is high but the etiology of orofacial pain is not well understood. Because of clinical treatment is not so effective, it is urgent to explore novel regimens with more effective and less side effects for clinical application. Materials and methodsMale mice (ICR strain) were injected with capsaicin (10μg/5 μl) in vibrissa pad. Spontaneous orofacial pain in 20 min was recorded after receiving capsaicin to quantify the nociceptive level. Green tea polyphenols (GTP 60 mg/kg), memantine (Mem 10 mg/kg), and GTPm (GTP 30 mg/kg plus Mem 3 mg/kg) were dissolved in 2% carboxymethyl cellulose, which was orally administered to mice twice per day and five times per week consecutively for 2 weeks. TruScan photobeam tracking was used to record changes of behavior and locomotor activities. ResultsGTPm by itself attenuated orofacial pain induced by capsaicin. Moreover, GTPm enhanced morphine analgesic effects, reduced morphine depressant side effects and delayed morphine tolerance. Along with this experiment, GTPm was tested on the hot plate (52 °C)-induced peripheral thermal pain. It was found that both memantine and GTPm reduced morphine-analgesia in hind paw thermal pain. ConclusionIn this study, GTP (60 mg/kg/day) orally administrated produced a significant analgesic effect on capsaicin–induced orofacial pain. Memantine combined with GTP synergistically not only reduced orofacial pain but also enhanced morphine analgesic effects. Thus, a new regimen of GTPm orally administered twice per day attenuated orofacial pain after consecutive 5 days.

Prevalence of orofacial pain in pregnant women: A cross-sectional study

Background: Pregnancy is a special time in woman's life, during this period, they are highly vulnerable for oral changes which would cause orofacial pain. Although the orofacial pain is invariably noticed, their basic data on prevalence and its characteristics has not been evaluated so far. The aim of this study was to assess the prevalence of orofacial pain and its characteristics in pregnancy. Materials and Methods: A descriptive cross-sectional study was conducted among 100 pregnant women to assess the prevalence orofacial pain and its characteristics. Questionnaire regarding sociodemographics, orofacial pain prevalence and severity were administered. Data were collected and analyzed. Results: Thirty-three percent reported to have orofacial pain. Most participants were aged 20–34 years. Majority (73%) of respondents were completed secondary School and 74% were homemakers. Large number of participants were belong to lower middle (28%), poor (26%), and below poverty line (21%). In regard to stages of pregnancy, 36% of participants were in second trimester, followed by third trimester (33%) and first trimester (31%). Majority (47%) of patient experienced tooth pain due to hot/cold liquids. Spontaneous burning sensation from tongue and oral mucosa was noticed in 8%. Most of the pregnant women suffered from acute pain (65%). With regard to frequency of pain, 31% of pregnant women get 4–5 episodes of pain weekly, which is followed by once a week (27%), and daily pain in (23%). Duration of pain lasts for Conclusion: Results draws an insight into baseline data on the prevalence orofacial pain and its characteristics. During pregnancy pain was high and the presence of tooth pain was dominant.

Orofacial pain and quality of life in early adolescents in India

Orofacial pain may have an impact on quality of life. It may affect the overall well-being of an individual. To assess the prevalence of orofacial pain and its impact on quality of life in early adolescents in Indore city, India. This was a cross-sectional study which included a total of 800 children selected from various public and private schools located in Indore city, India. A questionnaire was developed which collected information on sociodemographic characteristics and previous dental visits. The severity of pain was assessed using Von Korff pain scale and quality of life using the General Health Questionnaire 12 (GHQ-12). The chi-square test and logistic regression analysis were performed. The overall prevalence of orofacial pain was found to be 17.9%. Toothache (10.1%) was found to be the most prevalent orofacial pain followed by temporomandibular joint pain (4.3%). The highest severity of pain (Grades 3 and 4) was reported for toothache followed by temporomandibular joint pain. The results of the logistic regression model showed that the prevalence of orofacial pain (odds ratio=7.18, p-value<0.0001a) was strongly associated with poor quality of life. The orofacial pain has a negative influence on the quality of life of adolescents. Effective policies should be created to improve the quality of life of adolescents focusing on oral health education and prevention of oral diseases.

Prevalence and characteristics of orofacial pain in university students.

This cross-sectional study investigated the characteristics and prevalence of orofacial pain, and its associations with sociodemographic characteristics, in 319 university students: 188 second-year students in the Medical Faculty and 131 students in the Faculty of Technical Sciences at the University of Kosovska Mitrovica. A specially designed questionnaire was used to assess the prevalence and characteristics of pain. Among the 319 students, 101 (32%) reported previous orofacial pain, and pain was more frequent among women (P < 0.05). Logistic regression revealed that gender was an important predictor of pain and that the risk for pain development among women was 1.8 times that among men. Place of residence and relationship status were not associated with frequency of orofacial pain. The regions with the highest pain prevalences were the temporal region (7%; 95% confidence interval, 4-10%) and the region around the eye (6%; 95% confidence interval, 4-9%). The first episode of orofacial pain was less than 3 months previously in 59% of the participants, and 39% of students had sought professional medical help. (J Oral Sci 58, 7-13, 2016).

Role of the dentist in the management of orofacial pain.

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].

Facial pain: temporomandibular joint disorders

This paper is the first of a series of three looking at the complaint of facial pain. Facial pain may be a presenting complaint of a number of conditions that range from simple dental pathology, to malignancy. Patients with a complaint of facial pain usually present to their GP, however, some will seek advice from their General Dental Practitioner (GDP), as they may suspect a dental cause. In some cases of acute facial pain the cause is readily identifiable and the patient is managed appropriately, either by their GP or GDP. One population-based cross-sectional study undertaken in a North of England GP practice estimated the prevalence of orofacial pain among adult patients (aged 18–65) at 23%. Not only does facial pain have a significant effect on the individual patient's quality of life but it also impacts on their family and wider society, because of the economic burden of days taken off work. Facial pain can be difficult to diagnose because of its multifactorial nature. This article outlines the principal causes of facial pain and the clinical assessment of patients presenting with this complaint. The diagnosis and management of temporomandibular joint disorders in primary care is described.

Prevalence of Orofacial pain among urban adult population of Hubli - Dharwad and its impact on daily living

Background & aim: Orofacial pain (OFP) affects millions around the world in their daily activities, social relations and have substantial impact on quality of life. Present study was done with an aim to assess prevalence of OFP and its impact on daily living. Methods: 1600 subjects above the age group of18 years were chosen by cluster random sampling method. Closed ended questionnaire by interview method was used to collect information on OFP and impact using OHIP (Oral Health Impact Profile). Results: Prevalence of OFP was 26.94% which is more common in age group of 35-44 yrs (10.3%), females (14%) and low income group (9.05%). Toothache (15.44%) was most common in oral region, frequent headaches (4.25%) and pain in forehead (4.25%) in facial region. OHIP items showed more impact with being irritable with other people, difficulty-chewing food, disturbed sleep and worried about pain in 50% of the subjects. Mean OHIP score was 45, which increases in subjects with more number of symptoms (60.7 mean), increased intensity (mean 90), decreased frequency (mean 56.4), present pain (mean 55), upon arising (mean 47) and pain during sleep (mean 53) which showed negative impact on daily living and statistically significant difference was seen. (p<0.01). Conclusion: Quarter of study population had OFP, which showed impact in Social disability (38.4%), Psychological discomfort (35.5%), and Psychological disability (36.5%), functional limitation (31.1%), physical disability (18.5%) and handicap (7.2%).