The specialist management of non-temporomandibular orofacial pain: maxillofacial surgery’s known unknown?

In this study we aimed to provide an overview of the healthcare “journey” of a group of patients referred to a specialist unit with “complex” non-temporomandibular orofacial pain. We retrospectively reviewed all those who were referred over a six-month period and followed for up to three years. A total of 133 were included, 69% were female, and the mean (SD) duration of symptoms before assessment was 66.4 (88.8) months. Patients were treated for seven different conditions by a mean (SD) of 2.6 (1.2) specialties, and 3.2 (2.5) medications had been tried before assessment at the unit. A mean (SD) of 3.9 (3.3) appointments were attended over the three years, and 80% of patients were prescribed at least one medication. Patients were under the care of the unit for a mean (SD) of 11.9 (14.0) months, and 38% were still being seen at three years. Those with trigeminal neuralgia were most likely to remain in care at three years (p = <0.001), and those with burning mouth syndrome (p = <0.001) or persistent idiopathic facial pain (p = 0.005) were most likely to be discharged. In the current NHS climate, the lack of resources to treat facial pain and the focus on a mix of skills, mean that OMF surgeons are likely to have an increasing role in the treatment of these patients. This paper provides an important insight into these conditions.
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research