PDF: Chronic idiopathic orofacial pain: II - What can the general dental practitioner do?

Currently, the majority of facial pain patients are referred onto specialists but there are treatment options available to the primary care practitioner and, indeed, good reasons for interception at the acute stage to prevent the development of chronicity. 

This paper attempts to synthesize contemporary theory and clinical evidence into a management strategy for the general dental practitioner.

In brief
• The pain history is the key to diagnosis.
• Pain is only very loosely related to dental or TMJ pathology.
• Sympathetic enquiry, into how the pain interferes with the patient’s life, will reveal goals for improvement.
• Early discussion and intervention may prevent the development of chronic symptoms.

The management strategy described in this second paper is the result of many years’ clinical experience, combined with evidence from our own research and that of others, as cited in the first paper. 

Of course, there remains a need for clinical trials, with which we are currently engaged, but it will be several years before these are complete, and it would seem beneficial to the primary care of patients to disperse our ideas now, and to dispel some of the myths surrounding these conditions.

The strategy does not involve novel technological techniques warranting extensive investigation of unwanted effects, but rather a holistic patient-oriented approach based on good clinical practice.

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