Managing chronic orofacial pain: A qualitative study of patients', doctors', and dentists' experiences

Abstract

Current management of COFP is ineffective and unsatisfactory for patients and practitioners, which impacts on their relationship. Fundamental barriers to accessing and implementing psychological interventions for COFP arise from ineffective communication between physicians and patients, and between medical and dental practitioners. Statement of contribution What is already known on this subject? COFP is characterized by persistent pain in the face, mouth, or jaws that are not the result of organic disease or physical trauma. Patients with COFP present to both medical and dental services and receive sub-optimal care. No studies have examined the experiences of managing this problem from the perspectives of dentists, general practitioners and patients. What does this study add? Patients, dentists, and GPs recognize the role that psychological factors have in maintaining and addressing facial pain symptoms, yet principally manage it through biomedical interventions. Challenges exist over arriving at a diagnosis and managing the problem, and challenges are exacerbated by poor communication between doctors and medical services. Improvements are needed in liaison between medical and dental services and further training to support primary care clinicians to facilitate a stepped care approach to managing COFP.

Knowledge About Chronic Orofacial Pain Among General Dentists of Kermanshah, Iran

“…reported that the knowledge of general dentists about TMJ disorders was insufficient and the level was lower than specialist dentists [31]. Peters et al , reported that although psychological factors play a role in chronic orofacial pains, treatments provided to patients are insufficient and limited to therapeutic interventions [32]. Alonso et al ., reported that the lowest level of self-assessment of students about chronic orofacial pain was related to treatment abilities of pain with psychological origins [25].…”

Barriers to self-management of chronic pain in primary care: a qualitative focus group study

“…Fewer empirical studies include HCP experiences. Those that do highlight the emotional toll of treating patients with chronic pain; [29][30][31][32][33] 32,34 and not knowing the appropriate information to give patients. 29 The current study finds that these factors experienced by many patients and HCPs can also create barriers to successful selfmanagement.…”

'I just wanted someone to tell me it wasn't all in my mind and do something for me': Qualitative exploration of acceptability of a CBT based intervention to manage chronic orofacial pain

“…A guided self management intervention was developed based on CBT principles, using Medical Research Council (MRC) guidance for the development and evaluation of complex interventions (6,7).The intervention was developed using findings from a best evidence synthesis of 3 specially conducted studies (systematic review, (5) survey of dentists (8) and a qualitative study of dentists, GPs and patients (9). A full review of this process is available (10).…”