Primary care‐based facial pain unit inVantaa: the first experiences 2003–2009

Abstract

As an attempt to tackle the challenge in serving facial pain patients, the first primary care-based facial pain unit was founded in 2003 as part of public dental primary care of Vantaa, Finland. Data were collected, consisting of sex, age, sources of referrals, reasons for seeking care, diagnoses made, therapeutic procedures, and numbers of visits to dentists and phone consultations. To describe the development of the present pain management system, we divided the observation periods into two parts: 2003-2006 and 2007-2009 and compared frequencies of the studied parameters between the two follow-up periods. During 2003-2006, 370 patients were examined and the number of visits was 659, corresponding patients' number was 437 and visits' number 960 during 2007-2009. Referrals to the primary care facial pain unit came from primary care dentists (80%), respective primary care pain unit GPs (6%), oral hygienists (3%) and ordinary GPs (2%). Four percentage of the patients' referrals came from secondary and tertiary care clinics of various types and 5% from private sector dentists and specialists. The average number of telephone consultations per year increased from 51 to 300 between study periods. During the follow-up period, the main reason for seeking care from our unit was temporomandibular disorders. Education in self-care, oral appliance therapy and physiotherapy were mostly used as management for these pain problems. The facial pain management unit in primary health care could be a useful model to serve increasing numbers of chronic facial pain patients.

Patients referred to a German TMD-specialized consultation hour—a retrospective on patients without a diagnosis according to RDC/TMD decision trees

“…The treatment cascade that follows basically involves ENT physicians, oral and maxillofacial surgeons and specialists on temporomandibular disorders (TMD) [1]. General practitioners estimate TMD to be the most frequent reason for orofacial pain symptoms [1,2]. TMD has a complex etiopathology that is based on physical (axis I) and psychosocial (axis II) aspects.…”

“…Overall, specialized units or consultation hours for orofacial pain or TMD at hospitals/universities are visited frequently by patients seeking care [2]. The variety of TMD-and non-TMDrelated complaints is supposed to be large, and a high diversity of psychosocial characteristics might be estimated.…”