Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지

Psychosocial Impact of Chronic Orofacial Pain

만성 구강안면통증의 사회심리적 영향

  • Yang, Dong-Hyo (Department of Oral Medicine, School of Dentistry, Dankook University) ;
  • Kim, Mee-Eun (Department of Oral Medicine, School of Dentistry, Dankook University)
  • 양동효 (단국대학교 치과대학 구강내과학 교실) ;
  • 김미은 (단국대학교 치과대학 구강내과학 교실)
  • Published : 2009.12.30

Abstract

The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.

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References

  1. Merskey H: Pain terms: A list with definitions and notes on usage. Pain 1979;6:249-252
  2. Okeson JP: Bell’s orofacial pains: The clinical management of orofacial pain. 6thed.,Chicago,2005, Quintessence
  3. Zakrzewska JM and Harrison SD: Assessment and management of orofacial pain. Amsterdam, 2002, Elsevier
  4. Simpson KH: Chronic non-cancer pain In: Chronic pain. Dickman A & Simpson KH eds. Oxford, 2008, Oxford University Press
  5. Main CJ and Waddell G: Behavioural responses to examination. A reappraisal of the interpretation of 'non-organic signs'. Spine 1998:23:2367-2371 https://doi.org/10.1097/00007632-199811010-00025
  6. Aggarwal VR, McBeth J, Zakrzewska JM, Lunt M, Macfarlane GJ: Are reports of mechanical dysfunction in chronic oro-facial pain related to somatisation? A population based study. Eur J Pain 2008;12:501-507 https://doi.org/10.1016/j.ejpain.2007.08.002
  7. Murray H, Locker D, Mock D, Tenenbaum HC: Pain and the quality of life in patients referred to a craniofacial pain unit. J Orofac Pain 1996;10:316-323
  8. Macfarlane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV: Oro-facial pain in the community: prevalence and associated impact. Community Dent Oral Epidemiol 2002;30:52-60 https://doi.org/10.1034/j.1600-0528.2002.300108.x
  9. Siccoli MM, Bassetti CI, Sandor PS: Facial Pain:clinical differential diagnosis. Lancet Neurol 2006;5:257-267 https://doi.org/10.1016/S1474-4422(06)70375-1
  10. Spencer CJ, Neubert JK, Gremillion H, Zakrzewska JM, Ohrbach R: Toothache or Trigeminal Neuralgia: Treatment Dilemmas. J of Pain 2008;9:767-770 https://doi.org/10.1016/j.jpain.2008.07.001
  11. Lipton JA, Ship JA, Larach-Robinson D: Estimated prevalence and distribution of reported orofacial pain in the United States. J Am Dent Assoc 1993:124:115-121
  12. Locker D & Grushka M: Prevalence of oral and facial pain and discomfort: preliminary results of a mail survey. Community Dent Oral Epidemiol 1987;15:169-172 https://doi.org/10.1111/j.1600-0528.1987.tb00508.x
  13. Macfaralane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV: Orofacial pain in the community:Prevalence and associated impact. Community Dent Oral Epidemiol 2002;30:52-60 https://doi.org/10.1034/j.1600-0528.2002.300108.x
  14. Shankland WE: Differentiated diagnosis of two disorders that produce common orofacial pain symptoms. Gen Dent 2001;49:150-155
  15. Feinmann C: The mouth, the face and the mind. Oxford, 1999, Oxford University Press
  16. LeResche L: Epidemiology of orofacial pain. In: Lund JP. Lavigne GJ, Dubner R, Sessle BJ eds. Orofacial Pain. Chicago, 2001, Quintessence Publications
  17. Zakrzewska JM: Diangosis and management of nondental orofacial pain. Dent Update 2007;34:134-139 https://doi.org/10.12968/denu.2007.34.3.134
  18. Chung JW, Kim JH, Kim HD et al Chronic orofacial pain among Korean elders: prevalence, and impact using the graded chronic pain scale. Pain 2004;112:164-170 https://doi.org/10.1016/j.pain.2004.08.014
  19. Wolf E, Birgerstam P, Nilner M, Petersson K. Patients' experience of consultations for nonspecific chronic orofacial pain: A phenomenological study. J Orofac Pain 2006;20:226-233
  20. Foreman PA, Harold PL, Hay KD. An evaluation of the diagnosis, treatment and outcome of patients with chronic orofacial pain. N Z Dent J 1994;90:44-48
  21. McCracken LM, Evon D, Karapas ET: Satisfaction with treatment for chronic pain in a specialty service:preliminary prospective results. Eur J Pain 2002;6:387-393 https://doi.org/10.1016/S1090-3801(02)00042-3
  22. Von Korff M, Dworkin SF, LeResche L: Graded chronic pain status: an epidemiologic evaluation. Pain 1990;41:279-291
  23. Von Korff M, Ormel J, Keefe FJ, Dworkin SF:Grading the severity of chronic pan. Pain 1992;50:133-149 https://doi.org/10.1016/0304-3959(92)90154-4
  24. WHO. International classification of impairments, disabilities and handicaps. WHO 1980, Genf
  25. Mewes R, Rief W, Stenzel N et al: What is 'normal' disability? An investigation of disability in the general population. Pain 2009;142:36-41 https://doi.org/10.1016/j.pain.2008.11.007
  26. Zakrzewska JM, Jorns TP, Spatz A: Patient led conferences – Who attends, are their expectations met and do they vary in three different countries? Eur J Pain 2009;13:486-491 https://doi.org/10.1016/j.ejpain.2008.06.001
  27. Forssell H, Santalahti P, Puukka P, Talo S: Searching for an assessment instrument to determine temporomandibular disorders pain profiles for the purposes of primary health care. Int J of Rehabil Res 2005;28:203-209 https://doi.org/10.1097/00004356-200509000-00002
  28. John MT, Reißmann DR, Schierz O: Oral healthrelated quality of life in patients with temporomandibular disorders. J Orofac Pain 2007; 21:46-54
  29. Hahn HM, Yun TH, Shin YW, Kim KH, Yoon DJ, Chung KJ: A standardization study of Beck Depression Inventory in Korea. J Korean Neuropsychiatr Assoc 1986;25:487-502
  30. Cho MJ and Kim KH: Use of the Center for Epidemiologic Studies Depression (CES-D) Scale in Korea. J Nerv Ment Dis 1998;186:304-310 https://doi.org/10.1097/00005053-199805000-00007
  31. Iwata N, Saito K, Roberts RE: Responses to a self administered depression scale among younger adolescents in Japan. Psychiatry Res 1004;53:275-287 https://doi.org/10.1016/0165-1781(94)90055-8
  32. Zheng Y, Zhao J, Phillips MR, Dai C, Zheng H:Validity and reliability of the Chinese Hamiton Depression Rating Scale. Br J Psychiatry 1988;152:660-664 https://doi.org/10.1192/bjp.152.5.660
  33. Chibnall JT & Tait RC: The Pain Disability Index:factor structure and normative data. Arch Phys Med Rehabil 1994;75:1082-1086 https://doi.org/10.1016/0003-9993(94)90082-5
  34. Tait RC, Pollard CA, Margolis RB, Duckro PN, Krause SJ: The Pain Disability Index: psychometric and validity data. Arch Phys Med Rehabil 1987;68:438-441
  35. Tait RC, Chibnall JT: Factor structure of the Pain Disability Index in workers' compensation claimants with lower back injuries. Arch Phys Med Rehabil 2005;86:1141-1146 https://doi.org/10.1016/j.apmr.2004.11.030
  36. Von Korff M & Dunn KM: Chronic pain reconsidered. Pain 2008;138:267-276 https://doi.org/10.1016/j.pain.2007.12.010
  37. Turk DC, Rudy TE: Toward an empirically derived taxotomy of chronic pan patients: integration of psychological assessment data. J Consult Clin Psychol 1988;56:233-238 https://doi.org/10.1037/0022-006X.56.2.233
  38. Coulter A & Ellins J: Patient-focused interventions. A review of the evidence. London, The Health Foundation, 2006
  39. Won JY, Kim KS: Epidemiology study of patients with neuropathic pain in Korea. Kor J Oral Med 2007;33:353-374