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

Validation of an instrument for dentists' perception of pain in patients with communication difficulties

Pain is present in the dental clinic, whether due to oral problems such as dental caries and its complications or related to dental procedures. Pain evaluation in patients with communication difficulties (PCDs) is challenging for dentists, potentially compromising treatment. The aim of this study was to develop and validate an instrument to assess the perception of dentists about pain in PCDs. This study followed a quantitative methodological approach involving constructing and validating an instrument administered to 50 dentists. The initial instrument consisted of 29 items divided into four domains. Content and construct validity and internal consistency were confirmed. Content validation was performed by judges using the Content Validity Index. The instrument underwent construct validation and internal consistency assessments through exploratory factor analysis and confirmatory factor analysis using Cronbach's α, Kaiser-Meyer-Olkin, and Bartlett's sphericity tests. The final instrument consisted of 21 items divided into three domains, with a high Cronbach's α for one domain and moderate values for the others. The total variance accounted for was above 46.03%. Each factor retained at least three items, with factor loadings greater than 0.3, commonalities greater than 0.2, and eigenvalues >1. Despite the study's limitations, the instrument demonstrated its applicability and potential in evaluating the perception and management of pain in PCDs.

A Retrospective Study on the Etiological Factors of Orofacial Pain in a Malaysian Sample

OBJECTIVE

 This study aimed to examine the etiological factors of orofacial pain for patients attending dental clinic at Faculty of Dentistry, International Islamic University Malaysia (IIUM).

MATERIALS AND METHODS

 This retrospective study examined the data of 248 patients who have attended dental clinic at Faculty of Dentistry IIUM and suffering from different types of orofacial pain. The data were collected from January 2010 to November 2018. The etiologies of pain were classified according to International Classification of Orofacial Pain, 1st edition (2020).

STATISTICAL ANALYSIS

 The association of age and gender with orofacial pain was evaluated by using the Chi-square test, and the significance level was set to 0.05.

RESULTS

 Collected data showed that orofacial pain has different etiologies among the patients attending the dental clinic at Faculty of Dentistry IIUM. Moreover, a statistically significant relation was observed between orofacial pain toward gender and different age group.

CONCLUSION

 The findings proposed that the orofacial pain has a variety of etiological factors with the highest percentage of orofacial pain attributed to disorders of dentoalveolar and anatomically related structures among patients attending dental clinic at Faculty of Dentistry IIUM.

Self-perceived competence of dental students regarding the management of orofacial pain: a cross-sectional study

BACKGROUND

There is limited data on Pakistani dental students perceived competence in managing orofacial pain (OFP). This study aims to evaluate dental students self-perceived competence regarding the management of orofacial pain.

METHODS

This cross-sectional study was conducted in Karachi at randomly selected two public and four private dental schools. This survey was conducted online from November 2020 to December 2020 in six dental schools. A questionnaire link was sent to the 475 students. A chi-square test and independent-sample t-test were conducted to assess the frequency distribution and compare mean scores of knowledge, diagnosis, and management parameters.

RESULTS

Of the 475 students, 280 students filled the online survey leaving a response rate of 59%. A significant number of fourth-year students, 65 (51%, p = 0.005), feels knowledgeable regarding neuropathic pain compared to third-year students. The majority of the fourth-year students, 100 (78%, p = 0.010), feel comfortable managing intraoral pain. Almost all the students reported thinking that they need more knowledge related to five types of OFP. The fourth-year students had high mean scores related to knowledge, comfort in diagnosing and managing OFP categories.

CONCLUSION

This study found that dental students perceived competence regarding orofacial pain management varies in relation to specific categories, being lowest for psychogenic pain.

Perceived Practitioner Barriers to the Management of Orofacial Pain in the Kingdom of Saudi Arabia: A Cross-sectional Study

Background:

Orofacial Pain (OFP) is a group of non-dental painful conditions affecting the oral cavity and facial area.

Objectives:

The objective of this study was to explore which barriers to manage the patient with chronic OFP as perceived by general dentists versus dental specialists and to investigate whether if professionals with degrees from their home country versus another country or number of years of professional experience differ in their perceptions.

Methods:

A closed-end questionnaire was hand-delivered to 600 participants [300 general dentists and 300 dental specialists] in four major provinces in Saudi Arabia. Demographic data were expressed as frequency. Proportional t-tests and chi-square tests were used to analyse intergroup differences. Statistical significance for all analyses was set at P-value < 0.05.

Results:

Overall, the response rate was 56.6% (340/600). Around two-thirds of the participants were general dentists (60.9%), while the remainder were dental specialists (39.1%). There was an obvious consensus by the participants that “Low payment/reimbursement” and “Lack of OFP knowledge” were among the most common barriers (85% and 83.5%, respectively). In contrast, “Legal risks” were the least frequently reported factor (38.8%). The most commonly reported barrier by general dentists was “Shortage of patients/lack of demand;” this was significantly different from the experience of dental specialists (87% vs. 72.2%; P- value < 0.01). In terms of the country of graduation or years of experience, there were no significant differences.

Conclusion:

The study demonstrates the existence of many significant barriers other than OFP knowledge, such as reimbursement, facility and demand that could present obstacles and challenges to the management of OFP by general dentists and dental specialists. Most participants believed that dentists should manage this condition and that OFP courses should be included in the dental school curriculum.

Newly graduated dentists' knowledge of temporomandibular disorders compared to specialists in Saudi Arabia

Background

General dentists are often the first healthcare professionals to see patients with orofacial pain (OFP). OFP conditions associated with the temporomandibular joint are often confused with dentoalveolar disorders, which leads to mismanagement. The objective of this study was to evaluate the level of knowledge of temporomandibular disorders (TMD) among newly graduated dentists compared to OFP specialists in Saudi Arabia.

Methods

This was a descriptive cross-sectional study utilizing an anonymous validated questionnaire assessing professional knowledge regarding TMDs in newly qualified dentists and OFP specialists. The questionnaire interrogated four domains including chronic pain/pain behavior, etiology, diagnosis/classification, and treatment/prognosis. OFP specialists were used as the reference group.

Results

A total of 393 dentists participated, a response rate of 67.6% in newly graduated dentists and 77.3% in OFP specialists. The degree of agreement between newly graduated general dentists and OFP specialists was highest for the “chronic pain and pain behavior” domain. The consensus among specialists was highest for the “treatment and prognosis” domain and the least for the “chronic pain and pain behavior” domain.

Conclusion

Newly graduated general dentists have limited knowledge of TMD in almost all domains compared to specialists. Given that a lack of knowledge of TMD can lead to clinical mismanagement, dental school curricula must address this important knowledge gap.

Imaging in Orofacial Pain

Imaging usefulness in the diagnosis of orofacial pain includes all modalities that cover the soft tissue and bony structures in the region of the head and neck. Imaging techniques may include 2-dimensional and/or 3-dimensional imaging modalities. Both dentists and physicians should be aware of orofacial pain associated with a variety of sources and select the appropriate imaging technique based on the patient's medical and dental history and the clinical examination. The goal of imaging is to provide the clinician with information that will confirm or deny findings of the clinical examination and allow for the selection of an appropriate treatment.