Journal of Oral & Facial Pain and Headache最新文献

Background: Due to the many different underlying disorders causing orofacial pain, management of orofacial pain is a challenge. Many patients seek help from different healthcare providers during their patient journey. The primary aim of this study was to describe the physical and emotional patient journey of patients with orofacial pain. The secondary aim was to determine which personal factors may have contributed to number of healthcare providers visited and patient journey satisfaction.

Methods: For this, a concurrent triangulation mixed methods design was used. Patients 18 years or older with orofacial pain who visited the Orofacial Pain and Dysfunction (OPD) clinic of the Academic Centre of Dentistry Amsterdam were recruited. Participants filled out questionnaires regarding their patient journey, locus of control, readiness to change, catastrophizing, illness perception, and kinesiophobia. A linear regression analysis was performed to determine which factors were associated with the number of healthcare providers visited and the patient journey satisfaction. A subsample of participants was invited to an additional in-depth interview about their patient journey experiences.

Results: A total of 102 participants visited an average of 2.7 healthcare providers before their visit to the OPD clinic. There was an association between patient satisfaction and readiness to change as well as internal locus of control, and between the number of healthcare providers visited and readiness to change, as well as illness perception and chance-related locus of control. Themes related to a satisfactory patient journey included clear communication, feeling taken seriously, and thinking along with the patient. Non-helpful factors were long wait times, financial factors, perceived lack of knowledge of the healthcare providers, and feeling helpless.

Conclusions: The journey of patients with orofacial pain is complex, and the patient satisfaction could be improved by improving the efficiency and clear communication to patients.

Background: This study aimed to determine the frequency and associated factors of cervicogenic headache (CGH) in individuals with forward head posture (FHP). Additionally, craniovertebral angle (CVA)-related factors were examined in patients diagnosed with CGH.

Methods: This cross-sectional study included 117 patients aged 18-45 years who presented with neck pain and were identified with FHP. CGH diagnosis was based on the International Classification of Headache Disorders (ICHD-3) criteria. CVA was measured using posture analysis software, and assessments included the Neck Disability Index (NDI), Henry Ford Headache Disability Inventory (HDI-T), Headache Impact Scale (HIT-6), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Visual Analog Scale (VAS) for pain. Statistical analyses included independent t-tests, chi-square tests and logistic regression models.

Results: The frequency of CGH in patients with FHP was 53.8%. Compared to the non-CGH group, those with CGH had significantly lower CVA (p = 0.030) and higher PSQI (p = 0.001) and BDI scores (p < 0.001). Logistic regression analysis identified low CVA (Odds Ratio (OR): 0.878, p = 0.014) and poor sleep quality (OR: 1.140, p = 0.025) as independent predictors of CGH. Additionally, Body Mass Index and VAS scores were negatively correlated with CVA (p < 0.05).

Conclusions: FHP may be associated with CGH, possibly through increased biomechanical load and neuromechanical sensitivity. Interventions such as corrective exercises, weight management, and improving sleep quality may be considered as supportive strategies in CGH management; however, causal relationships cannot be inferred from this study. Further studies are needed to explore the long-term effects of postural interventions on CGH.

Background: Temporomandibular disorders (TMD) encompass musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ), masticatory muscles and other associated structures. While all dentists, regardless of their specialty, should possess a comprehensive understanding of TMD diagnosis and treatment, there is a limited number of studies assessing the knowledge and attitudes of pediatric dentists on this subject. The objective was to evaluate the knowledge and attitudes of pediatric dentists regarding the diagnosis and management of TMD in pediatric patients.

Methods: This observational, analytical, cross-sectional study included 266 pediatric dentists who completed a 41-item questionnaire. Of these, 35 items assessed knowledge, while six evaluated attitudes. Descriptive statistics were analysed, and the chi-square test was applied for comparisons, with statistical significance set at p < 0.05.

Results: The mean correct response rate across the four assessed domains was 49.5%. The lowest accuracy was observed in the pathophysiological domain (33%), followed by the psychophysiological domain (50%), the psychiatric disorders domain (64.1%) and the chronic pain domain (50.4%).

Conclusions: Pediatric dentists exhibited limited knowledge of TMD but expressed positive attitudes toward its diagnosis and treatment. Morever, they demonstrated a lack of awareness regarding their role in preventive education on this condition.

Background: It is unclear which oral behaviors are harmless and which might become harmful when performed excessively. This study aimed to determine which awake oral behaviors are associated with Temporomandibular Disorder (TMD)-related pain symptoms in a non-patient population.

Methods: Subjects' awake oral behaviors were assessed through: (i) Oral Behavior Checklist (OBC), a single-point self-report questionnaire that quantifies the frequency of awake functional and non-functional oral behaviors; and (ii) Ecological Momentary Assessment (EMA), a designated smartphone application which enabled real-time repeated data collection of oral behaviors throughout the day, for multiple days. 118 participants (62.7% female) completed both the OBC and EMA assessment modes. Subjects were allocated into two groups: (i) subjects with TMD-related pain symptoms (TMDPS, N = 34, 85.29% female); and (ii) subjects without TMD-related pain symptoms (noTMDPS, N = 84, 53.57% female).

Results: TMDPS subjects performed more awake oral behaviors compared to noTMDPS subjects. EMA behaviors that showed a significant predictive ability of masticatory muscle pain in binomial logistic regressions were entered into a multiple logistic regression model. Results show that teeth grinding increased the odds of subjects belonging to the TMDPS group by 22%. The final logistic regression demonstrated acceptable fit (Nagelkerke's R² = 0.232). In a multiple regression model evaluating the predictive ability of OBC behaviors, the final model showed a Nagelkerke's R² of 0.468. In addition to sex, three OBC behaviors came out as significant predictors in the final model: teeth grinding increased the odds of subjects belonging to the TMDPS group by 85%; holding or jutting the jaw increased the odds by 82%, and clenching increased the odds by 67%.

Conclusions: Reports of teeth clenching, holding or jutting jaw forward or to the side, and teeth grinding may be associated with the report of TMD-related pain symptoms in a non-patient student population.

A connection between orofacial, cranial and cervical regions has been documented through the trigeminocervical nucleus (TCN), but the predominant direction (orofacial/cranial-to-cervical or cervical-to-orofacial/cranio) of this connection still remains unclear. This scoping review was designed to determine the dominant direction of the connection between these two areas. Searches were conducted by combining these concepts: TCN, cervical and face/jaw/head region. Eighty-three studies were included. The most predominant direction was reported to be from the orofacial/cranial to the cervical region, with most of the studies conducted in mammals. The clinical implications of these findings for the spread and referral of pain between these regions are examined and discussed.

No abstract available.

Background: Persistent idiopathic facial pain (PIFP) is a complex condition characterized by chronic, unexplained facial pain that significantly impacts patients' quality of life and remains poorly understood by the general public. This research aimed to assess the knowledge and understanding of PIFP among the general population of Ha'il, Saudi Arabia.

Methods: This cross-sectional study examined Ha'il residents' attitudes and levels of knowledge regarding PIFP and investigated the associated factors. Anonymised surveys were distributed to 350 respondents between November 2023 and March 2024. The original survey draft was based on a combination of previously published research, the Facial Pain Association, and previously validated questionnaires addressing similar objectives. A standardised survey scheme was designed, pre-coded and validated. The refined survey instrument was then transformed into an online questionnaire using Google Survey© 2023 and distributed.

Results: In total, 254 respondents filled out the survey. The chi-square test was utilised to assess knowledge and attitudes in relation to participants' sociodemographic characteristics. Spearman's rank correlation coefficient (p < 0.05), odds ratios and confidence intervals were calculated to assess the relationship between attitudes and knowledge. Binary logistic regression analysis was performed to identify predictors of high knowledge levels and positive attitudes. The participants showed moderate knowledge of PIFP, with 51.24% correct responses. Notably, 96.90% identified dental issues, infections and nerve abnormalities as key factors. Gender influenced perceptions, with 30.9% of women and 45.9% of men downplaying PIFP's significance, while age, education and occupation had minimal impact (p > 0.05).

Conclusions: This study emphasises the critical need for targeted educational programs to address misconceptions and information gaps around PIFP. The information gained highlights the need for an advanced approach to health education and communication that is tailored to the unique cultural and demographic characteristics of Ha'il, Saudi Arabia.

Background: Temporomandibular disorders (TMD) refer to a collection of pathological conditions that impact the stomatognathic system, often associated with psychiatric comorbidities. Interestingly, previous studies have reported a higher prevalence of TMD in individuals affected by irritable bowel syndrome (IBS), a condition commonly linked to stress-induced psychosomatic factors. The aim of this systematic review is to clarify the prevalence of TMD in IBS-diagnosed patients.

Methods: A systematic search was conducted in PubMed, Scopus, Web of Science and Cochrane Library databases up to May 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Eligibility criteria included studies reporting prevalence data on TMD in IBS patients. Study quality was assessed using the Risk of Bias in Non-randomized Studies-of Exposure (ROBINS-E) tool.

Results: A total of five studies, involving 3138 patients, were included. TMD prevalence was significantly higher in IBS patients compared to pooled controls. However, no significant differences were observed among IBS subtypes regarding TMD prevalence.

Conclusions: This review highlights a substantially higher prevalence of TMD in IBS patients compared to the general population, suggesting a shared pathophysiological mechanism likely linked to stress response systems. These findings underscore the need for a multidisciplinary approach to patient management and emphasize the importance of further research to explore the causal links and underlying mechanisms between IBS and TMD.

The prospero registration: The protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the number CRD42024542233.

Background: This study examines the feasibility of preventative and acute treatment of chronic cluster headaches using vibration as a potential intervention to warrant a large-scale clinical trial.

Methods: The paper reports a study on sixty individuals suffering from tension or cluster-type headaches. The experimental group of 30 individuals received vibratory treatment at set frequencies, and the control received sham treatment. All individuals were evaluated prior to and immediately after the intervention, and at six and eight weeks after the conclusion of treatment.

Results: Significant improvement was noted in the experimental group as rated by the Headache Impact Test-6, Rivermead Persistent Post-Concussive Syndrome (PPCS) Questionnaire, Montreal Cognitive Assessment, Participant Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, and/or the Post Traumatic Stress Disorder Checklist.

Conclusions: The use of vibration and resonance-type devices significantly reduces mean pain ratings over time, pointing to their effectiveness as a potential maintenance or preventative type of therapy. This study contributes to the development and design of larger randomized controlled trials that could further evaluate the effectiveness of vibration and resonance with oscillating expiratory pressure on headache.

Clinical trial registration: ISRCTN37415803.

Background: Erenumab has proven efficacious in treating migraine headache. Temporomandibular disorder (TMD) is a painful disorder which has high co-occurrence rates with migraine. We hypothesized that erenumab-aooe may also be beneficial in reducing pain in TMD-related myalgia.

Methods: This phase II randomized placebo-controlled clinical trial evaluated the safety and efficacy of the off-label use of erenumab in reducing TMD-related pain. The TMD diagnosis was established using the Diagnostic Criteria for Temporomandibular Disorders. The primary outcome was pain interference as assessed by the 0-to-10-point Brief Pain Inventory (BPI). Secondary outcomes were depression, anxiety and somatic symptoms; jaw function; and percent of days taking pain medication. Subjects were randomized at baseline to receive either erenumab 140 mg or placebo administered subcutaneously every 4 weeks for a total of five treatments. Outcome assessments were conducted at baseline, 4, 8, 12, 16, 20 and 24 weeks.

Results: Thirty subjects were enrolled with 15 randomized to each treatment group. Baseline pain was mild (BPI interference of 2.19; BPI severity of 2.95). There were no significant treatment effects at any time points with the between-group BPI interference at 24 weeks being -0.19 (95% confidence interval -1.94 to 1.56; p = 0.82). The outcomes were similar between erenumab and placebo for all outcomes except the Patient Health Questionnaire 4-item scale (PHQ-4) which showed that depression/anxiety symptoms were modestly worse (p = 0.03) in the erenumab group. Five participants withdrew during the trial (4 in erenumab arm, 1 in placebo arm).

Conclusions: Erenumab was not efficacious in reducing TMD myalgic pain in this phase II trial of 30 subjects with relatively mild pain.

Clinical trial registration: The study was registered in clinicaltrials.gov (ID: NCT04884763).