Diagnostic delay and sub-optimal management in persistent idiopathic facial pain and persistent dento-alveolar pain; a cross sectional study

Publication date: Available online 22 February 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Yazan Hassona, Ahmad El-Ma'aita, Jacqueline Amarin, Anas Al Taee

Abstract

Objectives

To explore the diagnostic and therapeutic challenges encountered by patients with persistent idiopathic facial pain (PIFP), and to investigate factors influencing its delayed diagnosis.

Study Design

In this cross-sectional study, 34 newly diagnosed PIFP patients were interviewed. Data about diagnostic delay, number and nature of previous consultations, and previous medical and surgical interventions were recorded. Pearson correlation and Student's t-test were used to examine differences among various variables in relation to diagnostic delay.

Results

The average time between the onset of symptoms to the correct diagnosis was 19.3 ±11.1 months. Diagnostic delay was significantly longer in patient with pain localized to intraoral sites (22.6 ± 7.4) compared to patients with extra-oral pain (16.1 ±9.3). The average number of health care professionals consulted before correct diagnosis was 3.7 ±2.3. General dental practitioners were the most commonly consulted professionals (n=27; 79.4%). On average, patients were offered 2.3± 0.24 misdiagnoses prior to correct diagnosis, and were prescribed 3.5 ± 2.4 classes of drugs. Twenty-five patients (73.5%) underwent unnecessary surgical/dental interventions.

Conclusion

Patients with PIFP are frequently misdiagnosed leading to prescription of ineffective medications and unnecessary investigations and surgical interventions. Educational efforts should emphasize on improving knowledge and awareness of this condition.

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