Are dentists aware of post-traumatic trigeminal neuropathic pain? A web-based epidemiological survey

TL;DR

Many dentists are unaware of post-traumatic trigeminal neuropathic pain, leading to misdiagnosis and unnecessary treatments.

Contribution

This study reveals a significant lack of awareness among dentists regarding a specific type of neuropathic pain following dental procedures.

Findings

29% of dentists were unaware of post-traumatic trigeminal neuropathic pain.

Most dentists performed irreversible therapies instead of referring patients to pain specialists.

The condition is often misdiagnosed, leading to delayed proper treatment and high socioeconomic costs.

Abstract

Background: Post-traumatic trigeminal neuropathic pain represents
neuropathic pain in the distribution of the trigeminal nerve caused by trauma to
the trigeminal nerve. Dental traumatic interventions, such as root-canal therapy
and extractions, are reported to precede, in some cases, the onset of the
disease. The current study aims to investigate how much dentists are trained to
recognize, treat or properly address patients suffering from Post-traumatic
trigeminal neuropathic pain. Methods: Data were collected from a large
sample of Italian dentists in 2021. The setting of this study relates to an
epidemiological survey conducted on the web. Google Forms, a product of Google
Inc., was used as the operating system. An online questionnaire was sent to each
participant, and the degree of knowledge of the disease along with the direct
experience of having encountered it was investigated through specific
multiple-choice questions. Results: 634 dentists participated in the
survey. 29% of participants declared to be unaware of the existence of
Post-traumatic trigeminal neuropathic pain. 70% of dentists reported to have had
patients suspicious of such pain in their clinical activity, following endodontic
treatment (60%), tooth extraction (43%), spontaneously (37%) or other dental
therapies (21%). When encountered, only in one out of three cases were patients
sent to a pain specialist, and in most cases dentists performed irreversible
therapies the site of the pain. Conclusions: This study evidences a
major public health problem, such as the incapability of clinicians to perform a
correct diagnosis and management of Post-traumatic trigeminal neuropathic pain.
Such a lack of knowledge costs the patients mistaken and irreversible surgical
therapies in many cases, and resulting delays in receiving proper diagnosis and
management that could affect the success of the treatment. Furthermore, the
unawareness had high socioeconomic costs for both the healthcare system and the
patients due to the disability. Clinical Trial Registration: NP/2021/5460, Institutional Review Boards of the
University of Cagliari, Italy.

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