Unnecessary dental extractions in patients with Persistent Idiopathic Facial Pain: a qualitative and questionnaire-based study of patient perspectives

TL;DR

This study explores how patients with Persistent Idiopathic Facial Pain perceive unnecessary dental extractions, revealing emotional and physical challenges they face.

Contribution

The study introduces new qualitative insights into patient experiences with PIFP and unnecessary dental procedures.

Findings

Patients described physical metaphors and somatization related to facial pain.

Emotional reactions included catastrophic thinking and loss of agency.

Patients reported feeling neglected or misunderstood by the medical system.

Abstract

Background: This study aimed to explore the perspectives of individuals
with Persistent Idiopathic Facial Pain (PIFP) who sought dental extractions for
pain relief and to identify common themes from their experiences. PIFP
significantly impacts the quality of life, leading many patients to undergo
unnecessary dental procedures on healthy teeth for pain relief. Recognizing
unique characteristics in patients with a history of such interventions could
help prevent unnecessary treatments and associated complications.
Methods: We conducted qualitative research at the Headache Clinic, Tel
Aviv Sourasky Medical Center, involving 12 consecutive patients with PIFP who had
undergone dental extractions. Data were collected through medical records,
interviews, and questionnaires. The recorded interviews were transcribed and
analyzed using qualitative research guidelines, with a focus on descriptive,
linguistic, and conceptual comments. Results: Twelve participants aged
28–83 were included in the study. Data analysis revealed three main themes: (1)
physical metaphors (“like an exposed nerve”), (2) emotional and cognitive
reactions to pain (“life had stopped”), and (3) encounters with the medical
establishment (“not just injustice, it’s medical negligence”). Physical
metaphors included additional somatization, symbolic penetration, facial pain
analogous to emotional pain or a traumatic event, and pain as a silencer.
Emotional and cognitive reactions included catastrophic reactions,
incomprehensibility, loss of agency, and disconnection from emotional pain.
Finally, encounters with the medical establishment included complex interactions
with medical figures, as well as confusion and perplexity with the medical
system. Conclusions: This qualitative study offers insights into the
subjective experiences of PIFP patients. The identified themes highlight shared
challenges and the multifaceted nature of PIFP, underscoring the need for
comprehensive, multidisciplinary approaches.

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