Chronic pain disorder manifesting as dental pain: case report.
Chronic pain disorder is a challenging presentation for the dental surgeon, and carries considerable impairment for the affected individual. Patients undergo extensive unnecessary investigations and treatments before the correct diagnosis is reached. It is frequently a diagnosis of exclusion. We report the case of a 46-year-old man who experienced persistent severe orofacial pain superimposed upon pain involving other anatomical regions for more than 20 years. He received treatment by eight specialties and at five national centres with increasingly poor outcome. The importance of early recognition of medically unexplained pain will be discussed.


CONCLUSIONS
Dentists should have a high index of suspicion of pain disorder in those with multiple complaints of chronic pain in order to avoid unnecessary investigation and treatment.
Taye
Tesema
T
Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire AL7 4HQ, UK.
Fineberg
Naomi
N
Sherman
Jeremy A
JA
Rao
Harish
H
Creak
David
D
D000928:Antidepressive Agents / Q000627:therapeutic use; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000150:complications / Q000628:therapy; D003937:Diagnosis, Differential; D005157:Facial Pain / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000628:therapy
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors