title: Retrospective examination of the healthcare 'journey' of chronic orofacial pain patients referred to oral and maxillofacial surgery.
abstract: OBJECTIVE
  To gain a deeper understanding of the clinical journey taken by orofacial pain patients from initial presentation in primary care to treatment by oral and maxillofacial surgery.
  
  
  METHODS
  Retrospective audit.
  
  
  METHODS
  Data were collected from 101 consecutive patients suffering from chronic orofacial pain, attending oral and maxillofacial surgery clinics between 2009 and 2010. Once the patients were identified, information was drawn from their hospital records and referral letters, and a predesigned proforma was completed by a single examiner (EVB). Basic descriptive statistics and non-parametric inferential statistical techniques (Krushal-Wallis) were used to analyse the data. DATA AND DISCUSSION: Six definitive orofacial pain conditions were represented in the data set, 75% of which were temporomandibular disorders (TMD). Individuals within our study were treated in nine different hospital settings and were referred to 15 distinct specialties. The mean number of consultations received by the patients in our study across all care settings is seven (SD 5). The mean number of specialities that the subjects were assessed by was three (SD 1). The sample set had a total of 341 treatment attempts to manage their chronic orofacial pain conditions, of which only 83 (24%) of all the treatments attempted yielded a successful outcome.
  
  
  CONCLUSIONS
  Improved education and remuneration for primary care practitioners as well as clear care pathways for patients with chronic orofacial pain should be established to reduce multiple re-referrals and improve efficiency of care. The creation of specialist regional centres for chronic orofacial pain may be considered to manage severe cases and drive evidence-based practice.
authors.affiliation: School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK.
authors.forename: E V
authors.initials: EV
authors.lastname: Beecroft
authors.forename: J
authors.initials: J
authors.lastname: Durham
authors.forename: P
authors.initials: P
authors.lastname: Thomson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D059350:Chronic Pain / Q000175:diagnosis / Q000601:surgery*; D054869:Clinical Audit; D019091:Critical Pathways / Q000458:organization & administration* / Q000706:statistics & numerical data; D005157:Facial Pain / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013515:Surgery, Oral; D016896:Treatment Outcome