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

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.

Dentoalveolar pain; Anaesthesia dolorosa; Painful post-traumatic trigeminal neuropathy; Web epidemiological survey; Preventive medicine

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