Evaluation of Diagnostic and Therapeutic Measures in Patients with Persistent Idiopathic Facial Pain before a Definitive Diagnosis

Background: Persistent idiopathic facial pain (PIFP) is one of the chronic pains in the oral and maxillofacial region and its diagnosis has always been challenging. This study aimed to evaluate the diagnostic and therapeutic measures patients underwent before reaching a definitive diagnosis.Methods and Materials: This cross-sectional descriptive study, included patients referred to the pain clinic of Mashhad Dental School from April 2023 to February 2024, whom received a diagnosis of PIFP. In addition to demographic information, the average time between the onset of symptoms and the final diagnosis, the number of consultations before diagnosis and the history of undergone diagnostic and therapeutic measures for pain relief; were recorded. Spearman's correlation test was used to check for any correlation between diagnosis delay time and patients' age, number of previous consultations, and pain intensity score. Investigating the relationship between diagnosis delay and qualitative variables was done using the Mann-Whitney U or Kruskal-Wallis tests, with a significant level of 0.05.Results: A total of 56 patients, consisting of 42 females and 14 males, with an average age of 49.18 ± 14.86 years participated in this study. The average diagnosis delay was 22.37±17.45 months. Before definitive diagnosis, the patients had visited a doctor or dentist on average 6.41 ± 6.53 times and they had taken an average of 2.25 ± 0.94 classes of medication. According to Spearman's correlation test, more consultations before definitive diagnosis had a positive and significant relationship with longer time to visit the pain clinic (P=0.012, r=0.335). The rest of the investigated factors had no significant relationship with the diagnosis delay time.Conclusion: Our study showed that most patients had undergone dental procedures in an attempt to relieve pain. Despite numerous referrals of patients to general dentists, a very small percentage of patients were referred to the pain clinic; suggesting that professional delay played an important role in delayed diagnosis.