Unnecessary dental extractions in patients with Persistent Idiopathic Facial Pain: a qualitative and...

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.

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.

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.

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.