Prevalence of Referred Pain with Pulpal Origin in the Head, Face and Neck Region

INTRODUCTION: This study was designed to evaluate the prevalence of referred pain with pulpal source in the head, face and neck region among patients referred to Dental School of Shahid Beheshti University MC, Tehran, Iran in 2004. MATERIALS AND METHODS: In this cross-sectional study, 100 patients (55 males and 45 females) referred to oral medicine department of Shahid Beheshti Dental School evaluated via clinical and radiographic examination to seek their pain sources and sites. Inclusion criteria were report of pain and a dental clinician accomplished detection of pain origin. Exclusion criteria were non-odontogenic painful diseases, advanced periodontal disease, and substantial carious lesions. Visual analogue scale (VAS) was used to score pain intensity; meanwhile the patients were asked to mark the painful sites on an illustrated head and neck mannequin. RESULTS: Sixty-five percent of patients reported pain in sites which diagnostically differed from the pain source. According to statistical analysis, duration (P<0.01), spontaneity (P<0.001) and quality (P<0.01) of pain influenced its referral nature, while sex and age of patients, kind of stimulus, throbbing and intensity of pain had no considerable effect on pain referral (P>0.05). CONCLUSION: The prevalence of referred pain with pulpal origin in the head, face and neck region is moderately high which requires precise diagnosis by dental practitioners. Some hallmarks of irreversible pulpitis (e.g. spontaneous and persistent pain after elimination of stimulus) are related to pain referral.