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Persistent Orofacial Pain Attendances at General Medical Practitioners

Lookup NU author(s): Dr Charlotte CurrieORCiD, Dr Julia PalmerORCiD, Professor Mark PearceORCiD, Professor Justin DurhamORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Patients with persistent orofacial pain (POFP) can go through complex care pathways to receive a diagnosis and management, which can negatively impact their pain. This study aimed to describe 44-year trends in attendances at Welsh medical practices for POFP and establish the number of attendances per patient and referrals associated with OFP and factors which may predict whether a patient is referred. A retrospective observational study was completed using the nationwide Secure Anonymised Information Linkage Databank of visits to general medical practices in Wales (UK). Data were extracted using diagnostic codes (“Read codes”). Orofacial and migraine Read codes were extracted between 1974 and 2017. Data were analysed using descriptive statistics, univariate, and multivariable logistic regression. Over the 44-year period there were 468,827 POFP and migraine diagnostic codes, accounting for 468,137 patient attendances, or 301,832 patients. The overall attendance rate was 4.22 attendances per 1000 patient-years (95% CI 4.21-4.23). The attendance rate increased over the study period. Almost one-third of patients (n=92,192, 30.54%) attended more than once over the study period and 15.83% attended more than once within a 12-month period. There were 20,103 referral codes which were associated with 8,183 patients, with over half these patients being referred more than once. Odds of receiving a referral were highest in females (OR 1.23; 95% CI 1.17-1.29), in those living in rural locations (OR 1.17; 95% CI 1.12-1.22) and in the least deprived quintile (OR 1.39; 95% CI 1.29-1.48). Odds also increased with increasing age (OR 1.03; 95% CI 1.03-1.03). The increasing attendance may be explained by the increasing incidence of POFP within the population. These patients can attend on a repeated basis and very few are referred, however when they are this may occur multiple times, therefore, current care pathways could be improved.

Publication metadata

Author(s): Currie CC, Palmer J, Stone SJ, Brocklehurst P, Aggarwal VR, Dorman PJ, Pearce MS, Durham J

Publication type: Article

Publication status: Published

Journal: Journal of Dental Research

Year: 2023

Volume: 102

Issue: 2

Pages: 164-169

Print publication date: 01/02/2023

Online publication date: 30/10/2022

Acceptance date: 06/09/2022

Date deposited: 06/09/2022

ISSN (print): 0022-0345

ISSN (electronic): 1544-0591

Publisher: Sage


DOI: 10.1177/00220345221128226

ePrints DOI: 10.57711/75nt-s780


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Funder referenceFunder name
Doctoral Research Fellow DRF-2017-10-022