Opinions of UK specialists about terminology, diagnosis, and treatment of atypical facial pain: a survey

There are few robust, evidenced-based data about what constitutes the diagnosis of atypical facial pain and how it is best treated. We therefore aimed to find out the current opinion of those on specialist lists in the United Kingdom (UK) on whether they use the term atypical facial pain, how they reach their diagnosis, and what treatment they offer. We sent out questionnaires to 240 specialists randomly selected from the UK lists of those most likely to deal with atypical facial pain (oral and maxillofacial surgeons, oral medical specialists, ear nose and throat surgeons, anaesthetists, psychiatrists and neurologists). We divided the replies according to whether the specialists were medically or dentally based. Of the 209 valid questionnaires, 143 were returned (a response rate of 68%); 127 of the 143 used the term atypical facial pain, the others used various other terms. The two groups used significantly different criteria, mainly to exclude other conditions to achieve a diagnosis. About half used haematological tests and most used radiographic investigations routinely, and there were no significant differences among the specialities. No unified pattern of referral between different units was found. Treatment was mainly by antidepressant and anticonvulsant drugs, and counselling.