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Study Finds Profound Overlap of Facial Pain With Headache and Neck Pain, Lessening Towards Extremities

Alexandria, VA, USA – At the 95th General Session & Exhibition of the International Association for Dental Research (IADR), researcher Gary Slade, University of North Carolina, Chapel Hill, USA presented an abstract titled “Overlap of Facial Pain and Pain Elsewhere: Anatomical Location Matters.” The IADR General Session was held in conjunction with the 46th Annual Meeting of the American Association for Dental Research and the 41st Annual Meeting of the Canadian Association for Dental Research. 

Slade examined chronic facial pain and overlaps with pain disorders elsewhere in the body. If the overlap is a consequence of each pain disorder having the same underlying cause, such as central sensitization, the degree of overlap should be unrelated to anatomical location. The hypothesis was tested in a community based-sample of U.S. adults. In this case-control study of the OPPERA-2 (Orofacial Pain: Prospective Evaluation and Risk Assessment) project, 18-74 year olds living near four U.S. study sites were recruited by telephone screening. Cases were n=461 respondents who reported pain in the head, face, jaw or jaw joints for ≥5 days per month for ≥6 months; controls were n=965 respondents who reported no facial pain. Respondents completed a mailed questionnaire that asked about frequency of headache and included a body manikin with 42 checkboxes to denote locations where pain had lasted for ≥1 day. Other questions assessed potential confounders: somatic symptoms, psychological stress, sleep quality and mood. Odds ratios (OR) and 95% confidence limits (95%CL) were computed to quantify degree of overlap between facial pain and pain at seven other locations. Confounder-adjusted ORs were estimated using multivariable logistic regression. 

Slade’s study found pain prevalence in controls ranged from 13% (upper limbs) to 46% (headache). Among all subjects, degree of overlap with facial pain was ranked anatomically: headache OR=14.4, neck OR=7.8, shoulder OR=4.2, trunk OR=4.1, upper limbs OR=3.6, hips OR=3.5, and lower limbs OR=2.9 (all P-values<0.001). The ranking for three broad anatomical locations persisted in multivariable analysis: headache (OR=10.7, 95%CL = 7.2, 15.8), neck/shoulder (OR=3.4, 95%CL=2.6, 4.5) and below-shoulder (OR=2.4, 95%CL=1.8, 3.4). The ranking was not altered after adjustment for confounders. 

Slad concluded overlap with facial pain was profound for headache and neck pain, and lessened towards the extremities, suggesting underlying causes specific to the upper body such as biomechanical or segmental neurologic mechanisms.

This is a summary of abstract #3037 titled “Overlap of Facial Pain and Pain Elsewhere: Anatomical Location Matters”, presented by Gary Slade on Saturday, March 25, 2017, 8 a.m. – 8:30 a.m. at Moscone West, San Francisco, Calif., USA.

About the International and American Associations for Dental Research
The International Association for Dental Research (IADR) is a nonprofit organization with nearly 11,000 individual members worldwide, dedicated to: (1) advancing research and increasing knowledge for the improvement of oral health worldwide, (2) supporting and representing the oral health research community, and (3) facilitating the communication and application of research findings. To learn more, visit
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