Lobbezoo Frank, Weijenberg Roxane A F, Scherder Erik J A
Department of Oral Kinesiology, Academic Center of Dentistry Amsterdam, Research Institute MOVE, University of Amsterdam, The Netherlands.
J Orofac Pain. 2011 Winter;25(1):6-14.
This article presents a comprehensive review of the literature on the diagnosis of pain in the orofacial region of patients suffering from a cognitive impairment or a dementia. This review was based on a literature search yielding 74 papers, most of which dealt with the assessment of pain in general in nonverbal individuals, for which several observational tools were developed. Unfortunately, none of these tools have been designed for the specific assessment of orofacial or dental pain. Thus, none of them can be recommended for use in the dental setting. There is hardly any information available in the literature on how to assess orofacial and/or dental pain in patients with a cognitive impairment or a dementia. Given the expected increase in the incidence of dementia over the upcoming decades, it is of the utmost importance that dentists can use well-tested tools that can help them in the diagnosis of orofacial and dental pain in this vulnerable patient population. Such tools should incorporate specific orofacial/dental pain indicators, such as the patient holding/rubbing the painful orofacial area, limiting his/her mandibular movements, modifying his/her oral behavior, and being uncooperative/resistant to oral care.
本文对有关认知障碍或痴呆患者口面部区域疼痛诊断的文献进行了全面综述。该综述基于一项文献检索，共获得74篇论文，其中大部分涉及对非言语个体疼痛的一般评估，为此开发了几种观察工具。遗憾的是，这些工具均未针对口面部或牙齿疼痛的具体评估而设计。因此，它们均不推荐用于牙科环境。文献中几乎没有关于如何评估认知障碍或痴呆患者口面部和/或牙齿疼痛的信息。鉴于未来几十年痴呆发病率预计会上升，牙医能够使用经过充分测试的工具来帮助他们诊断这一脆弱患者群体的口面部和牙齿疼痛至关重要。此类工具应纳入特定的口面部/牙齿疼痛指标，例如患者握持/揉搓疼痛的口面部区域、限制下颌运动、改变口腔行为以及不配合/抗拒口腔护理。
