Division of Population and Patient Health, Dental Institute, King's College London, London, United Kingdom.
Pain. 2018 Jul;159(7):1235-1243. doi: 10.1097/j.pain.0000000000001203.
Little is known about the burden and impact of orofacial pain in deprived areas, and whether it mediates the relationship between socioeconomic position and impacts on daily life. We analysed data from a representative sample of 2168 adults, aged 16 to 65 years, from the East London Oral Health Inequality study. Participants completed a validated questionnaire on demographics, socioeconomic position (area deprivation), orofacial pain (by anatomical site) in the past month, and impacts related to oral conditions on daily life. Negative binomial regression models with robust variance estimator were fitted. The prevalence of orofacial pain was high (30.2%). The most common subset of orofacial pain was intraoral pain (27.5%). The prevalence of pain related to temporomandibular disorders was 6.8%. The most common subsets of intraoral pain were tooth (20.4%) and gingival (11.4%) pain. Orofacial pain, its subsets (intraoral and temporomandibular disorder-related pain), and intraoral pain subsets (tooth and gingival pain) consistently showed associations with all dimensions of impacts on daily life that were highly statistically significant: functional limitation, psychological discomfort, disabilities, and handicap. Socioeconomic inequalities were present in orofacial pain and some dimensions of impacts on daily life. Orofacial pain did not mediate the relationship between area deprivation and impacts on daily life. Our study demonstrated a substantial burden and impact of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom. To address this burden, interventions that lie within the remit of health services are needed to improve access to dental care for adults with orofacial pain.
关于贫困地区口腔颌面部疼痛的负担和影响，以及它是否在社会经济地位和对日常生活的影响之间起中介作用，目前知之甚少。我们分析了来自东伦敦口腔健康不平等研究的一个有代表性的 2168 名 16 至 65 岁成年人的样本数据。参与者完成了一份关于人口统计学、社会经济地位（地区贫困）、过去一个月口腔颌面部疼痛（按解剖部位）以及口腔状况对日常生活影响的验证问卷。使用稳健方差估计的负二项回归模型进行拟合。口腔颌面部疼痛的患病率很高（30.2%）。最常见的口腔颌面部疼痛亚组是口腔内疼痛（27.5%）。与颞下颌关节紊乱相关的疼痛患病率为 6.8%。最常见的口腔内疼痛亚组是牙齿（20.4%）和牙龈（11.4%）疼痛。口腔颌面部疼痛、其亚组（口腔内和与颞下颌关节紊乱相关的疼痛）以及口腔内疼痛亚组（牙齿和牙龈疼痛）始终与日常生活影响的所有维度存在关联，且具有高度统计学意义：功能受限、心理不适、残疾和障碍。社会经济不平等存在于口腔颌面部疼痛和日常生活影响的某些维度中。口腔颌面部疼痛并未介导地区贫困与日常生活影响之间的关系。我们的研究表明，在英国一个社会贫困和文化多样的地区，口腔颌面部疼痛的负担和影响很大。为了解决这一负担，需要在卫生服务范围内采取干预措施，以改善有口腔颌面部疼痛的成年人获得牙科护理的机会。
