Weak Evidence Supports the Use of Psychosocial Interventions for Chronic Orofacial Pain.

Themessl-Huber M.  Evid Based Dent. 2012 Jun;13(2):58. doi: 10.1038/sj.ebd.6400865.

Source

Oral Health and Health Research Programme, Dental Health Services Research Unit, University of Dundee, Scotland UK.

ABSTRACT:

DATA SOURCES:

Cochrane Oral Health Group's Trials Register, Central, Medline, Embase, PsycINFO.

STUDY SELECTION:

Randomised controlled trials of psychosocial interventions for chronic orofacial pain were included. Psychosocial interventions targeted towards changing thoughts, behaviours and/or feelings that may exacerbate pain symptoms through a vicious cycle were eligible. Primary outcomes were pain intensity/severity, satisfaction with pain relief and quality of life.

DATA EXTRACTION AND SYNTHESIS:

Two reviewers independently screened studies, extracted data and assessed risk of bias. Dichotomous outcomes, were expressed as risk ratios with 95% confidence intervals, continuous outcomes as mean differences with 95% confidence intervals. Heterogeneity was assessed using the Cochrane test for heterogeneity and the I2 test. Meta-analyses were conducted using the random-effect or the fixed-effect models.

RESULTS:

Fifteen of the 17 eligible studies were on temporomandibular disorders (TMDs), two on burning mouth syndrome. Psychosocial interventions improved long-term pain intensity (standardised mean difference (SMD) -0.34, 95% confidence interval (CI) -0.50 to -0.18) and depression (SMD -0.35, 95% CI -0.54 to -0.16). However, the risk of bias in these studies was high.

CONCLUSIONS:

There is weak evidence to support the use of psychosocial interventions for chronic orofacial pain.

(Originally published in the Cochrane Database Syst Rev , EBD reprinted this article.  They reviewed over 60 years of studies.  Note the the risk of bias clause).