Interprofessional Management of Orofacial Pain: Wearing Many Hats!

Orofacial pain is one the commonest chronic oral health disorder. Yet, its complete management is still a researchable matter as it is a disorder which is caused due to various factors. It is very rare is find a single etiology leading to orofacial pain. It often encompasses multiple etiological factors. Hence it is important to understand that not one but multiple healthcare professionals are needed for its successful outcome and thus forming an interprofessional management team becomes important. Copyright:

Orofacial pain has become a public health challenge with prevalence as high as 70% in adult population. The reason for this is that orofacial pain is not just any pain, but it is a chronic pain with etiology being not singular but multiple, often interlinked. Furthermore, the present management scenario includes multiple referrals being made from one health-care specialist to another. Hence, it is important to understand that, if what is being followed as a management protocol is not addressing the discomfort of the patient, the treating dentist must think about a more standard and advanced strategy to diagnose and manage orofacial pain. As a responsible health-care provider, the treating dentist should never hesitate to collaborate with other health specialists like an interprofessional team who would be skilled and knowledgeable enough to diagnose and treat chronic oral, facial, and head pain.[1]

Without a doubt, orofacial pain is not a disorder belonging to a particular health professional field but a multiple health professional fields and hence may require an interprofessional effort which may include dentistry, neurology, physical medicine, rheumatology, psychology, etc.

The Dean at Louisiana State University School of Dentistry, Henry A. Gremillion, believes that orofacial pain is not discipline specific and that dentists are often the first point of contact by the patients; hence, it is time for dentists to understand and acknowledge the necessity to update their knowledge also in the areas of anatomy, physiology, neurology, and psychology, so that an accurate diagnosis is being made and an appropriate treatment plan is designed for those individuals suffering from orofacial pain. It is important to have Interprofessional team as a strategy to manage orofacial pain. Hence the title, “wear many hats”.!

INTERPROFESSIONAL EDUCATION AND COLLABORATIVE PRACTICE

A statement of support for interprofessional education and collaborative practice (IPECP) was issued by the WHO (the World Health Organization) in 2010. The WHO emphasized that to make global healthcare stronger, the health-care providers should learn with, from, and about members of other health professions.[2] There are many health disorders which requires an interprofessional care to improvise the overall health outcomes of the affected individual. Orofacial pain is one such health disorder which requires timely and interprofessional collaborations for its effective management.[3]

Oro facial pain is a chronic health condition, and a chronically ill patient is often referred to multiple health-care professionals; hence, there is a definite need to have interprofessional collaborations for the effective management of chronic illness.[45]

Health-care specialists are trained to develop their own discipline specific treatment plans. However, for chronic health conditions like orofacial pain, it is important to align discipline-specific treatment plan with interprofessional-shared care plan. A shared care plan is a step toward providing patient-centered care.[6] A shared care plan is defined as a collaborative plan that incorporates inputs from interprofessional team of health-care specialists, leading to patient-centered care.[7]

However, to avoid conflicts and miscommunication between the team members, before adapting an interprofessional approach, it is important that the health-care professionals should first be oriented about the concept and principles of Interprofessional education and collaborative approach. It is necessary to understand and learn the core competencies of interprofessional approach.[8]

COMPETENCY 1: VALUES/ETHICS FOR INTERPROFESSIONAL PRACTICE

Work in a way to have mutual respect and shared values toward every professional in the team.

COMPETENCY 2: ROLES/RESPONSIBILITIES

Utilizing one's own skill and those of other health-care providers to accurately assess and address the concerns of the patients to enhance the overall health of the society.

COMPETENCY 3: INTERPROFESSIONAL COMMUNICATION

Communicate with patients, their families, society, and health-care specialists in a responsible way assisting in team approach which helps in advancement of health and thereby prevention and control of disorder.

COMPETENCY 4: TEAMS AND TEAMWORK

Apply relationship enhancing morals and ethics of team dynamics to plan, execute, and evaluate patient-entered care that are safe, effective, and time bound.

An interprofessional team approach is the only way to adequately address the concerns of the patients with orofacial pain. It is important to understand that interprofessional care and collaborative approach is the best management tool for managing most of the chronic health conditions. In this regard, every health-care specialist should be competent in providing interprofessional care and collaborative practice. Furthermore, it is important that every health science student (learner) be exposed to IPECP during their learning period (introducing into the curriculum).

Some of the benefits of interprofessional collaboration are as follows:[91011]

Interprofessional collaboration can have productive and effective results on health-care processes and outcomes

Interprofessional collaboration is the best way to enable a patient-oriented care

Improved learning and education

Enhanced quality of care for the patients

Positive workforce environment leading to improved job satisfaction

Improved professional, personal relationships, and workflows.

STRATEGY FOR THE MANAGEMENT OF OROFACIAL PAIN

The strategy is simple but requires responsibility and commitment as a health-care professional. We need to move from what is being followed [Figure 1] to what must be followed [Figure 2]. As shown in Figure 2, all the professionals involved in the management of orofacial pain must come together to learn from each other and work under same roof for the proper diagnosis and management of orofacial pain. We need to stop referring the patient, i.e., sending patient from one building to another building.

Figure 1

Present scenario cycle of referrals

Figure 2

Interprofessional education and collaborative practice for the management of orofacial pain

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Conflicts of interest

There are no conflicts of interest.