The Journal of the American Dental Association
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J Am Dent Assoc, Vol 135, No 11, 1518.
© 2004 American Dental Association
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LETTERS

Authors’ response

We agree with Dr. Zinman that psychological screening does not identify causes of chronic pain and that psychopharmacological agents can be quite helpful (for example, antidepressant medications for patients with major depression). We also agree that persistent orofacial pain warrants assessment by a specialist, and correct diagnosis always should be the goal.

Unfortunately, many patients continue to suffer orofacial pain, despite thorough assessment and appropriate treatment by specialists. In the context of chronic pain, therapies focused solely on eliminating pain not only may fail, but also may carry risks. Both biomedical and psychosocial factors may contribute to ongoing pain, suffering and pain’s interference with customary activities. Screening for psychosocial as well as biomedical contributors yields the potential to introduce interventions that may improve the patient’s quality of life and enhance the patient’s response to dental therapies.



Judith A. Turner, Ph.D., Professor
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle

Samuel Dworkin, D.D.S., Ph.D., Professor Emeritus
Department of Oral Medicine and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle



This Article
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