A Case in Which Quantitative Test and Feedback of Test Results Helped Decision of Treatment Policy

Abstract

Patients: After a 38-year-old female underwent extraction of tooth 38, which was in close proximity to the mandibular canal, she presented with mental nerve dysesthesia. She was then prescribed vitamin B12. However, her symptoms remained unchanged one month after starting the medication; thus, she requested treatment at a pain clinic. Under the diagnosis of trigeminal neuropathy, she was treated with a stellate ganglion block and acupuncture. After 20 sessions of stellate ganglion block treatment, the pain shifted from dysesthesia to paresthesia; however, there was no significant improvement in subjective symptoms, and the patient was unsure about continuing the treatment. Improvement was observed in the precise tactile function and the electric current perception threshold tests, and these positive results were conveyed to the patient. The patient wanted to continue treatment. After 10 sessions of acupuncture, she was again re-examined. Further improvement was observed in the precise tactile function and the electric current perception threshold tests, and these positive results were conveyed to the patient. As the patient was satisfied with the treatment results and the improvement in her symptoms, she requested treatment cessation.
Discussion: As in the present case, there are cases in which laboratory values improve despite no change in patient complaints about symptoms.
Conclusions: Therefore, for patients, particularly those with orofacial pain, who are hesitant to continue treatment due to a lack of observable change in symptoms, a qualitative examination and provision of feedback on test results showing improvement can be useful in enhancing their decision-making regarding the treatment, thus contributing to the overall improvement in patient satisfaction.