Discussion of evidence

All the studies are small and may contain a very heterogeneous group of patients. Given the prevalence of orofacial pain, it is surprising that there are so few high-quality studies. Although there is some evidence for the success of antidepressants, some patients do not have a good response and this could be due to certain patient characteristics: nonanxious somatiz-ers, dysfunctional health beliefs, history of unsuccessful surgery, no life event before pain onset. Treatment needs to be continued for a long time and relapses are common. As in other chronic pain, CBT is helpful in improving quality of life but may not directly result in a decrease in pain intensity.

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