Help Desk: http://www.ucl.ac.uk/ras/portico/helpdesk
- Honorary Professor
- Restorative Dental Sciences
- Eastman Dental Institute
- Faculty of Medical Sciences
My research on orofacial pain and particularly trigeminal neuralgia is clinically based and I am working not only with multidisciplinary teams at UCLH, London but also with teams nationally and internationally.
The following are my key areas of research :
i. Clinical trials in trigeminal neuralgia
I have conducted a RCT, a cohort study and open labelled studies on drugs used in trigeminal neuralgia. We had to close an RCT on the use of IVG immunoglobulin due to administrative problems. I currently have one ethically approved study on natural history study of trigeminal neuralgia
ii Systematic reviews , guidelines
I have completed two Cochrane systematic reviews on management of trigeminal neuralgia. I have been part of an international taskforce which has issued guidelines on management of trigeminal neuralgia , published and on the web www.aan.com .
iii. Patient involvement in trigeminal neuralgia studies
As Trustee and chairperson on the Medical Advisory Board of the Trigeminal Neuralgia Support group UK as well as member of the US one I have looked at how patients view these organizations, how they perceive their management and I have been involved in patient survey of 10,000 patients. We are looking to develop a web based survey internationally. I regularly involve patients in my research studies.
iv. Decision making
Many of our patients whose medical management becomes difficult then face the decision about surgical treatments for their TN. To facilitate this process we conducted a study on 156 patients ( in conjunction with Prof Kay from the dental school in Manchester and also involving centres in Liverpool, Bristol and Southampton) to help patients make a decision about future treatments. This is now leading to further work to determine the long term effects of drugs and their effect on cognitive function.
v. Visual language of pain - face2face.
Currently co- supervising an arts and humanities PhD student to determine how photographic images may improve clinical care of patients with facial pain and how their outcome through the service can be monitored through the use of photographic images co created with an artist. We have had a public exhibition and the material now needs to published.
vi. Classification /diagnostic criteria for facial pain
Part of an international taskforce to revise the International Headache Classification of facial pain and also provide improved criteria for non dental facial pain.
I aim to inspire students by example and show especially our undergraduate students how theoretical teaching is put into clinical practise which includes bringing patients to lectures and using evidence based medicine at the chair side. The advent of HIV/AIDS led to a need to train not just undergraduates but also the teaching staff both medical and dental. I established a teaching package for consultants and students which I then trialled at the University of Perambuco in Brazil.Further developments included a course on oral awareness developed with Dr H. Fry , now Head of Education at Imperial College, for medical undergraduates which we hope other medical schools will adopt . I have now taken up the challenge of increasing the teaching of Pain at all levels of the medical and dental curricula. I introduced a special thread on pain in the new 1999 dental curriculum and would like to introduce it into the medical curriculum.
I take the training of my junior staff seriously and in order to understand better the problems they are facing I undertook a UK wide study into the training of oral medicine and I was chair of the Speciality Training Committee for the Additional Dental Specialties in the London Deanery for a term of five years.