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Get involved and help us with our research 


What happens with your patient referrals

After patient referral patients will be asked to complete data online   On referral we have several questionnaires we need your patient to complete before they see us. They include;

 

  • Patient details

  • Patient medical history

  • Details of Patients  nerve injury (how when it happened)

  • What pain, altered sensation your Patient is experiencing

  • What functional difficulties your Patient is experiencing

  • Psychometric questionnaires (7 of them)

  • Euroquol (EQ-5D-5L)

  • HAD score

  • OHIP 14

  • PCL (Brief version)

  • PCS score

  • PSEQ

  • Pain detect

 

Specific comments and questions you may have for us
 

All this data is stored anonymously and securely as you are given a coded login and password once you have been referred to us. We can then construct a report from your data and formulate a summary sheet of your history and presentation that will help us with your consultation appointment and our research On attending clinic the patients may be approached to participate in further research including;

 

  • Consent to provide patient videos

  • Consent for bloods for genetic assessment of neuropathic pain related to post surgical neuropathy

  • Consent to complete specific additional questionnaires


If reparative surgery is planned;

The patient will be asked to provide samples of nerve, mucisa and blood during the procedure to assess pain receptor biomarkers at sites affected by nerve injury Consent will also be sought for digital photography


Ongoing additional research in our department include : 

  • Research aims and objectives

  • Summary of ongoing and planned research in trigeminal pain in man at KCL


Short term Goals

 

  • Development of trigeminal pain clinical / psychological research teams for chronic orofacial pain

  • Development of expertise for chronic orofacial pain

  • Identification of research area needs using Cochrane reviews

 

Medium term goals

 

  • Evaluation of ongoing service developments for chronic orofacial pain

  • Build on existing links with IoP, Neurology, Neurosurgery, Physiotherapy

  • Development of further links with Industry to support research funding

  • Evaluation of psychological needs of OFP patients and identify best practise in management

 

Long term goals

 

  • Establishing the research team as national and international lead in trigeminal pain Establishing the research team as national and international lead in the prevention and management of trigeminal nerve injuries

  • Leading centre in pharma trials for analgesics and anxiolytics


Areas of research interest
 
 

Acute post surgical pain model (basis of clinical analgesic trials)

 

  • Influence of genetics, psychometrics on pain (38 genes identified up regulated or down regulated in association with trigeminal pain)

  • Pain pathways fMRI Biomarker of ongoing pain in man (proof of concept studies to follow with Perfalgen and Diclofenac)

  • Evaluation of the placebo effect

  • Immunohistochemical analysis peripheral pain receptors

 

Dental pulpal pain (unravelling the modality of dental pain and Dental Sensitivity)

  • Influence of genetics, psychometrics

  • Pain pathways fMRI

  • Immunohistochemical analysis peripheral receptors /effects of blocking agents

  • Evaluation of neurophysical and biological pathways

  • Cell culture of neural stem cells form dental pulp

  • Characterisation of neural cell physiology derived form human pulp

  • Evaluate novel methods of obliteration/obstruction of dentinal tubules

 

Chronic orofacial pain 

  • Conditions include headaches [migraine, tension, cluster, trigeminal autonomic syndromes, giant cell arteritis] neuralgias [trigeminal neuralgia –typical and atypical, post surgical neuropathy, PHN] and neuropathic pain [persistent idiopathic intra oral and extra oral pain, trigeminal neuropathy, Temporomandibular pain, burning mouth syndrome].

  • Phenotyping of patients attending OFP /neurology clinics 

  • (pain history / QST / LA blocks / Specific adjuvants)

  • Influence of genetics, psychometrics –pain questionnaires

  • Pain pathways fMRI

  • immunohistochemical analysis peripheral receptors /effects of blocking agents

  • evaluation of neurophysical and biological pathways

  • Evaluation of psychological needs of OFP patients and identify best practise in management

 

 

Relationship of Parkinson’s and orofacial pain

  • Epidemiology 

 

Trigeminal nerve injuries

  • Prevention and management optimization

  • Psychological effects of iatrogenesis

Our research Staff

  • Dental Institute Clinical Orofacial Multi disciplinary pain clinics 

  • Professor Tara Renton Oral Surgery KCL / Hon Cons KCHFT / GSTFT

  • Dr Sam Chong Neurology   Consultant KCHFT

  • Dr Tom Smith Pain management Input STH

  • Mr Nick Leese Neurosurgeon KCH

  • Mr Sinan Barazi Neurosurgeon KCH

  • Mr Peter Bullock Neurosurgeon KCH

  • Dr Lisa Page Liaison Psychiatrist

  • Dr Sarah Barker Clinical psychologist

  • Dr Leigh Ann Morgan GDP and Clinical teacher

  • Dr Jared Smith  Health Psychology

Other clinical staff

  • Professor Saman Oral Medicine KCL / Honorary Consultant KCHFT

  • Dr Michael Escudier Consultant Oral Medicine GSTFT

  • Dr Tim Poate Consultant Oral Medicine KCHFT

  • Dr Helen Mac Pharlane Staff Grade Oral Medicine GSTFT

  • Nicky James Health psychologist

  • Professor Ray Chaudery Neurology   Consultant KCHFT

  • Professor Ammar AlChalabi Neurology  Consultant KCHFT  genetics

  • Academic trainees

  • ACF Nadine Khawaja clinical PhD student

  • ACF Kiran Beneng clinical PhD student

  • ACF Clare Gleeson clinical PhD student

  • KCL Non clinical

  • Professor Lucy Di Silvio Lead KCL Dental tissue engineering

  • Dr Garrit Koller  Post Doc Oral Surgery

  • Mr Obi Obsesian PhD student Oral Surgery

  • Dr Andy Grant MRC Post Doc KCL Wolfson Institute

  • Dr Brenda Williams  Senior lecturer James Black Centre

  • Dr Zehra Yilmaz Post Doc PT RA Oral Surgery

  • CNS IoP KCL

  • Professor Steve Williams

  • Dr Matthew Howard

  • Ms Kristina Krause PhD Student

  • Professor Gunter Schumann IoP SGBD

 

Collaborations

  • Professor Praveen Anand Dept Peripheral neuropathy Imperial College

  • Paul Facer and Yiangos Yiangou Post Docs

  • Dr Anish Bahra Neurologist Queens Square

  • Professor Joanna Zakzrewska Oral Medicine Consultant UCL

  • Professor Tony Pogrel Oral and Maxillofacial Surgery UCSF

  • Prof Margie Byers Neurophysiology University Washington Seattle

Laboratories used

  • Prof Anand Imperial College Hammersmith 

  • Dr Andy Grant Wolfson Institute KCL Guys

  • Prof Lucy Di Silvio Biomaterials KCL Guys

Ethics Applications / HTA information

  • All projects R&D approved at both GSTFT and KCHFT

  • Italix = studies not started  

 

1. Evaluation of receptor expression and activity in relation to acute dental pulpal pain NRES: 06/MRE00/5 

  • Tissue samples collected at GSt and KCH

  • The blood samples are stored and registered in storage system at the SGDP labs in the basement. They are in an alarmed -80 freezer in accordance with the HTA Sent to

  • Biomaterials labs floor 17 GST

  • Imperial college Dept Peripheral neuropathy

 

2. Evaluation of receptor expression and activity in relation to chronic orofacial pain conditions NRES:06/MRE00/6 

Burning mouth syndrome (before and after NT)

  • Erythema migrans

  • Lingual nerve injury

  • Pemphigus and pemphigoid

  • Tissue samples collected at GSTand KCH

  • The blood samples are stored and registered in storage system at the SGDP labs in the basement. They are in an alarmed -80 freezer in accordance with the HTA Sent to

  • Biomaterials labs floor 17 GST

  • Imperial college Dept Peripheral neuropathy

 

 

3. Evaluation of receptor expression and activity in relation to post traumatic trigeminal nerve branches NRES:   06/MRE00/4

Tissue samples collected at GSTand KCH

  • The blood samples are stored and registered in storage system at the SGDP labs in the basement. They are in an alarmed -80 freezer in accordance with the HTA Sent to

  • Biomaterials labs floor 17 GST

  • Imperial college Dept Peripheral neuropathy

 

4. Genetic and psychometric role in post surgical acute pain using ASL / regional cerebral blood (rCBF) flow NRES: 07/H0808/115 

  • Blood samples collected IoP KCL The blood samples are stored and registered in storage system at the SGDP labs in the basement. They are in an alarmed -80 freezer in accordance with the HTA.

  • Tissue samples collected at GST and KCH

  • Stored Rayne institute (need another site)

  • Sent to Biomaterials labs floor 17 GST

  •  

    Imperial college Dept Peripheral neuropathy

     

 

5. Stem cell culture from dental pulps of extracted teeth. Evaluation of the odontoblast ole in dental pain Corec ref AB /137374/1 KCH REC 08/0808/119

  • Tissue samples collected at GST and KCH

  • The blood samples are stored and registered in storage system at the SGDP labs in the basement. They are in an alarmed -80 freezer in accordance with the HTA Sent to

  • Biomaterials labs floor 17 GST 

  • Imperial college Dept Peripheral neuropathy

  • Wolfson Institute GST KCL

 

6. Genetic and psychometric role in chronic orofacial pain using ASL / regional cerebral blood (rCBF) flow. COREC AB/65914/1 KCH REC 08/H0808/105

  • Tissue samples collected at GST and KCH

  • The blood samples are stored and registered in storage system at the SGDP labs in the basement. They are in an alarmed -80 freezer in accordance with the HTA Sent to

  • Craniofacial Lab Floor 27 GST

 

7. Assessing the potential role of dental pulpal stem cells and progenitor cells in pain and related gene expression. COREC AB/137337/1 KCH REC 08/0808/104

  • Tissue samples collected at GST and KCH

  • The blood samples are stored and registered in storage system at the SGDP labs in the basement. They are in an alarmed -80 freezer in accordance with the HTA Sent to

  • Biomaterials labs floor 17 GST 

  • Imperial college Dept Peripheral neuropathy

  • Wolfson Institute GST KCL

 

Evaluation of the effectivity of medical screening of dental casualty patients in identifying those at risk form the big three (IHD, DM and CVA) COREC AB 133547/1 KCH REC 08/H)0808/106

  • Tissue samples collected at GST and KCH

  • Stored Rayne institute (need another site)

 

Grants funding

  • MRC DPFS CO Investigator Steve Williams Matt Howard Nadine Khawaja and Tara Renton MRC DPFS Co PI Development pain biomarker in man £380K

  • Royal College of surgeons CBCT assessment high risk M3Ms 2011 £9.6K

  • Royal College of Surgeons Characterisation of immortal odontoblast cell line 2011 £9.8

  • Patient donation for research 2011 50K

  • UKCRN flexibility and sustainability funding 2011 40K

  • British pain society 2010 45K

  • R&D funding 2009 60K

  • Pfizer Post surgical third molar pain genetics and imaging 2007-8 £600K

  • RCD Walport posts 4 academic clinical fellowships and 2 clinical lecturers 2006-10 £800K

  • Royal Academy Bursary Grant 2005 £500

  • BAOMS Research grant 2005 £5,500

  • Joint R&D Bart’s and The London Hospitals 2004 £90,000

 

PhD Studentship

  • London Central Fund 2004 £7,000