Sir, recently a 12-year-old male child, accompanied by his mother, reported with a complaint of frequent and severe pain in his maxillary left central incisor. The problem had started following trauma four months back. The previous dentist had initially treated him as a case of traumatic pulpitis. As the subsequent clinical and radiological findings did not corroborate with the persisting complaint, he was referred for specialist opinion. The dental students who took this case for work-up were also clueless about the condition.
During consultation, the history provided by the child was often incongruent with his mother's version. Further, his pain reaction to percussion of the allegedly traumatised tooth appeared exaggerated, inconsistent with the facial expressions, and erratic during repetition. Following a separate interview and a bit of gentle persuasion, the child confessed to malingering. He admitted to playing truant by frequently enacting 'tooth-ache following injury' learnt from his friend.
The incident made us realise that conditions such as malingering and factitious disorders have not received due attention in our professional education and practice, thereby leaving many dentists inept when they encounter them. It's time we include some basic training about these entities in the dental curriculum and prepare ourselves to recognise and handle them appropriately.
1. Puducherry, India
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Gayathri, H., Madhan, B. Case report: Malingering and factitious disorders. Br Dent J 218, 610 (2015). https://doi.org/10.1038/sj.bdj.2015.480
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DOI: https://doi.org/10.1038/sj.bdj.2015.480
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