Orofacial pain management is a branch of dentistry that deals with the prevention, evaluation, diagnosis, and treatment of pain experienced in the teeth, jaws, head and face. These conditions may result from post-operative pain, arthritis, spasm or injury. They may also be syndromes where pain is the primary problem such as TMJ disorders, neuropathic pain or headaches.
Types of Orofacial Pain
Most types of jaw pain that is not related to tooth decay, gum disease and associated conditions and infections fall under the scope of orofacial pain. These may include:
- Temporomandibular joint disorders, otherwise known as TMJ disorders or TMJ pain.
- Cervical musculoskeletal pain, which is pain associated with the neck.
- Masticatory musculoskeletal pain, which is pain associated with the jaw and with the act of chewing.
- Neurovascular pain, or headaches that are related to tooth or jaw pain.
- Neuropathic pain, or pain associated with nerve damage or disorders.
- Orofacial dystonia, or spasms in the jaw and facial muscles.
- Sleep disorders related to various types of orofacial pain.
- And any other intracranial, extracranial and intraoral conditions and disorders, including systemic disorders, that may cause or be related to orofacial pain.
Of course, while this list of orofacial pain categories is long, the list of potential causes is equally lengthy, which is why correctly diagnosing and treating this type of pain is a valuable branch of dentistry.
Causes of Orofacial Pain
There are so many forms of orofacial pain in existence that it makes sense there are number of potential causes. In some cases, the cause is largely mechanical, related to malformations or damage to structures like the jaw bones. In other cases, it may well be related to tooth conditions, or even to the treatment of those conditions, while other cases are the result of nerve damage.
Diseases like cancer and HIV, diabetes or fibromyalgia can be behind orofacial pain, while in other cases, it may be related to a particular behavior, like habitual gum chewing, tooth clenching or tooth grinding.
Current research is also investigating the role of genetics, epigenetics and stress on the development and perpetuation of pain.
How Is Orofacial Pain Diagnosed and Treated?
The first step in treatment is arriving at an accurate diagnosis.
Dr. Shackleton uses patient medical histories, imaging studies (e.g. panoramic radiographs, isolated joint x-rays, CBCT or MRI), laboratory tests and a direct physical examination to determine the root cause of the pain. Once we have established, the location, the severity and the cause of the pain, we put together a comprehensive treatment plan to address the condition. Often treatment is performed entirely within our office but sometimes there may be several other medical specialists involved in the treatment and pain management plan.
For instance, if there is damage or deformity in the jaw, an oral surgeon may be required to repair or rebuild the area. If pain is related to untreated neurological disorder, onward referral to a neurologist may be part of the treatment plan. Often, we will work with physiotherapists when managing TMJ pain to ensure optimal function of all structures in the should, neck, head and jaws.
There are nearly endless reasons for developing orofacial pain, but effective management always begins with diagnosis, and the best way to do that is to refer the patient to an experienced dentist in the field.
For more information on dental care following a motor vehicle accident or to schedule an appointment with Dr. Tom Shackleton, please contact us at 403-242-9952 today.