The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” This is an important definition to understand when your dentist or doctor approaches your treatment – pain is unpleasant; it is actual or potential damage; or is simply just described in those terms. That means you may show up without any of the traditional signs that your dentist or doctor looks for – swelling, something funky on an x-ray, something that shows up in your bloodwork, and so on. That means arriving at an accurate diagnosis can take time and may involve some trial and error. Some pain syndromes are diagnosed based on your response to treatment, which means you are treated first and diagnosed later. Of course, your dentist or doctor probably won’t start treating you without good reason.
Chronic pain can exist anywhere in your body. Orofacial pain can be thought of as pain in in your head that has nothing to do with your teeth. It can be pain in your jaw joint (known as the temporomandibular joint or ‘TMJ”), your jaw muscles, then tendons that attach your muscles to your jaws, or sometimes it’s pain in one or more nerves in your face or even a combination of some or all of these tissues. The problem with orofacial pain is that it can very tricky to understand, making diagnosis difficult. This is often why so many people suffer with orofacial pain for years before someone figures out what is going on and offers treatment that may actually help.
Arriving at that correct diagnosis usually begins with what feels like an endless stream of questions. Where is your pain? How long has it been there? What does it feel like? Does it burn? Is it electric? What makes it better? What makes it worse? Tell me about your personal and professional life. It may seem a bit impertinent, but the more information your dentist or doctor has, the better. You don’t live in a bubble and neither does your pain.
After your dentist has a description of your pain, they will perform a physical examination. Unfortunately, this involves someone poking and pushing your jaw around, which, well, hurts. We dentists do this because we’re trying to reproduce your pain so we can better understand where and how much you hurt. This is a bit of an admixture of the subjective and objective, but at the moment, it’s the best we have. Lastly, your dentist will often will request some imaging studies, like a 2-D x-ray, a cone beam study (3-D imaging for bones) or an MRI (3-D imaging for soft tissue, like cartilage).
All of this information helps your dentist arrive at the most accurate diagnosis, which will then direct treatment. This can take time, sometimes several visits to arrive at a correct diagnosis, and it may take even longer to find treatment that works for you. It’s important to understand that treating orofacial pain often does not result in a cure, but rather management. We can usually reduce your symptoms, making them easier to live with, but total elimination can sometimes be very tough. Bearing this in mind, you should be very cautious of those who promise an absolute cure for your chronic pain.
If you have any questions or would like an opinion, please call our office any time to schedule a consultation.