Orofacial Pain

Orofacial pain is a branch of dentistry which focuses on finding the cause of nerve pain in the head & neck area, jaw and muscular pain, or headache disorders. Orofacial pain is often experienced as ‘Referred Pain’ because it can present in an area of the body other than where it is being caused. Subsequently it can be difficult for both patients and dentists to identify the source for or cause of this type of pain. A unique and multidisciplinary approach to treatment is often taken with the collaboration of medical doctors and orofacial pain specialists

We understand that patients experiencing orofacial pain can be nervous or frustrated, particularly if they have been experiencing this pain for any length of time. As patient comfort is always our priority, we always take the time to explain what we are doing, in what order, and why.

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What can cause Orofacial pain?

The causes of Orofacial pain conditions are many and varied but will usually involve injury, or strain to nerves and muscles of the face. Orofacial pain conditions can be separated into:
1. Neuropathic (Nerve) pain
Neuropathic pain conditions may include: trigeminal neuralgia, burning mouth syndrome and other neuropathies of the head and neck. Sometimes patients will present with this pain after a simple dental procedure like a filling or an uneventful tooth extraction.
2. Musculoskeletal (Muscular and joint) pain
Musculoskeletal pain conditions may include: myofacial pain, TMJ pain, or arthritis. There are many potential causes of musculoskeletal pain, including trauma to the jaw joint, a clenching or grinding habit, age, or genetics
3. Neurovascular (Headache) pain
Neurovascular pain conditions may include:  tension type headaches, migraines, and autonomic cephalgias.

Headaches can be the result of TMD, sleep apnoea, or other nerve or orofacial pain disorders.


What to expect in an orofacial pain consultation

Visits relating to orofacial pain will always include a thorough medical history, including a medications list & history. Orofacial pain is a complex symptom with many possible causes, so we want to be as thorough as possible and avoid the need for intrusive and potentially painful or unnecessary physical examinations.

X-rays and possibly blood tests may also be ordered at this initial consultation. Again, these are chosen as non-intrusive diagnostic tools which provide greater insight for the dentist without causing unnecessary anxiety for the patient.

Questions? Answers.

What is orofacial pain?

Orofacial pain may present as jaw ache, toothache, ear ache, facial pain, headache, or as a feeling of pressure in the face and head. It can be difficult to diagnose the cause or source as it often presents as ‘Referred Pain’ i.e. the symptom is felt in an area of the body other than where the cause is. Patients are often referred to dentists in this regard due to jaw ache or toothache, and/or to rule these out as causes.

What tests can be used to diagnose orofacial pain?

During an initial consultation we may order blood tests, x-rays, dental photography, or a CBCT scan to help us build an accurate medical image of your mouth and jaw, which we will use to examine and diagnose any potential issues in a non-intrusive and anxiety free way.

How is orofacial pain treated?

Diagnosing and treating orofacial pain can often require a number of visits. This is because your dentist will need to develop a thorough understanding of your particular medical history, and conduct diagnostic tests and examinations.

When a cause has been found treatment may involve pain medication, prescription formulated topical creams and rinses, a mouthguard, muscle relaxants, trigger point injections with anaesthetic, Botox injections (to reduce over-active muscles or nerves), and/or physiotherapy.

What is an orofacial pain specialist?

Orofacial pain specialists are fully trained and licensed dentists who have undergone additional, comprehensive training in the branch of dentistry focused on orofacial pain disorders. They usually work in conjunction with medical colleagues in neurology, ENT surgery, and maxillofacial surgery to carry out the diagnosis, treatment, and management of patients suffering with orofacial pain.

What are the symptoms of orofacial pain?

Patients with orofacial pain will often complain of: 

  • jaw pain 
  • facial pain 
  • toothache 
  • headache 
  • neck pain 
  • clicking, popping, or locking in the jaw 
  • ear pain or ringing in the ears
Could my toothache really be caused by orofacial pain?

Often patients will be convinced that their pain is coming from a tooth and they may even want to have this tooth extracted. 

Orofacial pain is often described as ‘referred pain’. The structures of our face, mouth, and teeth are innervated (or supplied) by different branches of the same nerve. This means that although you may feel like pain is coming from your tooth, the source of the pain may be elsewhere and the sensation is travelling along the nerve to your tooth. For this reason your dentist may refuse to carry out treatment on your tooth if they believe you are suffering from orofacial pain. A thorough examination by an orofacial pain specialist will eliminate the risk of unnecessary and irreversible, permanent dental treatment being carried out.  

If you suspect that you are suffering from orofacial pain, please call us today for an initial consultation.