Introduction to orofacial pain
Differential diagnosis of the
orofacial pain patient:
Various categories of Orofacial Pain
Toothache due to sinusitis/ malignancy
This lecture will serve as an
introduction to the field of orofacial pain and the various
sources of pain in the orofacial area, other than those
coming from the teeth. For instance, myofascial trigger
points can refer pain to the teeth and gingiva and can be
mistaken for a toothache and may lead unnecessary endodontic
treatments or even extractions.
We will cover various other sources of
orofacial pain such as mid-face migraines, post-traumatic
trigeminal neuropathy, etc. These topics will be covered in
more detail in the following lectures.
(Includes diagnosis, imaging, lab
studies and management)
These lectures will cover basic TMJ
anatomy and biomechanics, review the masticatory muscles,
disc displacement disorders, subluxation (closed vs. open
locks), retrodiscitis, arthralgia, myofascial pain. We will
also go over the conservative management of each condition,
including appliance therapy.
We will discuss the various arthritides
that can affect the TMJ such as, rheumatoid arthritis,
psoriatic arthritides as well the sero-negative arthritides.
After this presentation, the dentist
should be able to diagnose and differentiate between the
various presentations of TMD's.
Burning mouth syndrome
Neuralgias such as trigeminal neuralgia
and glossopharyngeal neuralgia will be covered in these
lectures. Differential diagnosis will be covered as
trigeminal neuralgia is commonly mistaken for acute
pulpitis. The pathogenesis and management of
trigeminal neuralgia will be covered.
Post-traumatic trigeminal neuropathy,
which is a common condition of persistent, continuous pain
after multiple dental treatments such as endodontic
treatment, implant placement will be discussed in this
lecture. We will cover how to document these cases, perform
sensory testing and management, including when to refer.
Burning mouth syndrome: this condition
can manifest as constant burning pain on the tongue or other
parts of the mouth. We will discuss how to work these
patients up, including how to differentiate between
idiopathic burning versus other disorders that can cause
burning such as candidiasis, elevated blood glucose levels,
etc. Management of this condition will also be discussed in
Post-herpetic neuralgia, which is a
sequela of an attack of the Herpes Zoster virus and can lead
to debilitating pain especially in the elderly and the
immune compromised patient, will be covered in this lecture.
Trigeminal autonomic cephalalgias:
Hemicrania continua and Paroxysmal Hemicrania
SNOOP paradigm- You may save a life
following this paradigm!
Headaches that mimic toothaches, such
as mid-face migraines, trigeminal autonomic cephalalgias
will be discussed in this engaging lecture. We will discuss
how to work these patients up, when to order imaging and
We will also discuss the ominous signs
of headaches and how to manage emergent conditions,
including the SNOOP paradigm.
Obstructive Sleep Apnea:
When to order a sleep study
How to work up a patient for a
mandibular advancement device
How to manage a patient with both OSA &
The warning flags that a patient may
display of OSA will be discussed, including the interplay
between sleep and pain. Screening and when to refer for
testing will be discussed.
the orofacial pain patient:
How overlying anxiety and depression
can affect the chronic orofacial pain patient
Learn about the modulatory system in
the pain pathway- and how it can affect the patient's pain
Learn how common psychological
disorders such as anxiety and depression can affect the
management of the orofacial pain patient.
Learn about the risk factors that can predispose a patient's
pain perception and possibly cause them to develop chronic
the orofacial pain patient:
Learn how to perform the cranial nerve
Evaluation of the TMJ: Range of motion
measurements, recording the gait of the mandible, palpation
of the TMJ, auscultation of the TMJ
Examination of the orofacial pain
patient will be covered in this engaging lecture- including
cranial nerve screening, TMJ evaluation (listening for joint
noises, measuring the range of motion, the gait of the
mandible) Muscle palpation (including how to locate trigger
points) will be covered. Lots of clinical pearls will be
covered in this talk for you to use
when you get back to your office.