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Orofacial Pain

Persistent pain in the face, ears, teeth, and/or jaw has often been accompanied by tightness and soreness in the jaw and facial muscles, limited jaw opening, difficulty chewing, and, at times, symptoms like burning and tingling in the face and lips.

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Orofacial pain problems often fall into one of the categories below:
1. Pain of Tooth Origin (odontogenic)
2. Pain of Muscle and Joint Origin (TMD)
3. Pain of Neural Origin (neuropathic)
4. Facial Pain and Headache(Neurovascular)
5. Pain due to Regional Medical Problems


In the absence of trauma or significant tissue damage, persistent orofacial pain complaints are misunderstood and often misdiagnosed because of four resounding reasons:


1. Referred Pain: The site of the pain is not the source of the pain. The phenomenon of
referred pain is common in the face, leading to treatment at the location of the
described pain, but not at the true origin. As a result, pain continues.


2. Pain can occur in the absence of tissue injury or disease. The real problem is a
malfunctioning neural system; the patient essentially has an alarm that is triggered
despite the presence of ongoing insults or structural damage. Treatment for some
facial, tooth, or jaw pain may be mechanical in nature and directed at sites that have
nothing wrong with them. Treatment focused on the wrong target inevitably fails.


3. Orofacial pain can be so intense that patients and/or providers assume something is
terribly wrong. While intensity of symptoms often has nothing to do with the
seriousness of a problem, providers may be motivated to escalate treatment as pains
persist even if advanced tests and images don’t support such decisions.


4. The influence of emotions and stress on body physiology and reflex is often neglected
or poorly understood. The physical output (pain or dysfunction) experienced by the
body, very often the muscles, can increase, linger and become more difficult to treat
over time.


In a comprehensive evaluation, your cranial nerves, jaw joints, facial and neck muscles along
with your teeth and other oral structures will all be examined. The exam reveals whether your
problem lies within nerves, muscles, joints, teeth or other neighboring structures, and whether
we need other tests to make the best decisions for your condition.

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