Orofacial Pain and Temporomandibular (TMD) Disorders
Orofacial pain is the second most common reason for an emergency dental visit after a toothache.
At Future Dental, we can provide you with a range of treatments to ease orofacial pain.
Chronic orofacial pain can be debilitating at the best of times, given that it creates constant pain in the head and neck. Many patients do not necessarily associate orofacial pain with dentistry, with many simply raising their history during discussion and questioning by the dentist and not thinking much more about it.
Many, however, have experienced chronic facial, oral, cranial and neck pain for years and have had exhaustive investigations by various medical specialists without arriving at a satisfactory diagnosis. Not infrequently, they are the result of a cause that has eluded them for years, and is diagnosed by investigation into these MPD (myofascial pain and dysfunction) and TMD symptoms.
For some patients, the reason for visiting the dentist is acute orofacial pain and some may have been referred from the medical profession. For these patients, it is important to understand that their symptoms will likely require teamwork management with other medical professionals. Any history of headaches requires further investigation outside the dental office, and we will very likely refer you to others to act in the investigation also.
Causes of orofacial pain
Orofacial pain can have a variety of causes. The reasons for orofacial pain can include the following:
- Myofascial Pain and Dysfunction (MPD) and Myalgia (muscle-related and often referred pain perhaps felt in a different area).
- TMJ (Temporomandibular Joint) internal derangement, inflammation, and trauma, collectively known as Temporomandibular Disorders (TMDs).
- Occlusion related to dental pain.
- Neurogenic pain, neuralgias.
- Headaches, Primary and Secondary.
- Potentially life-threatening causes.
Headaches, neck discomfort, ear discomfort, dental pain, facial burning or stinging sensations, and jaw joint discomfort are common symptoms. Symptoms may also include atypical pains or sensations such as tinnitus (ringing in the ears), dizziness, muscular incoordination, and even strange itching or tingling in the head and neck area are examples of symptoms.
Another common cause of orofacial pain is occlusal disharmony or bite imbalances. These are two areas often overlooked, but simple to fix with immediate benefits when treated correctly. Occlusal equilibration is often performed to restore a balanced bite.
Orofacial Pain services in Cairns
At Future Dental in Cairns, we offer the following pain management services and relaxation techniques to treat orofacial pain:
- TMJ Pain
- Occlusal Splint Therapy
- Occlusal Therapy & Migraine Treatment
- Therapeutic Injectables
- Neuropathic Pain
Myofascial Pain and Dysfunction (MPD) and Myalgia
Myofascial Muscular Pain and Dysfunction (MPD) is often felt in areas called trigger points, that are not actually felt where the pain originates. Patterns of referred pain and trigger point knowledge is essential in managing myofascial pain and dysfunction (MPD). MPD’s are heavily influenced by mastication muscles, the muscles of the neck and shoulders which are all involved in jaw movements.
These are often associated with cervicogenic headaches and tenderness. Pain from hyper-activity of these masticatory muscles is the most common form of Orofacial pain, after the toothache that does originate in the teeth and gums. With experienced hands, a diagnosis of MPD is quick and simple.
MPD is most often caused by Bruxism, which is the subconscious habit of teeth grinding and teeth clenching and is often accompanied by headaches, neck, and shoulder pain. MPD is usually managed in stages, and usually starts with Myofunctional Therapy. This can be performed in-house at Future Dental, or on referral to physical body workers such as physiotherapists, remedial massage practitioners, myologists, chiropractors and osteopaths.
For pain of muscular origin, after myofunctional therapy, various dental splints are often recommended. A Flat Plane or Michigan Splint is often a start, and typically these need to be worn nightly often for months until the cause is managed. Thereafter it may only be needed if and when symptoms reoccur.
What is TMJ pain, and what are TMJ disorders?
The temporomandibular joints (TMJ) are the joints which connect your jaw to your skull. Temporomandibular joint disorders encompass a range of conditions involving the jaw joints, the muscles of the jaw, or both. These joints are located in front of your ears and can lead to pain in the jaw.
TMJ Pain is often caused by inflammation of the joint (Capsulitis) or by internal derangement where the fibro-cartilage disc (meniscus) becomes pulled forward in the joint by the pterygoid masticatory muscles.
At Future Dental, the team can evaluate and treat TMJ disorders with industry leading technology.
Treatments for orofacial pain
Some treatments may include occlusal splints. These include flat plane or Michigan splints, an Anterior Positioner Splint such as an Olmos ON1 or ON3 Orthotic, and in some cases an Olmos OD1 Daytime orthotic. All Splints require monitoring and adjustment, so several dental visits are likely required for the best results.
At times, joint pathology results from disturbances to the position and alignment of the teeth.
From minor bite adjustments to eliminate these bite disturbances to the longer-term bite reconstruction may be warranted, but that will never occur until stability and symptom reduction have occurred over a sustained period.
At times orthodontic treatment may be advised to eliminate bite disturbances.
Disc Displacement without reduction, especially with acute pain and limited jaw opening in a Closed Lock, may require quite rapid treatment.
This is first attended in the dental office, where a temporary Rescue Device like an Aqualiser may be used.
How Future Dental in Cairns can help
Once your evaluation has been performed, we will devise a long-term pain management plan to combat any orofacial pain and temporomandibular disorders you are currently facing.