If you’ve never heard the term orofacial dentist, I’m not surprised. I’m one of only a few hundred formally trained orofacial dentists in the United States. That’s because orofacial dentists have not been terribly visible on the health care playing field. But that is changing.
Orofacial dentists like me treat patients who suffer with pain of muscle origin, joint origin, and nerve origin that is focused in the head, neck, mouth, face and jaw area. For example, we treat people who have chronic tooth and gum pain despite multiple dental evaluations and treatment. We treat very challenging problems related to the TM Joints which are characterized by pain, limited mouth opening capacity, jaw clicking and jaw locking (commonly called TMJ). Patients come to us with problematic headaches seeking additional care to complement treatment by their physicians and other health care providers. And in many cases, we see patients with pain in the nerves that supply the teeth, gums and other facial tissues.
At times we also are called upon to diagnose and or treat patients with complex medical problems that result in facial pain.
Why don’t more people know about orofacial dentists?
Because this specific area of dentistry has not been granted “specialty status” by the American Dental Association. It is specialty status programs in dental schools that enable dentists to become oral surgeons, endodontists (root canal), periodontists (gum therapies) and orthodontists (braces). Although efforts have been made at both the national and state levels to push through specialty applications for my field, success has so far been elusive.
And that’s why orofacial dentists are difficult to find. Patients who are in pain often seek advice from their primary care physicians, ENT doctors, neurologists, and oral surgeons. Sadly, these patients are often told that either “nothing is wrong” or they are provided care that falls short. That’s because all dimensions of their pain problem have not been considered.
In my office I see suffering patients who have been in pain for months (sometimes years) before they finally find their way to me.
To help our patients, orofacial dentists rely on a wide variety of treatment options including education, medication, therapeutic injections, oral appliances, and muscle and joint rehabilitation therapies. Patient education is crucially important in my field as many of the problems we treat in the jaw muscles and joints are the result of daytime jaw overuse behaviors and sleep related teeth grinding and clenching. Most orofacial dentists have a strong relationship with physical therapists, clinical psychologists, pain management physicians, psychopharmacologists, chiropractors and even acupuncturists and leaders of meditation programs. All of these together allow us to successfully care for our patients’ individual needs.
And here’s the big bonus of going to an orofacial dentist: We often validate the fact that your pain is not only real but is also helpable despite past treatment failures. I believe that just knowing that there’s an answer starts making my patients feel better right away.
I predict that in not too many years orofacial dentistry will finally achieve the specialty status it deserves. Not only will patients be better informed and have more access, but more dental students will more often choose it as their field of concentration.