Orofacial pain

The oral and maxillofacial surgeon very often is asked to diagnose and treat patients’ complaints related to facial pain, typical or atypical. A usual etiology of orofacial pain and headaches constitute the disorders or dysfunction of the temporomandibular joint (TMJ). TMJ disorders appear with a wide range of symptoms which can include earaches, headaches and limitation in mouth opening (trismus). Patients can also complaint for noises and clicking during the function of the temporomandibular joint (i.e. the joint between the mandible and the rest of the cranium), as well as for pain during opening or closure of the mouth.

The causes of TMJ dysfunction might be degenerative diseases (e.g. osteoarthritis), injuries (such as dislocation of the disc or its injury), inflammations (e.g. rheumatoid arthritis), or even stress. Some patients present a combination of muscular and joint problems. Diagnostic approach includes clinical examination, various pertinent particular imaging methods (such as radiographs, CTs and MRIs), as well as nerve blocks with local anesthetics. Conventional management of TMJ disorders and the accompanying orofacial pain, constitutes the first step of any therapeutic intervention, and usually includes soft diet, NSAIDs, as well as physiotherapy alone or assisted by placement of a specific stabilization splint. In some particular cases of course a surgical operation to the TMJ is demanded. Arthroscopic surgery of the joint constitutes a minimally invasive procedure, which has been proven to be effective in the restoration of some particular disorders, concerning dysfunction and pain of the TMJ. This surgical procedure can be performed at the outpatient clinic in a hospital setting under general anesthesia, whereas more severe disorders of the TMJ are managed with more complicated oral and maxillofacial surgical operations, always in a hospital setting.