The results of a recent study in the Journal of the American Dental Association showed results that 16.1% of patients experienced orofacial pain. It turns out that this is almost the same number of patient visits to physicians for migraine or headache pain. Is there a connection to TMJ disorder?
The October 2015 Journal of the American Dental Association presented a study entitled Frequency of Orofacial Pain in Dental Patients. The study looked at 100 dental practices, chosen over a three-year period. The dentists took a random sample of their patients that were seen and screened them for current orofacial pain or any pain within the previous year.
The results showed that 1 in 6 patients, a 16.1% prevalence, had in the previous year experienced orofacial pain. The most prevalent pain was in the tooth and gum (dental-alveolar) followed by muscle and ligament (musculoligamentous) pain.
This is important for dentists and physicians. A 16% prevalence represents a high number of patient visits. According to the CDC, physician visits for headache/migraine in 2009 was 16.1%. It is interesting that the number of visits to physician for headache and migraine pain is the same as dental visits for orofacial pain. It is quite possible that instead of migraines, those patients may be suffering from the musculoskeletal symptoms of a temporomandibular disorder.
Temporomandibular disorders can present as neck pain, pain under the ear, or occipital headache pain. In 2009 the CDC reported incidence of physician visits for neck pain was 15.1% of office visits.
Orofacial pain is fairly common presenting symptom in dental offices. In addition to evaluating possible dental causes, general dentists should measure TMJ range of motion of the TM, which this study did not mention. If range of motion indicates disorder, the patient should be referred to a TMJ expert if the physician or dentist doesn’t want to manage a potential TMJ disorder. Dentists should also refer patients for a TMJ screening if the pain doesn’t resolve in 7-10 days using common protocols of rest, ice, and anti-inflammatory medications. Long-term medication is not treatment.
Physicians seeing patients for headache or neck pain should also measure TMJ mobility and/or consider it in their diagnosis. Many physicians are unaware that most general dentists are not trained to manage TMJ disorders. Therefore, simply telling the patient to see their dentist doesn’t always result in a qualified examination.
It is common for patients that are referred to me to have been experiencing pain for months, a year, or even longer, and have tried several diagnosis and treatments to alleviate the pain. Head and upper neck pain in the presence of jaws that click, pop, or feel stuck should seek out a TMJ focused practice for an evaluation. Jaws and mouths that don’t open well, or patients who have pain in the muscles or jaw joints when eating should also seek consultation for a TM disorder.