Chronic Orofacial Pain

Temporomandibular disorders (TMD) are more common than temporomandibular joint disorders (TMJD), which are more likely to be seen by oral surgeons. Correct diagnosis is critical, as inaccurate diagnosis can lead to inappropriate treatments creating further problems. Treatment approaches differ, some are controversial, and not all treatments are evidence-based. Advances in understanding pain mechanisms also show that convergent afferent nociceptive transmission from nontrigeminal, extraoral cervical sources can enter the trigeminal system. TMD pain may also present as dental, sinus, and headache. Myofascial trigger points are a major source of pain that is often overlooked, and psychosocial factors also play a major role in the development and chronicity of TMD. This Master Class addresses some of the issues involved and looks at management approaches. Demonstrations and practical work in pairs will help consolidate the material presented.

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