Many TMJ problems can be managed by a general dentist, but persistent jaw pain, locking, or facial pain without a clear dental cause is the work of an orofacial pain specialist, a dentist with at least two years of accredited residency training in pain disorders of the jaw, face, head and neck. This article explains the difference and when it matters.
Is orofacial pain a recognized dental specialty?
Yes. The National Commission on Recognition of Dental Specialties and Certifying Boards recognized orofacial pain as a dental specialty in 2020. The specialty covers the diagnosis, management and treatment of pain disorders of the jaw, mouth, face, head and neck.
What does residency training add?
An orofacial pain residency is a CODA-accredited postgraduate program. Dr. Masudian, DDS, MPH completed a two-year residency at the Herman Ostrow School of Dentistry of USC. Residency training covers diagnosis using standardized criteria, pain mechanisms, medications for nerve and muscle pain, and work with neurologists, sleep physicians and physical therapists. General dental training covers TMJ disorders more briefly.
How is TMJ pain diagnosed?
The standard is the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which give validated criteria for the most common pain-related TMJ disorders and screening questionnaires for jaw function, pain-related disability and psychological distress (Schiffman 2014). A diagnosis matters because muscle pain, joint pain, disc displacement and nerve pain are treated differently. Read more about TMJ disorders: jaw pain, clicking and locking.
Which TMJ treatments have the best evidence?
For chronic TMJ pain lasting three months or more, a 2023 BMJ clinical practice guideline made strong recommendations in favor of cognitive behavioral therapy, therapist-assisted mobilization, manual trigger point therapy, supervised jaw and postural exercise, and usual care such as home exercises and education (Busse 2023). It made conditional recommendations against reversible occlusal splints, botulinum toxin injection, trigger point injection and low-level laser therapy, and strong recommendations against irreversible oral splints, discectomy, and NSAIDs combined with opioids. An orofacial pain specialist uses this evidence to put the best-supported options first. See TMJ treatment without surgery.
When should I see an orofacial pain specialist instead of my dentist?
- Jaw pain that has lasted more than three months
- Jaw locking, or opening that is getting smaller
- Facial pain with no dental cause found
- Burning, electric or shooting facial pain (see neuropathic facial pain and trigeminal neuralgia)
- Headaches with jaw pain or clenching
Will a specialist replace my dentist?
No. Sleep Apnea and TMJ Dental Group provides no general dentistry. Your dentist keeps your routine care and receives a written report. The office is at 23101 Sherman Pl, Suite 415, West Hills, and is expected to open in mid-January 2027. Call (818) 877-0118 or read about Dr. Masudian.
References
- Busse JW, Casassus R, Carrasco-Labra A, et al. Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline. BMJ. 2023;383:e076227. PMID 38101929. doi:10.1136/bmj-2023-076227
- Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications. J Oral Facial Pain Headache. 2014;28(1):6-27. PMID 24482784. doi:10.11607/jop.1151
- National Commission on Recognition of Dental Specialties and Certifying Boards. Recognized dental specialties. ncrdscb.ada.org/recognized-dental-specialties
