Dental perspective on face pain

The majority of patients with chronic pain disorders involving the face and craniomandibular mechanism have so-called temporomandibular joint (TMJ) syndrome, atypical face pain, trigeminal neuralgia or neuropathy, or iatrogenic pain. The term "TMJ disorder" is often a misnomer, because the joint itself frequently is not implicated. Diagnosis requires persistent multidisciplined investigation. Initial treatment is aimed at relief of pain and restoration of function. Treatment may then be directed at the source of the problem. For patients with atypical face pain, a complete and detailed history must be obtained before further examination and treatment can be pursued. Trigeminal neuralgia and trigeminal neuropathy must be differentiated before treatment is initiated, because of major differences in therapy. Iatrogenic pain is most often the result of overtreatment.