Orofacial pain consultation

Pain in the face can have many sources: the chewing muscles, the temporomandibular joint (TMJ), the facial nerves, the teeth, the sinuses, or a headache that “spreads” to the face. The right treatment depends on the source, so everything starts with the diagnosis.

The consultation is carried out by Dr. Raluca Draghici, a Primary Dentist in Prosthodontics with advanced training in orofacial pain and TMJ disorders (Master’s degree, University of Siena). Its aim is not an immediate procedure, but to understand what hurts, why, and what really helps in your case.

How the consultation works

1. Talking (your history). We listen to the story of your pain: when it started, where it is, how strong it is, what triggers it, what you have tried, how you sleep, and your other health conditions. This is the most important part of the diagnosis.
2. Questionnaires. We use questionnaires that help measure the pain and its impact on daily life. You can fill in the first one at home: it is on this page, under “Patient brochures”.
3. Examination. We examine the face and neck muscles, the jaw joints, how your mouth opens and moves, joint sounds, your teeth and bite, following internationally used protocols.
4. Tests, only if needed. Sometimes imaging (an X-ray, CBCT or MRI of the joint) or blood tests are needed. We recommend them only when the result can change the diagnosis or the treatment.
5. Diagnosis and plan. Finally, we explain what you have in plain words and propose a step-by-step treatment plan.

Step-by-step treatment

Most TMJ problems and facial muscle pain improve with simple, conservative and reversible treatments. That is why we start with the simplest steps and go further only if needed:

• Information and self-care: what is happening, what to avoid, how to rest your muscles, simple exercises at home.
• Targeted treatment: exercises and physiotherapy, an occlusal splint, medication where indicated.
• Procedures: therapeutic injections (for example botulinum toxin or trigger-point injections) or nerve blocks, when the earlier steps are not enough.
• Working together: when the pain also involves other specialties, we refer you to the right colleagues (neurologist, ENT doctor, sleep physician, physiotherapist, psychologist) and work with them.

One important principle: TMJ pain is not treated by grinding the teeth or by extensive dental work, which cannot be undone. Dental work is done when the teeth need it, not to treat muscle or joint pain.

What to bring

• The questionnaire, filled in (on this page, under “Patient brochures”).
• X-rays, CBCT, MRI or other tests done earlier for this pain.
• A list of the medication you take and of what you have tried for the pain.
• Your splint, if you have one.
• If the pain comes and goes, a few days of the pain diary help you show us its pattern.

Conditions we assess

• Temporomandibular disorders: muscle and joint pain, clicking, jaw locking
• Bruxism: clenching and grinding
• Trigeminal neuralgia and neuropathic pain
• Headaches that overlap with facial pain
• Burning mouth syndrome and other persistent facial pain
• Snoring and sleep apnoea (with a mandibular advancement device)

Book a consultation or call us on +40 244 434 843.