Role of Oral Medicine in the Teaching of Temporomandibular Disorders and Orofacial Pain

This paper discusses the role of oral medicine in the teaching of temporomandibular disorders (TMD) and orofacial pain. Education in orofacial pain and TMD has traditionally been managed in academic dental settings as 2 distinct processes separate from the teaching of diagnosis and management as applied to systemic diseases and oral conditions. The rationale for such a segmented approach appears to have been driven by the concept that orofacial pain usually reflects a localized disease rather than arising as a component of more generalized systemic disease or modulated in intensity or morbidity by systemic pathology, generalized neurobiological, or behavioral contributors. Conversely, oral disease and head and neck manifestations of systemic disease often provoke pain as a major symptom. Management of such conditions should include acute and long-term pain management strategies when the underlying condition has no definitive cure and the pain is disabling. An argument is made for integrating the teaching of oral medicine and orofacial pain to enhance a broad-based approach to the assessment and management of primary pain disorders and to assure appropriate management of pain that is associated with mucosal disease and other forms of regional or systemic pathology including behavioral disorders that present as somatic and painful complaints. Keywords: orofacial pain, temporomandibular disorders, dental curriculum, educational conference, oral medicine