An orofacial pain specialist (OFP) is a dentist specializing in diagnosing and treating conditions that cause pain in the jaw, face, head, and neck. These specialists focus on identifying causes of pain outside of the typical toothache. Orofacial pain specialists undergo additional training and must pass a board exam to be certified.

This article discusses orofacial pain specialists—who they are, what they do, their training, and their certification.

What Do They Treat?

Orofacial pain specialists treat conditions that cause pain in the jaw, mouth, face, neck, and head. These conditions can be caused by muscles, nerves, joints, or blood vessels.

Orofacial Pain Specialty

Orofacial pain was formally recognized as the 12th specialty in dentistry on March 31, 2020, by the National Commission on Recognition of Dental Specialties and Certifying Boards.

In addition to pain, orofacial pain conditions can cause other symptoms, such as:

  • Headaches
  • Ringing in the ears (tinnitus)
  • Decreased coordination with movement
  • Itching or tingling sensations
  • Dizziness

Dentists in general practice treat tooth issues that cause acute (sharp and sudden) pain. Conditions treated by an orofacial pain specialist are typically chronic (long term) and are usually caused by structures other than the teeth.

The International Classification of Orofacial Pain (ICOP)—the first internationally recognized system for classifying facial pain, established in 2020—recognizes six subgroups of facial pain, which are:

  • Orofacial pain from disorders of dentoalveolar and anatomically related structures (such as dental pain or pain from the jaw bone, glands, or mucosa in the mouth)
  • Myofascial orofacial pain (caused by trigger points in muscles)
  • Pain in the temporomandibular joint (TMJ)
  • Pain caused by injury or disease of the cranial nerves (trigeminal or glossopharyngeal nerves)
  • Orofacial pain that resembles symptoms of primary headaches (i.e., orofacial migraine, neurovascular pain)
  • Idiopathic (unknown cause) orofacial pain

Orofacial pain specialists can also treat sleep bruxism (teeth grinding and clenching), which contributes to other sleep-related medical conditions such as:

  • Snoring
  • Obstructive sleep apnea
  • Insomnia
  • Gastroesophageal reflux disease (GERD)
  • Rapid eye movement (REM) sleep behavior disorder
  • Restless legs syndrome (RLS)

Procedural Expertise

Orofacial pain specialists use a variety of treatment interventions, some of which require additional training. Examples include:

Temporomandibular Disorder (TMD)

The temporomandibular joints connect your jaw to your skull. Located in front of your ears, these joints are a common source of orofacial pain. TMD is often caused by:

  • Prescription medicationsFabrication of mouth appliancesExercise instructionOral surgerySteroid injectionsBotox (onabotulinumtoxin-A) injectionsBiofeedbackCognitive behavioral therapy (CBT)Training in relaxation techniques

Orofacial pain specialists also refer patients to other healthcare providers for complementary treatment, such as:

  • Physical therapists
  • Acupuncturists
  • Chiropractors
  • Ear, nose, and throat (ENT) doctors
  • Neurologists
  • Occupational therapists
  • Psychologists
  • Neurosurgeons
  • Sleep specialists

Training and Certification

According to the American Academy of Orofacial Pain (AAOP), orofacial pain specialists are licensed dentists who demonstrate expertise in diagnosing and treating orofacial pain through formal education, clinical experience, or research. In addition, one or more of the following standards must be met:

  • Completing at least two years of formal advanced education in orofacial pain, accredited by the Commission on Dental AccreditationBeing a fellow of the American Academy of Orofacial Pain (AAOP)Passing the American Board of Orofacial Pain (ABOP) Certification Examination

Find an Orofacial Pain Specialist

Your dentist will often be the first provider to recognize that your orofacial pain is not a result of a tooth problem. If you have orofacial pain that your general dentist can’t treat, they might refer you to an orofacial pain specialist.

The American Academy of Orofacial Pain

The AAOP is an organization that focuses on education, research, and excellence in care for orofacial pain. Members of the organization include dentists and other healthcare professionals who treat people with these conditions.

You can also search for providers using the AAOP member directory.

Summary

An orofacial pain specialist is a licensed dentist specializing in diagnosing, managing, and treating disorders causing pain in the mouth, jaw, head, neck, and face. Although these conditions can cause tooth pain, the root cause of the disorder is not the teeth. Issues with muscles, nerves, ligaments, and bones in the face or surrounding areas can cause orofacial pain.

Orofacial pain specialists often work as part of an interdisciplinary team with other healthcare providers to treat these conditions. Treatments include prescribing medications, surgery, exercise instruction, mouth appliances (such as a mouth guard or splint), or injections of steroid medications or Botox.

Orofacial pain specialists require additional training and have the option of taking a licensing exam for certification.