Frequently Asked Questions
Orofacial Pain Related Questions
I've never heard of Orofacial Pain. What is it?
Orofacial Pain is the 12th and newest ADA-recognized dental specialty, similar to other more well-known specialties you've probably heard of, like Orthodontics.
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How does an Orofacial Pain specialist differ from a:
• TMJ specialist
• Craniofacial Pain specialist
• Neuromuscular dentist
• Dental Sleep specialist?
Orofacial Pain is one of the 12 ADA-recognized dental specialties, similar to other more well-known specialties like Orthodontics.
TMJ, Craniofacial Pain, Neuromuscular Dentistry and Dental Sleep Medicine are not ADA-recognized dental specialties thus board-certification with various organizations does not designate specialty status. Understandably, this can be very confusing for patients.
To protect the general public from misinformation, the ADA publishes information on the 12 recognized dental specialties and the corresponding approved specialty board.
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ADA-Recognized Dental Specialties
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What is an Orofacial Pain specialist?
An Orofacial Pain specialist is a dentist who has completed additional training in diagnosing and treating pain disorders in the head and neck region and sleep-related breathing disorders. The dentist has typically passed the ADA-recognized board exam with the American Board of Orofacial Pain (though this is not required in some states). Dr. Wang has completed a Masters degree in Orofacial Pain and Oral Medicine (another recognized dental specialty) and has completed Board Certification with the American Board of Orofacial Pain as well as with the American Board of Dental Sleep Medicine.
What does an Orofacial Pain specialist do that is different from other dentists?
An Orofacial Pain specialist focuses on diagnosing and treating TMJ-related disorders, nerve disorders of the face/neck region, primary headaches (such as migraines) and sleep-related breathing disorders. Orofacial Pain specialists are trained to determine the source of your set of symptoms. General dentists can provide care for some of these disorders, however they do not have the same education, training and board-certification.
I was told that I have TMJ. What does that mean?
TMJ stands for the temporomandibular joint. This joint connects your lower jaw to your skull. There can be pain and dysfunction resulting from disorders related to either or both of these joints. These symptoms are collectively referred to as TMJ Disorders (TMJD or TMD) and can be caused by various factors.
I was told that my TMJ disc is dislocated, and that someone could put it back in place. Can you do that?
Once a TMJ disc is completely dislocated, it does not need to be “put back in place”. The TMJ is a complex joint with many structures, including muscles, ligaments, and bones. When the disc is displaced, it affects the overall balance of these structures. Over time, the surrounding tissues adapt to the new position of the disc. This makes it unnecessary to restore the disc to its original location. If Dr. Wang diagnoses a displaced disc, she will educate you on the process of adapting to this new disc position and how best to support your jaw during this process.
I was told that my TMJ disc is dislocated. Does that mean I will need surgery?
TMJ disc dislocation does not typically require surgery. The majority of joints are able to adapt and to function comfortably even with a dislocated disc ligament.
I have a toothache. Why are you checking my muscles?
Muscles in the head and neck region have the unique ability to refer pain that can mimic pain in other structures or areas. Dr. Wang is trained to identify the specific muscle(s) that may be contributing to your pain.
Do you do jaw surgery?
No. Dr. Wang is not a surgeon. If it is determined that you may benefit from surgical intervention or consultation, she will coordinate an appropriate referral to a knowledgeable team of surgeons. Most TMJ related issues do not require jaw surgery.
How do you treat TMJ disorders?
Determining appropriate treatment for facial/jaw pain requires a thorough history, exam and diagnosis first. Once diagnosed, a custom therapy plan can be created, as there is not a one-size-fits-all solution. Dr. Wang focuses on determining an accurate diagnosis. TMJ disorders is not a diagnosis. It is a group of different disorders, with different therapy options. Dr. Wang has found from experience and published evidence that an accurate diagnosis and conservative therapies are most effective for managing many jaw related pains.
I already have a nightguard. Do I need to have a different one made?
Typically, no. All patients are instructed to bring any oral appliances that they are using, to their initial evaluation. Dr. Wang will check to see if your appliance might be contributing to your symptoms and will review her findings with you.
My dentist made me a nightguard but I can't tolerate wearing it. Can you make me a better one?
Not necessarily. For some patients with undiagnosed sleep apnea, it may be difficult to tolerate a nightguard because it can cause the airway to close. This is why Dr. Wang screens for sleep apnea risk with all of her patients and will discuss any concerns with you. In some situations, Dr. Wang may recommend having a sleep physician consultation and possibly a sleep study prior to making a nightguard.
My dentist recommended Botox for teeth clenching and grinding. Will that stop my clenching and grinding?
Botox is not typically the best way to address clenching and grinding. Dr. Wang will discuss other more conservative and appropriate options prior to recommending Botox therapy.
TMJ & Muscle Related Questions
Headache & Nerve Related Questions
I see a neurologist for my headaches already. You are a dentist. Why would I need to see you?
While seeing an Orofacial Pain specialist is not mandatory for headache treatment, an evaluation can help determine if any head or neck issues may be contributing to your headaches.
I’m on a lot of medications for my migraines. Are there really other options for treating migraines?
Yes, Dr. Wang is trained to offer non-invasive, non-pharmacological therapies for managing migraines and cluster headaches. All of the therapies offered are backed by research and utilize FDA-cleared methods. She will determine if you are a candidate for these therapies. Please see "What We Treat/Migraine Therapies" for more information.
I’m having jaw pain. Why are you asking me about headaches?
Headaches can be related to jaw or facial pain. Understanding this connection can aid in managing both conditions.
My tooth hurts but no one can find anything wrong. How can you figure out why it's hurting?
Dr. Wang is trained to examine tooth-related structures as well as additional areas in the head and neck region to determine if there might be a muscle or nerve causing pain. Most dentists and medical providers do not have this additional training. For some patients, the source of the pain can be easily identified by an exam. For others, it may be more complex and additional testing or imaging may be needed.
I’ve been told that I have mild sleep apnea and that I don’t need any treatment. Is that true?
All levels of sleep apnea should be addressed since they can increase long term health risks, such as high blood pressure, diabetes and stroke. Dr. Wang works with your sleep medicine physician to manage obstructive sleep apnea by reviewing your sleep study results and presenting treatment options.
Are you a Sleep Dentist?
No. Dr. Wang is a Board Certified Orofacial Pain specialist with additional Board Certification with the American Board of Dental Sleep Medicine. The ADA-recognized dental specialty of Orofacial Pain includes the treatment of sleep-related breathing disorders such as obstructive sleep apnea. Sleep dentistry is not a separate ADA-recognized dental specialty.
What kind of treatments are available for sleep apnea?
I hate my CPAP. My doctor told me to get a sleep appliance. Why do I need an evaluation? Can't I just get the sleep appliance?
Not everyone is a good candidate for oral sleep appliance therapy. Dr. Wang will need to review the results from your sleep study, complete a thorough oral exam, and determine which therapy options are most appropriate for you. Oral appliance therapy has risks just like anything else. Oral appliance therapy can result in bite changes. Morning occlusal guides and simple exercises are ways to minimize those bite changes, but changes are almost certain to occur with long-term use. Bite changes are not necessarily detrimental, especially if the trade off is that you can keep your brain oxygenated while you sleep. Oral sleep appliances can also make your obstructive sleep apnea worse. This is why Dr. Wang will work closely with your sleep physician, after appliance delivery, to confirm that the appliance is helping you. Dr. Wang feels that it is important for patients to fully understand these risks prior to starting therapy.
If you've been diagnosed with obstructive sleep apnea, you can schedule a consultation to explore treatment options and to determine if you are a candidate for oral appliance therapy.
