The Brotman Clinic mission is three-fold: 1) To provide the diagnosis and state of the art compassionate and customized care through a multidisciplinary approach, supported by evidence based treatment modalities, to enhance the quality of life of individuals suffering from orofacial pain disorders; 2) To advance our understanding of orofacial pain through scientific study, thereby leading to improved evidence-based treatment approaches; 3) To educate a new generation of dental practitioners in the prevention, diagnosis and management of these disorders.
Patient Information: 410-706-7961
Orofacial and Head Pain
Orofacial pain disorders are prevalent and debilitating conditions that involve craniofacial musculature, the temporomandibular joint (TMJ), and associated structures. The orofacial region is complex and pain can arise from many sources and etiologies and occasionally resemble chronic toothaches. Temporomandibular disorders (TMD) are the 2nd most prevalent orofacial pain conditions (after dental pains) for which patients seek treatment. TMD include several clinical problems that involve the cervical musculature, the masticatory musculature and the TMJ. Another type of orofacial pain condition, trigeminal neuropathic pain, can be idiopathic or arise from nerve injury secondary to dental procedures, neoplasias, disease, or physiological dysfunction of the nervous system.
Neurovascular disorders, such as primary headaches, can be present as orofacial pains too, such as in the case of facial migraine, where the pain can be felt as a ‘headache’ and be localized in teeth and/or in the maxilla or mandible. These disorders present a diagnostic and therapeutic challenge for the majority of clinicians and uncertainty and distress for the sufferer. Pain felt in the head and face tends to engage our brain’s emotional centers more so than pain felt in other parts of the body, therefore multidisciplinary management should include approaches to decrease the pain itself, but also to address the emotional impact of the patient’s experience.
Services We Provide
We provide the evaluation, diagnosis and management of a wide spectrum of orofacial pain disorders, that includes Temporomandibular disorders (TMD), chronic and persistent dental pains, cranial neuralgias, peripheral and central neuropathies, as well as primary headache disorders:
Musculoskeletal pains including:
- Temporomandibular Disorders (TMD)
- Temporomandibular joint (TMJ) pain, jaw/mandible pain, pain with mastication, mouth opening, jaw locking, clicking or popping of the TMJ
- Clenching, grinding
- Myalgia and myofascial pain, pain in cervical and masticatory muscles
Neuropathic Pains:
- Nerve pains including:
- Trigeminal neuralgia, glossopharyngeal neuralgia, occipital neuralgia
- Peripheral and centralized trigeminal neuropathies
Neurovascular disorders including:
- Primary headache disorders:
- Migraine, headache and TMD co-morbidity, tension type headache, trigeminal autonomic cephalalgias (in consultation with neurology)
About Our Clinic
Our management is conservative and individualized for the specific needs of the patient. Management includes pharmacological approaches (including injectable medications), physical therapy modalities, as well as behavioral approaches to pain management. The optimal management of orofacial pain conditions can be attained in a multidisciplinary manner, including pharmacological and non-pharmacological modalities. Referrals to physical therapy, neurology, neurosurgery, oral and maxillofacial surgery, ENT, oral medicine, sleep medicine, pain psychology and pain psychiatry are available as well.
For Patients
To learn more about the Brotman Facial Pain Clinic and the services we provide, contact us by telephone at (410) 706-7961. Please bring any night guard or mouth appliance currently in use as well as any relevant dental and medical records, list of medications currently taking, laboratory results, MRIs, X-rays or other type of imaging taken outside the school to the appointment. Thank you.
For Doctors
You may complete the form to refer a patient to the Brotman Facial Pain Clinic. The form can be received by Fax (410) 706-0309 or it can be given to the patient to bring to his/her appointment. If you have any questions please contact our clinic staff at (410) 706-7961.
Research
The Brotman Facial Pain Clinic serves as a venue for several clinical research studies on TMD and related disorders. The largest and longest research study conducted here is the OPPERA study (Orofacial Pain: Prospective Evaluation and Risk Assessment). The OPPERA study is a multi-center study aimed at identifying the factors that contribute to the development and persistence of Temporomandibular Disorders (TMD). In collaboration with Dental Schools at the University of North Carolina – Chapel Hill, University of Florida, and University at Buffalo, the Brotman Clinic served as a recruitment and assessment site for the largest prospective study of TMD funded by the National Institute for Dental and Craniofacial Research. As of the end of 2017, 32 peer-reviewed papers have been published based on this research. Other clinical research studies, including those evaluating neural mechanisms underlying normal and pathological pain, have been conducted over the last two decades.
To learn more about currently ongoing studies, visit Clinical Research Currently Recruiting.
Faculty
