Updated to reflect the latest research in orofacial pain, this revised edition of Dr Welden Bell's classic text is designed to assist the practicing dentist in managing orofacial pain disorders, from diagnosis to treatment selection. It presents an updated classification system for orofacial pain disorders, especially in the complicated area of neuropathic pain conditions, and describes the differential diagnostic and therapeutic considerations for each classification. Many new photographs illustrate the concepts and techniques that are discussed, and a new section on injection techniques for the diagnosis and management of orofacial pain has been added. The book also includes 35 case reports to help the clinician better understand orofacial pain disorders and how to treat them effectively.
ISBN: 0-86715-439-X
978-0-86715-439-9 , 9780867154399
592 pp; 223 illus
Contents:
Section One: The Nature of Pain
Defining the Problem
The Neural Anatomy of Orofacial Pain
The Neurophysiology of Orofacial Pain
The Processing of Pain at the Brainstem Level
The Processing of Pain at the Supraspinal Level
Section Two: Clinical Considerations of Orofacial Pain
The Various Presentations of Pain
Category Classification of Orofacial Pains
Principles of Pain Diagnosis
General Considerations in Managing Orofacial Pains
Section Three: Clinical Pain Syndromes
Cutaneous and Mucogingival Pains
Pains of Dental Origin
Pains of Muscle Origin
Temporomandibular Joint Pains
Other Musculoskeletal Pains
Visceral Pains
Vascular and Neurovascular Pains
Neuropathic Pains
Psychologic Factors and Orofacial Pain: Axis II
Preface
In the early spring of 1982, I first had the opportunity to listen to Dr Welden E. Bell lecture on the subject of orofacial pain. Through his written work I had already known him as an international authority on this subject. I will never forget the first words from his mouth: “Pain is not a sensation,” he proclaimed. I remember squinting slightly, thinking that I had misheard his statement, but then he repeated the seemingly ridiculous remark. I thought, why, of course pain is a sensation. How could such an authority make such a misleading statement? He then went on to say that “pain is far more than a simple sensation; pain is an experience.” I must admit that at that time in my professional development I really did not appreciate what he was saying. Following that course and after much further reading of his and other texts, I began to better appreciate his words. There is an old saying that “when the student is ready, the teacher will appear.” At that moment, Dr Bell became my teacher and later my mentor.
As my career progressed, I learned more and more from Dr Bell. He continued to write even after his retirement from practice, completing seven editions of his two classic texts on orofacial pains and temporomandibular disorders. As I grew to know him personally, my admiration grew even stronger.
In 1985, I published my first textbook on occlusion and temporomandibular disorders. The first letter that I received commenting on this new text came from Dr Bell. His praise and compliments meant more to me then he would ever know. Later he honored me by writing the foreword to the second edition of that text.
In October 1989, I received a letter from Dr. Bell informing me that he had just finished the fourth edition of Orofacial Pains. He was then 79 years old and asked if I would consider coauthoring the fifth edition of this text when the time came. His letter presented me with two very different emotions. I immediately felt that I had just received the greatest professional compliment of my career; yet at the same time, I was confronted with the most difficult task I had ever been asked to accomplish. I dared to say yes, but I certainly could not say no. I immediately called Dr Bell to discuss his proposal. I told him of my feelings and he comforted me by explaining that although he would like for me to take the major responsibilities, he would be there for direction and continuity. With a certain amount of pride and a great deal of insecurity, I accepted his invitation.
In the spring of 1990, I had the privilege to meet with Dr Bell on three occasions; two were during meetings that were dedicated to him for his outstanding contributions to the professions. I had the privilege to speak at both of these meetings and I felt so proud to have him in the audience. During those three meetings, we were able to take some quiet time to discuss new research findings that altered the current views of muscle pain. He contributed greatly to the muscle pain model you see in this text.
In May of 1990, shortly after the publication of the third edition of his textbook on temporomandibular disorders, Dr Bell became suddenly ill and died. His death was a tragic loss to his family and especially his wonderful wife of 58 years, Lucy. His passing was also a tremendous loss to the profession. I personally felt as though I had lost my professional father, and, in fact, I had. During the next year I considered and reconsidered how I would accomplish the monumental task of rewriting this text. At times I even considered not attempting it at all, but my admiration for Dr Bell would not let me linger long on such thoughts. As such, the fifth edition was published in 1995.
After Dr Bell's death I kept in close personal contact with Lucy Bell. During the writing of the fifth edition I sent her chapters as I completed them, for her review. I wanted her to be a part of the project, as she had been with Dr Bell. She was always so kind and would only compliment me on my writings. Whenever I was in Dallas I would tried to meet with her for lunch and conversation. She was a very special person, one of the finest I have ever known. I know how Dr Bell found the strength to dedicate so much work to the profession; it was because of Lucy's love and support. Even 13 years after Dr Bell's death, she was still mourning her loss. In December 2003 she left this life to once again join him. It is truly a match made in heaven. I miss her greatly.
My goal in writing the sixth edition of this text is an attempt to update the clinician with the latest findings related to pain. This text is divided into three major sections. The first section presents the normal neuroanatomy and function of the trigeminal system. With a clear understanding of normal function, the clinician can begin to understand and manage dysfunction. The second major section presents a classification of the various orofacial pain disorders and describes the history and examination procedures that can be used to differentiate each disorder. This process, called diagnosis, is the most important aspect of orofacial pain management. The third major section presents management considerations for each orofacial pain disorder. It is hoped that this sequence of information will allow the reader to improve his or her skills in the complicated field of orofacial pain.
The work involved in this edition is a labor of love dedicated to Dr Welden Bell. It would not have been possible, however, without the love and support of my wonderful wife of 34 years, Barbara. None of my accomplishments would have been possible without her love, understanding, and constant support. Dr Bell dedicated his books to Lucy, “the light of my life.” Barbara is the light of my life and I am indebted to her greatly. She is “the rock on which I stand” and “the wind beneath my wings.” Thanks, honey, for all you are and do.
Jeffrey P. Okeson, DMD
Director
Orofacial Pain Center
Chairman
Department of Oral Health Sciences
University of Kentucky
College of Dentistry
Lexington, Kentucky
