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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.
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