Orofacial Pain
We identify the cause of non-dental pain and treat it at its root without unnecessary dental procedures
OROFACIAL PAIN
There is pain that persists
even after dental treatment
Pain that won't go away even after repeated root canals or extractions. If you keep hearing "nothing is wrong" from multiple dentists, the cause may not be in your teeth at all.
Pain continues even after root canal treatment
The same area still hurts after extraction
The dentist says nothing is wrong, but it still hurts
Dental Pain
Caused by teeth or periodontal tissue
Cavities, pulpitis
Periodontitis (gum disease)
Cracked or fractured teeth
Inflammation around wisdom teeth
The cause is confirmed on dental X-ray and examination; treating the affected tooth resolves the pain.
Non-dental Pain
Causes outside the teeth — oral medicine domain
Myofascial pain (masticatory/cervical muscles)
Neuropathic pain (trigeminal neuralgia, etc.)
Headache-related pain
Psychogenic and other pain
No abnormality is found on dental examination and dental treatment does not resolve it. Differential diagnosis by an oral medicine specialist is required.
PAIN TYPES
4 Types of Orofacial Pain
Accurate classification of the type is essential for proper treatment.
01
Headache
Tension headache · TMJ-related pain
Masticatory muscle tension from TMJ disorders or oral parafunctions can cause headaches. If pain radiating to the jaw, temple, or back of the head recurs inexplicably, integrated oral medicine diagnosis is needed.
02
Neuropathic Pain
Trigeminal neuralgia · Burning mouth syndrome
Trigeminal neuralgia causes intense pain triggered by ordinary stimuli such as washing the face or brushing teeth. Burning mouth syndrome causes persistent burning pain inside the mouth without any obvious oral pathology.
03
Myofascial Pain
Masticatory & cervical muscle trigger points
Pain originating from trigger points in the chewing muscles (masseter, temporalis) and neck muscles. It is characterized by referred pain spreading to the jaw, ear, temple, and shoulder, and may feel like a headache.
04
Non-odontogenic Toothache
Non-dental pain that feels like a toothache
Pain that feels like a toothache despite no dental abnormality. Myofascial pain, neuropathy, and psychogenic factors may be the cause. Many patients undergo repeated root canals and extractions without knowing the actual cause.
WHY ESAM
Pain with no answer found —
ESAM Oral Medicine is different
“When the problem is not the tooth itself, it is difficult for a general dental practice to make an accurate diagnosis, and many patients miss the golden window and suffer from unexplained pain. For complex orofacial pain, accurate diagnosis by an oral medicine specialist from the outset is essential.”
— ESAM Dental SpecialistTREATMENT
ESAM Orofacial Pain Treatment Process
Detailed History Taking
The nature, location, duration, aggravating, and relieving factors of the pain are systematically assessed.
Cone-beam CT & Imaging
Structural abnormalities of the TMJ and teeth are confirmed to differentiate dental from non-dental causes.
Medication
Anticonvulsants, antidepressants, muscle relaxants, or NSAIDs are prescribed based on the pain type. For neuropathic pain, standard analgesics are ineffective, so specialist drug selection is crucial.
Physical & Behavioral Therapy
Physical therapy and self-stretching are effective for myofascial pain. Relaxation training and behavior modification are added when stress or psychological factors are involved.
FAQ
Frequently Asked Questions
The dentist said nothing is wrong — why does it still hurt?
Dental and non-dental pain feel similar but have different causes. Pain that feels like a toothache with no dental abnormality is likely due to non-dental causes such as myofascial pain, neuropathy, or TMJ disorders. Repeating dental treatment without accurate differential diagnosis can make the condition more complex.
How do I know if it is trigeminal neuralgia?
Trigeminal neuralgia causes sudden, intense pain like an electric shock on one side of the face lasting seconds to tens of seconds. It is triggered by light stimuli such as washing, brushing, or eating, and the intervals between attacks are completely pain-free. Diagnosis is made through clinical findings and imaging, so specialist evaluation is necessary.
Can burning mouth syndrome be treated?
The goal is symptom control rather than a cure. Anticonvulsant/antidepressant medications and psychological support therapy are effective. If a systemic condition such as diabetes, anemia, or thyroid disease is the cause, treating that condition can also improve symptoms.
Can headaches also be treated at a dental clinic?
Headaches caused by TMJ disorders or clenching are treated in oral medicine. Reducing masticatory muscle tension through oral appliance therapy or botox often improves both the frequency and intensity of headaches. However, if a neurological cause is suspected, co-management with neurology is arranged.