Abstract

Orofacial Pain, Bruxism, and the Evolution of a Discipline: a Challenge and an Opportunity

by Manfredini Daniele

The last decade has been characterized by major developments in the orofacial pain field: 1. The Recognition of the Orofacial Pain Specialty in the United States, which followed similar pathways in other countires, and the derived PostGrad courses that are fluorishing all over Europe and the rest of the world; 2. The progressive recognition of Dental Sleep Medicine as a subject attracting a raising scientific, clinical, and ethical interest; 3. The new definition of bruxism and the derived multidimensional evaluation system (i.e., Standardized Tool for the Assessment of Bruxism). The evolution of knowledge featuring the fields of orofacial pain, dental sleep medicine, and bruxism, represents both a challenge and an opportunity. For dental professionals, who are the first line practitioners involved in the management of individuals with any of the above families of conditions, thinking outside of the usual “magic” box of dentistry, where each procedure seems deemed to a 100% of success rate, is surely an uncomfortable action. On the other hand, the combination of the three topics, all surrounded by a sparkling atmosphere and enthusiasm, represents the biggest opportunity for the dental profession to get definitively out of the muddy waters of gnathology. Now that evidence has grown in support of the complexity of the diagnostic pathway for orofacial pains, of the role of dentists as a fundamental sentinel for sleep disorders, and of the multifaceted nature of bruxism in the dental office, dental professionals can become pivotal players to access the actual medical gates of dentistry. As in the case of all the big opportunities, this fascinating evolution also represents a tremendous challenge. Paradigm shifts require time. Shifting the attention away from the good and safe business of dental occlusion will require time, but if dentistry still wants to be considered a medical profession, the time is now for taking on the challenge. Within this framework, bruxism is the inevitable entry point. Bruxism, as a spectrum of different muscle activities, is the medical gate of dentistry from multiple access points: 1) bracing is a new kid on the block to explain musculoskeletal orofacial pains; 2) arousal-related masticatory muscle activity is linked to any medical condition that may fragment sleep; 3) an open-minded definition of sleep and awake bruxism has been provided to frame everything.

Learning Objectives

After this lecture, you will be able to know the existence of orofacial pain practice
After this lecture, you will be able to understand the importance of dental sleep medicine
After this lecture, you will be able to understand that bruxism is the dental gateway to medicine