Orofacial Pain Treatment

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Orofacial pain is pain of the jaw, mouth, face, head, or neck. Orofacial pain is often confused with pain originating from structural tooth or dental problems, leading to misdiagnosis. Duke Health’s board-certified orofacial pain specialists are specially trained to diagnose and treat this type of complex pain.

Our Location

Our primary orofacial pain clinic is in Duke Innovative Pain Therapies at Brier Creek.

Orofacial Pain Conditions We Treat

  • Burning mouth syndrome
  • Chronic headaches and migraines
  • Face pain
  • Glossopharyngeal neuralgia
  • Jaw movement disorders
  • Myofascial pain and other masticatory muscle disorders
About Orofacial Pain Specialists


What Is an Orofacial Pain Specialist? 
Orofacial pain specialists are dentists who are specially trained to diagnose and treat oral and facial pain. Duke’s board-certified orofacial pain specialists -- two of the few in North Carolina -- each have more than 20 years of experience.


When to See an Orofacial Pain Specialist
You should see an orofacial pain specialist when constant or intermittent pain in your mouth, face, jaw, head, or neck is not improving with over-the-counter therapies or despite ongoing treatment by a regular dentist or other health care provider. For the most complex cases, Duke orofacial pain specialists partner with headache specialists, otolaryngologists, surgeons, and others to provide the most comprehensive care.


Tests to Diagnose Orofacial Pain

History and Physical Exam
On your first visit, an orofacial pain specialist will spend at least 90 minutes with you learning about you, your symptoms, and your medical history. They will examine your mouth, face, head, and neck to determine your type of pain and search for its origin.

Imaging Scans
CT or MRI scans help your doctor visualize your oral and facial structures and soft tissues.

Blood Tests
Blood tests may be performed to help rule out inflammation or other issues as potential causes of your pain.

Call for an Appointment

Orofacial Pain Treatments

Once the source of your problem is identified, your doctor will recommend a customized treatment plan and schedule follow-up appointments to monitor your pain and adjust treatment as needed.

Orofacial pain specialists administer and manage the following treatments:

Oral Appliances
Customized oral appliances, such as mouth guards or splints can help align structures like your jaw, reduce damaging nighttime oral habits, protect your teeth, reduce tension and pressure in the chewing muscles, reduce TMJ symptoms, and reduce pain.

Your doctor may recommend topical or oral anti-inflammatory medications, steroids, muscle relaxants, or other pain-relieving medicines.

Injections and Nerve Block Procedures
These procedures deliver medications or numbing agents close to the source of your pain and offer temporary pain relief.

  • Injection types:
    • Trigger point injection
    • Steroid injection
    • Hyaluronic acid injection
    • Platelet-rich plasma injection
    • Onabotulinum toxin A (commonly called Botox) injection
  • Nerve block types:
    • Sphenopalatine ganglion block
    • Trigeminal nerve branch block
    • Occipital nerve block

You may be eligible for surgery if other treatments fail and/or if you have severe pain, a tumor, or difficulty opening your mouth.

Your orofacial pain specialist may also recommend or refer you for these conservative treatments:

Lifestyle Changes
Getting more sleep and avoiding certain foods, behaviors, or triggers may help prevent painful episodes.

Physical Therapy
Physical therapists teach you stretches and exercises to optimize your mouth and facial function, prevent injury, and reduce pain.

Cognitive Behavioral Therapy
Specialized psychologists offer counseling and teach coping skills to help you manage your pain.

Complementary Treatments
Medical massage therapy, acupuncture, and chiropractic care may help relieve symptoms.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 10 pediatric specialties by U.S. News & World Report for 2024–2025.

This page was medically reviewed on 03/12/2024 by