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Preface
O r o f a c i a l P a i n : W h e r e We A r e a n d
W he r e We A r e G oi n g

Steven D. Bender, DDS

Editor

It is well known that pain is the primary reason people seek care from their health care
providers. The term orofacial pain (OFP) commonly refers to pain associated with the
hard and soft tissues of the head, face, oral cavity, and neck. An estimated 25% of
the population has experienced some form of OFP, with the highest prevalence in
the 18- to 25-year-old age group. OFP may be due to disease of the orofacial struc-
tures, musculoskeletal system disorders, peripheral or central nervous system disor-
ders, systemic maladies, the manifestation of psychosocial disorders, or possibly
the sequela of poor sleep. OFP can be primary in presentation or secondary due to
referral from other sources, such as cervical or intracranial structures. These presen-
tations may include pain of dental origin or of the oral mucosal structures due to infec-
tion or inflammation, neurovascular disorders, including poststroke pain, pain from
nerve trauma, idiopathic atypical pains, headaches, and finally, disorders of the
temporomandibular joints and associated musculature. The diversity of these
numerous structures and their complex innervations is at the least partially responsible
for the sometimes-puzzling symptoms these patients present with.
In this issue of Dental Clinics of North America, it is my hope that the reader not only
will be provided with updated information as to the multiple facets of OFP but also will
find new information that will further aid them in the diagnosis and management of
these often enigmatic disorders. The field of OFP has seen significant progress and
change since it was last reviewed in the Dental Clinics of North America, both in
what we know and in the realization of how needed this specialty is. Also, as our knowl-
edge base has increased, it has become quite clear that the professional who
endeavors to diagnose and manage these disorders must commit to look beyond
the obvious structures and traditional mechanistic approaches and view the suffering
patients as complex and unique individuals who may express pain in very different
ways. The clinician must also appreciate the reality that due to the complexity of these

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patients and the disorders that they present with, a multimodal and multidisciplinary
approach to diagnosis and management is critical to positive outcomes. As guest
editor, I have purposefully gathered a multinational group of experts in an effort to pre-
sent a well-balanced and evidence-based treatment of this subject matter. I am
extremely grateful to these esteemed contributors for their hard work on this issue. I
also wish to express my gratitude to John Vassallo and Laura Fisher for their editorial
expertise as well as the entire Elsevier team for their work on this very worthwhile proj-
ect. I am forever grateful to my father, who always encouraged me to do my very best
because “good enough never is.” Finally, I wish to thank my best friend and beautiful
bride, Micaela, for never giving up on me and hanging in there even though I can’t
seem to figure out how to spell or pronounce the word “no.”

Steven D. Bender, DDS

Department of Oral and Maxillofacial Surgery
Facial Pain and Sleep Medicine
Texas A&M College of Dentistry
3302 Gaston Avenue
Dallas, TX 75246, USA
E-mail address:
bender@tamhsc.edu