University of Kentucky

The Orofacial Pain Clinic at the University of Kentucky was founded in 1977 for the purpose of helping patients suffering with various temporomandibular disorders. It was the first clinic in the USA dedicated to the management of facial pain disorders associate with dental and nondental issues. Since that time, it has expanded into a multi-disciplinary clinic for the management of complex orofacial pain problems, including temporomandibular disorders. Patients are routinely evaluated by dentists, clinical psychologists, and physical therapists. Medical and dental specialists are called upon regularly to assist in the diagnosis and management of complex pain problems.

The Orofacial Pain Clinic has been providing graduate education in the areas of temporomandibular disorders and orofacial pain since 1985. Presently, the clinic offers three full-time graduate training programs and three part-time continuing education programs.

The University of Kentucky Orofacial Pain program was fully accredited in 2011, the first year this accreditation was offered. The Orofacial Pain Residency Program is a two-year program specifically designed for dentists who wish to gain a broad-based experience in the field of orofacial pain. The program includes didactic, clinical, and research components.

The overall goal of the orofacial pain residency program is to produce an excellently prepared orofacial pain clinician who is able to distinguish him/herself either in private or academic practice. 

A brief description of the program components are listed below: 

Didactic Component

The didactic component consists of the following five weekly seminars:

• Two hours of literature review on pain topics
• One hour of literature review on dental sleep medicine
• One hour reviewing current orofacial pain and TMD literature
• One and one half hours of case conferencing reviewing patients with the orofacial pain faculty, psychology faculty, and psychology residents
• One and one half hours seminar dedicated to an orofacial pain topic

The didactic component also includes courses in oral medicine, dental sleep medicine, oral pathology, research design, epidemiology, weekly neurology grand rounds, and monthly dental grand rounds. Weekly topic seminars include dental and medical pain specialists in the areas of psychology, radiology, rheumatology, rehabilitative medicine, otolaryngology, ophthalmology, neurology, headache, oral medicine, addiction, dental sleep medicine, behavioral sleep medicine, oral and maxillofacial surgery, and physical therapy.

The clinical component of the program consists of approximately 60 percent of a resident’s time clinically evaluating and managing orofacial pain, oral medicine, and sleep apnea patients. The program encourages a medical-biopsychosocial model for the diagnosis and management of orofacial pain rather than manual dental skills to alter dental structures. Emphasis is placed on establishing a proper diagnosis and management plan, including collaborations with appropriate medical specialists. Behavioral, pharmacologic, and physical therapies including injections and / or intraoral orthopedic appliances when appropriate are routinely used to manage orofacial pain patients.

Successful management of pain conditions is based, in part, on the ability of the clinician to obtain a comprehensive history through verbal communication and skillful understanding of the patient’s complaints. If a resident or fellow originates from a country where English is not the primary language, he or she will need to demonstrate superior verbal and comprehension skills in order to actively participate in the clinical assessment and management of patients. The Program Director and the Clinic Director will determine the timing of clinical participation, in consultation with other faculty members.

Research Component

All Orofacial Pain residents are required to research significant articles related to an approved topic and write a review article suitable for submission to a peer-reviewed Journal. Residents may also have the opportunity to participate in ongoing research efforts in the clinic, depending on the availability and type of research activity at the time. The Director of Research will determine the degree of research participation for residents and fellows.

October 7th 2024