Author: Mayoor Patel, DDS, MS

If you’ve been watching the news (even just in passing), you might already be aware that there is a war on drugs–specifically opioids. We are in an opioid epidemic right now and many dentists and physicians are feeling the brunt of it. When do you prescribe pain medicine? Should you stop altogether? What if you have a patient with chronic pain? The dilemma is causing quite the stir lately.

I recently read this blog entry from a guest columnist that I found interesting and I want to share some of her story with you. Lorelei is a 51-year-old wife, mother, grandmother and businesswoman. However, she lives with chronic pain and it has taken quite the toll on her daily life. She states that she doesn’t like to be labeled as a “chronic pain patient” because it comes with so much stigma and derogatory implications. As many of you know, our patients who suffer from chronic pain often get treated like they are lying about their condition, but that isn’t the case with many of these patients. The same goes for Lorelei.

Never Ending Pain

Lorelei first felt pain in her left ear in 2010 and suspected it was an ear infection. As a result, she went to her primary care physician who asked a lot of questions because he saw no infection. He suggested the pain might be related to the temporomandibular joint (TMJ). Lorelei had heard of the term before but had always thought it was the result of grinding or clenching our teeth. However, after visiting her dentist, there was no sign of grinding or clenching.

As a result, Lorelei started visiting oral surgeon after oral surgeon, searching for a solution. Therapy after therapy and failed surgery after failed surgery, she couldn’t find any relief. During this two-year journey, her primary care doctor and the various surgeons continued to write her pain medication prescriptions, which ended up being her only way to deal with the pain.

Too Little Too Late

After the two years she was referred to an oral surgeon who specialized in patients with TMD. A CAT scan revealed arthritis had destroyed almost all the bone structure in her jaw, requiring two major surgeries. The surgeon warned her that the surgeries would restore function to her jaw, but that she would still have pain. He was right. She continued to experience chronic pain. All the while she was working with a pain specialist until one day he told her he was no longer treating pain patients. Luckily her primary care physician continued to work with her. However, due to new state laws, her dosage was later cut in half.

How Your Dental Practice Can Help

With the opioid epidemic at hand, treatment of pain patients continues to be an obstacle we must overcome. It is very important that we pay close attention to our patients and get them treatment as soon as possible before their conditions worsen. I’m not sure if Lorelei could have been helped sooner if she had gone to an appropriate dentist that is trained in craniofacial pain and TMD, but it is a possibility. This is even more reason to continue your education and remain up-to-date on the latest advancements in craniofacial pain treatment.

Get started on expanding your knowledge and sign up for any of our in-depth TMD/Pain seminars and CE courses today!

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