Face pain


Sometimes the painful area does not match the source of the pain, which is what we call referred pain and is usually caused by muscular trigger points.

The significance and treatment of myofascial trigger points in the pain process was set out by Dr. J. G. Travell and Dr. D. G. Simons in their renowned book Myofascial Pain and Dysfunction, which is the current therapeutic decision-making guide. The symptoms related to these disorders can be discovered by carrying out a basic questionnaire:

  • Clicking of joints in the ear area
  • Clicking or pain while chewing
  • Teeth grinding while sleeping or doing certain tasks
  • Teeth grinding while sleeping or doing certain tasks
  • Having worn teeth or teeth that make no contact when biting


For a comprehensive treatment of these disorders, the orthodontist needs the collaboration of different medical specialists such as the rehab technician, the otolaryngologist or neurologist, and the physiotherapist and psychologist. There are several treatments for temporomandibular disorders and they should be administered taking into account each patient’s individual needs. The treatments can be grouped according to the source and location of the disorder: muscular, joint, dental, etc. dysfunctions. We apply different therapeutic techniques to each case:

Orthodontic treatments
Occlusion means the relationship between the superior and inferior arches. When it is misaligned we use orthodontics in order to achieve a proper chewing balance.
Rehabilitation with prostheses
The absence of teeth leads to an imbalance in the distribution of masticatory forces. Patients may need a dental prosthesis in order to achieve a stable bite and solve a temporomandibular disorder. Prostheses can be fixed, removable, mixed, or placed over implants.
Night guard
To relax masticatory muscles, reduce joint pain, and avoid teeth wear.
Physiotherapy corrects the proper tonicity of muscular groups and joints; it restores the postural balance of the head-neck-shoulders-back chain. It also reduces pain and inflammation by relaxing the muscles and increasing mandibular movements. TENS, ultrasounds, and soft laser equipment help to enhance recovery.
Likewise, intra-articular injections using restorative substances for the cartilage of the temporomandibular joint, such as hyaluronic acid, can help to treat arthritis or arthrosis in this joint. Intramuscular injections with local anaesthetic or botulinum toxin may be a very useful method for treating some types of temporomandibular joint pain.
Tension control techniques
Daily stress implies an increase of the muscular activity that overloads dental and joint surfaces as well as the muscles themselves. Relaxation techniques and biofeedback help the patients to learn how to control their muscular tension.
Surgery is rarely used, it can generally be avoided if temporomandibular dysfunctions are diagnosed and treated in time. It is only recommended in cases where conservative treatment does not produce satisfactory results, which only happens in a minority of patients.