Mass General's OMS care team understands that orofacial pain often requires a team approach to properly evaluate, diagnose, and treat.

Orofacial Pain

Orofacial pain disorders are a complex group of pain problems that occur in the head, face, oral cavity, and neck. These paid disorders are associated with significant morbidity and suffering. There is a strong association with other chronic pain disorders and with numerous co-morbid medical, psychiatric, and psychosocial conditions. Orofacial pain disorders occur primarily in woman of middle age. There are significant work-related issues that compound these problems, which have a large financial burden to society and the health care system.

Orofacial pain disorders can be challenging to diagnose and treat. An interprofessional approach to treatment involving many disciplines of the health care team are often necessary to properly evaluate, diagnose, and treat these patients. 

The Division of Oral and Maxillofacial Pain in the Department of Oral and Maxillofacial Surgery at Massachusetts General Hospital have pain specialists with varied backgrounds and expertise in management of these problems.

Keith DA, Scrivani SJ:  Cephalgic Neuralgias. In Conn RB, Borer WZ, Snyder JW (eds.): Current Diagnosis, Ninth ed., W. B. Saunders Co., Philadelphia, PA., 807-809,1996.

Scrivani SJ, Keith DA, Kulich R, Mehta N, Maciewicz RJ: Post-traumatic Gustatory Neuralgia: a clinical model of trigeminal neuropathic pain. J Orofacial Pain. 12:287, 1998.

Scrivani SJ, Chaudry, A, Keith DA, Maciewicz RJ: Chronic neurogenic facial pain: lack of response to intravenous phentolamine. J Orofacial Pain. 13:89-96, 1999.

Scrivani SJ, Kulich R, Israel HA: Establishing an Orofacial Pain Center. In Dym H (ed.): Facial Pain: Diagnosis and Management. Oral and Maxillofacial Surgery Clinics, W. B. Saunders Co., Philadelphia, 12: 343-354, May 2000.

Israel HA, Scrivani SJ: The interdisciplinary approach to oral, facial and head pain. JADA. 131:919-926, July 2000.

von Peter S, Balmaceda C, Scrivani SJ, Jobe D, Okvat H, Korkin E, Gross M, Ting, W: Survey on the use of complementary and alternative medicine among patients with headache syndromes. Cephalalgia, 22:395-400, 2002.

Israel HA, Ward JD, Horrell B, Scrivani SJ: Oral and Maxillofacial surgery in patients with chronic orofacial pain. J Oral Maxillofac Surg. 61:662-667, 2003. 

Kulich RJ, Driscoll S, Scrivani SJ, McAlary P, Mehta N: A Survey of Medico-Legal Practices Among Pain Specialists. Pain Medicine. 5(1):98-103, 2004.

Chandwani B, Kulich RJ, Andrew L, Scrivani SJ:  Tapering Chronic Opioid Therapy in Chronic Neuropathic Facial Pain – An Interdisciplinary Approach:  Case Report. J Opioid Therapy. 4:167-173, 2008.

Scrivani SJ, Chandwani B, Keith DA, Kahn M, Heilman C: Woman with Severe Facial Pain – Clinicopathological Conference. Oral Surg Oral Med Oral Path Oral Rad Endo, 107:151-156, 2008.

Mehta N, Scrivani SJ, Maciewicz R: Dental and Facial Pain. In Benson HT, Rathmell JP, Wu CL, Turk DC, Argoff CE (eds.): Raj’s Practical Management of Pain, 4th ed., Elsevier, Philadelphia, PA., 505-527, 2008. 

Mehta N, Scrivani SJ: An Integrative Approach to the Diagnosis and Treatment of Head, Face and Neck Pain. In Mehta N, Maloney GE, Bana D, Scrivani SJ (eds): Head, Face and Neck Pain: Science, Evaluation and Management. 1st ed., John Wiley & Sons, Inc., Hoboken, NJ, 3-6, 2009.

Hasselgrun G, Green D, Scrivani SJ: Tooth Related Pain. In Mehta N, Maloney GE, Bana D, Scrivani SJ (eds): Head, Face and Neck Pain: Science, Evaluation and Management. 1st ed., John Wiley & Sons, Inc., Hoboken, NJ, 330-342, 2009.

Scrivani SJ, Mehta NR, Keith DA, Stiles A, Maciewicz RJ, Kulich RJ: Facial Pain. In Ballantyne JC, Rathmell JP, Fishman SM (eds.): Bonica’s Management of Pain, 4th Edition, Lippincott Williams & Wilkins, Philadelphia, PA., 972-999, 2010.

Scrivani SJ, Keith DA, Bassiur J, Mehta NR:  Nonsurgical Management of Craniofacial Pain. In Bagheri SC, Bell B, Kahn HA (Eds.): Current Therapy in Oral and Maxillofacial Surgery.  Elsevier, St. Louis, MO., 247-263, 2011.

Rapoport A, Scrivani SJ: Vascular and Nonvascular Intracranial disorders. In de Leeuw R, Klasser G (eds.): Orofacial Pain: Guidelines for Assessment, diagnosis and Management, 4th Ed. The  American Academy of Orofacial Pain, Quintessence Publishing Co., 59-70, 2013.

Shapiro R, Scrivani SJ: Primary Headache disorders. In de Leeuw R, Klasser G (eds.): Orofacial Pain: Guidelines for Assessment, diagnosis and Management, 4th Ed. The American Academy of Orofacial Pain, Quintessence Publishing Co., 71-82, 2013.

Mehta N, Spierings ELH, Scrivani SJ: Dental and Facial Pain. In Benson HT, Rathmell JP, Wu CL, Turk DC, Argoff CE (eds.): Raj’s Practical Management of Pain, 5th ed., Elsevier, Philadelphia, PA., 424-440, 2014.