Getting to the root of orofacial pain, a condition affecting millions of Americans, can be frustrating for patients and a daunting task for physicians and dentists. Symptoms caused by temporomandibular disorders (TMD), a variety of conditions affecting the jaw, joints and nerves, often mimic other conditions such as headache, migraine and sinus and tooth pain.

To further complicate diagnosis, research reveals TMD may be related to fibromyalgia, a chronic musculoskeletal pain and fatigue disorder that causes pain in the muscles, ligaments and tendons, according to a report in the March/April 2003 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD).

Both TMD and fibromyalgia produce similar painful symptoms in the muscles of the neck, shoulders, back, face and head. Dizziness and sleep disturbances can also be a symptom of both conditions.

"We've found many patients suffering with TMD problems also suffer later in life from fibromyalgia," says Thomas P. Sollecito, DMD, lead author of the report. "Typically thought of as unrelated, this potential connection is being further explored."

The dentist may often hold the key to recovery for many head pain sufferers, explains AGD spokesperson Lois Duerst, DDS, MAGD.

"Dentists are trained to evaluate various types of facial pain and often can pinpoint the cause of the pain and make treatment recommendations," says Dr. Duerst.

TMD checklist:

• An earache without an infection
• Jaw pain or soreness that is more prevalent in the morning or late afternoon
• Jaw pain when you chew, bite or yawn
• Clicking associated with pain when opening and closing your mouth
• Difficulty opening and closing your mouth
• Locked or stiff jaw when you talk, yawn or eat
• Sensitive teeth when no dental problems can be found