Treatment of Oral and Facial Pain in Alexandria

The key to successful treatment is accurate diagnosis. Once the likely source of the pain is identified, the treatment process begins. At the Alexandria, Virginia office of Center for Dental Anesthesiology, Dr. James Snyder will always try to look for any and all sources of your pain complaint before recommending a course of treatment. Philosophers say that "you can only find something you are looking for".

If the source of pain is entirely tooth / periodontium or merely has a dental component, we can usually provide the needed therapy to reduce the problem. A broad range of dental care treatments can be provided by the doctors and staff and the CDA. Crowns, fillings, root canals, and invasive and minimally invasive periodontal treatments can be provided if indicated.

Often, the pain source involves the tissue around the teeth and periodontium. Common treatments include the use of orthotics, injections, medications, TENS, iontophoresis, and an array of conventional physical medicine treatments. In short, most of the strategies utilized to treat these findings in other parts of the body can be applied to "TMD" (the omnibus, temporomandibular disorder, term used to describe head, neck, and face pain associated with the dental apparatus but not including the teeth or periodontium). Working with you to select the best treatment of combination of treatments is vital to success. No one treatment is suitable for every patient or condition. No treatment is 100% successful and most treatments have some side effects. Sometimes the preferred strategy just won't fit into your life. By offering many proven strategies it is more likely one will be found to improve your pain.

A word about medications: an array of safe and effective medications can be used to reduce the misery of chronic pain. Traditionally, narcotics have been used for pain control. Interestingly, narcotics are a very poor choice for chronic head and neck pain. Most of the time, the traditional 'artesian' principle of pain transmission is not the primary pathway for head and neck pain. Drugs other than narcotics are more effective and provide a more favorable risk:benefit ratio in this situation. Dr. Snyder has a good deal of experience balancing pain relief with risk moderation. Those patients requiring narcotic pain medication for management of other conditions will require a "pain contract" at the CDA or with another physician.

A recent addition to the treatment armamentarium is Botox, not for cosmetic purposes, but for TMD pain relief. For those patients who have tried other treatment strategies without success, Botox injections in the face and temple can be very helpful. The FDA has approved the use of Botox for treatment of certain muscle conditions and is widely used "off label" for trigger points and spasm in the muscles of mastication. The treatment generally lasts for about three months (sometimes less) and would have to be repeated to provide continued relief. Some patients do get much longer term relief from a single injection 'session' as a result of the 'cycle breaking' aspect of pain relief. In those situations where other treatment has failed or is not suitable, Botox can be spectacular.

Contact us at the Center for Dental Anesthesiology to determine the source of your pain and the best possible solution to it!

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James A. Snyder, DDS, MS

Center for Dental Anesthesiology

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