Orofacial Pain and Dysfunction

Program Overview

Robert Merrill, DDS
Program Director

The UCLA Orofacial Pain and Dysfunction Postgraduate Training Program is a postgraduate certificate program renowned for providing hands-on experience in treating headache, neuropathic pain disorders, TMJ disorders, and obstructive sleep apnea. Heavy emphasis is placed on learning a medical model for assessing and treating patients, including developing competencies in neurological, stomatognathic, myofascial, and psychological assessment of patients.

The comprehensive curriculum includes didactic, clinical, and clinical research components. Most notable are the didactic components because very little of the required pain sciences are presented in predoctoral or traditional dental specialty training programs. Individuals who successfully complete this program will be competent in the basic and applied pain sciences as well as very knowledgeable regarding the science and literature about the more traditional dental and TMD/TMJ approaches. Topics include neurology, neuroanatomy, and neurological exam; laboratory and behavioral medicine; neurobiology of pain; neuropathic pain; headache disorders; musculoskeletal and myofascial pain disorders; pharmacotherapeutics for pain and pain management; TMJ disorders, sleep apnea, and orofacial dystonias; and occlusion.

Clinical experience is hands-on following an observational probationary period that is determined based on the participant's prior experience. Initially more TMD patients will be assigned, and then the patient assignments will be expanded to more chronic pain profiles. The UCLA program gives actual treatment experience of the whole spectrum of orofacial pain conditions as well as traditional temporomandibular disorders rather than simply screening, diagnosis, and referral for treatment.

Clinical or applied research is an option for those who are interested. Postgraduates may choose to be involved in research in the area of clinical outcome measures for pain, sleep disordered breathing, headache, and/or neuropathic pain.

Mission Statement: The mission of the UCLA Orofacial Pain Residency is to train dentists—in the most comprehensive manner—to manage all aspects of orofacial pain including those conditions that would be classified as musculoskeletal (“TMD”), neurovascular and neuropathic pain problems, as well as dental sleep medicine related problems. In accomplishing its mission, the Residency Program will be guided by its core values emphasizing the compassionate, ethical, proficient, and safe management of patients utilizing the best evidence-based pain treatments and procedures. In addition, the Program recognizes its responsibility to advance the art and science of orofacial pain in dentistry and to provide access to high-quality orofacial pain care for the underserved populations.

This program is accredited by the Commission on Dental Accreditation of the American Dental Association.

Non-CODA graduate enrollment is administered through UCLA Extension.

The program in Orofacial Pain and Dysfunction is accredited by the Commission on Dental Accreditation and has been granted the accreditation status of "Approval without Reporting Requirements”. The Commission is a specialized accrediting body recognized by the United States Department of Education. The Commission on Dental Accreditation can be contacted at (312) 440-4653 or at 211 East Chicago Avenue, Chicago, IL 60611-2678. The Commission’s web address is: http://www.ada.org/100.apsx .

The Commission on Dental Accreditation has accredited the postdoctoral program in Orofacial Pain and Dysfunction. However, accreditation of the program does not in itself constitute recognition of any dental specialty status.

Length of Program: 2 years

Number of Positions: 3 (2 positions for graduates of CODA accredited dental schools and 1 position for graduates of non-CODA accredited dental schools)

The 4 Overall Program Goals, Objectives and Emphasis are as follows:

1.     Knowledge specific to Orofacial Pain: The graduate must have the in-depth medical knowledge necessary to evaluate patients with orofacial pain, form appropriate differential diagnoses, develop a suitable treatment plan, provide appropriate care in a safe and proficient manner, and respond effectively to emergencies related to such care. The graduate must also master the skills to be a life-long learner with regard to anxiety and pain control and demonstrate critical thinking skills necessary to evaluate the relevant medical literature.

2.     Resident Education: The Orofacial Pain program must provide the best and most currently available information on basic pain science and orofacial pain disorders. This information is provided in lectures, demonstrations, mini-residency and Study Club formats to expose the resident to the most updated information available. In addition, the resident is guided through the most current literature from the leading peer-reviewed journals relative to pain, in addition to reviewing classical literature on pain. The reviewed journals include but are not limited to: Headache, Pain, Journal of Orofacial Pain, Sleep, Cephalalgia.  The graduate must have in-depth medical knowledge necessary to evaluate patients with orofacial pain, develop appropriate differential diagnoses, plan and execute tests and examination protocols to arrive at the correct diagnosis, develop appropriate treatment plan, provide appropriate treatment related to safe care and respond to medical problems related to such treatment. The graduate must master the skills to be a life-long learner with regard to pain management in dentistry and be able to demonstrate critical thinking skills necessary to evaluate the relevant medical literature. Graduates must understand the value of working collaboratively in an atmosphere of cordiality, collegiality and professionalism.

3.     Patient Care: The graduate must be able to provide appropriate treatment for a wide variety of orofacial pain conditions and patients in varied treatment settings. Skills pertaining to the management of orofacial pain must be mastered including the use of all available modalities of pain management, awareness of the behavioral aspects of pain, and be competent in interacting with dental and medical colleagues to accomplish the best possible patient outcomes. The graduate must pain understand and be able to order appropriate imaging, laboratory tests and other medical assessments necessary to perform an appropriate medical evaluation for the pain patients.   In addition, the graduate must understand the pharmacological management of chronic pain conditions and be able to prescribe appropriate medications to treat chronic orofacial pain, as well as manage untoward reactions and side-effects to the medications and treatments rendered.

4.     Research: Research is the backbone of knowledge. Each resident is assigned to a clinical research protocol through the duration of their program. They are expected to present posters at a scientific meeting.

Contact Us

Please email postdds@dentistry.ucla.edu for any questions or for more information.