American Board Certified Orofacial Pain Specialist · Yelahanka

Facial, Jaw or Tooth Pain That Nobody Has Been Able to Explain?

The Pain Is Real. The Source May Not Be Where You Feel It.

Whether your teeth overlap, stick forward, have gaps, your bite feels wrong, or your teeth have shifted after previous braces — the first step is finding out why.

At GardenCity Smiles, Dr. Deepthi Kalahasti evaluates the pattern and possible source of persistent or complex facial pain before recommending treatment.

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Dr. Deepthi Kalahasti
American Board Certified in Orofacial Pain
American Board Certified in Orofacial Pain

One of a small number of dentists in India with this qualification.

Comprehensive Facial Pain Assessment

Structured evaluation of all possible pain sources before any treatment.

TMJ & Jaw Function Evaluation

Clinical assessment of joints, muscles, movement and bite.

Medical Referral & Co-management

Coordination with neurology, ENT and other specialists when required.

Start Here

Start With What You Feel — Not What You Think the Diagnosis Is.

The location of your pain is where we begin. The source may be somewhere else entirely.

🦷

My Tooth Hurts but Nothing Shows Up

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😬

My Jaw Hurts

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👂

Pain Near My Ear

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😣

My Face Hurts on One Side

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🔒

My Jaw Clicks or Locks

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🌅

I Wake With Jaw Pain

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🤕

I Have Headaches With Jaw Tightness

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🔥

My Mouth or Tongue Burns

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I Get Electric-Shock-Like Pain

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⚠️

Pain Started After Dental Treatment

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📅

I've Had Pain for Months

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I'm Not Sure Where the Pain Is Coming From

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Understanding Your Pain

What Is Orofacial Pain?

Orofacial pain refers to pain experienced in the mouth, jaw, face and related structures. It may arise from teeth and gums, chewing muscles, temporomandibular joints, nerves, headache disorders or other medical conditions. Because several conditions can produce similar symptoms, identifying the source of pain is often more important than immediately treating the location where the pain is felt.

The field of orofacial pain focuses on understanding why pain occurs where it does — not simply on treating the most obvious or accessible structure. This matters because pain is sometimes referred: felt in one area but originating in another.

An orofacial pain assessment considers all possible sources before recommending treatment — including structures beyond the teeth themselves.

Where Pain Can Come From

Teeth & Supporting Structures

Dental, periodontal, periapical

1

Jaw Muscles

Myofascial, masticatory muscle disorders

2

Temporomandibular Joint

Articular disc, joint surfaces, ligaments

3

Cranial Nerves

Trigeminal nerve, neuropathic conditions

4

Headache-Related Facial Pain

Migraine, tension-type, secondary headaches

5

Persistent Orofacial Pain

Central sensitisation, chronic pain conditions

6

Educational overview only. Diagnosis requires clinical assessment.

Where You Feel Pain Is Not Always Where the Problem Begins.

Pain can sometimes be referred from one structure to another. Muscle-related pain can be felt around a tooth, temple or ear. Certain nerve-related pain can resemble toothache. Headache disorders may sometimes be experienced in facial regions.

Irreversible dental treatment should not be performed simply because pain happens to be felt in a tooth.

Diagnostic Categories

Different Conditions Can Feel Surprisingly Similar.

This is why orofacial pain requires a systematic evaluation — not just treatment of the most obvious symptom.

Dental & Dentoalveolar Pain

Conditions involving teeth, gums or surrounding tissues. The most common source — but not the only one.

Myofascial Orofacial Pain

Pain involving the muscles responsible for jaw movement. Can closely mimic toothache or ear pain.
Temporomandibular Disorders

Conditions involving the temporomandibular joints, jaw muscles and related structures. One category — not the whole field.

Neuropathic Orofacial Pain

Pain related to injury or dysfunction involving nerves. Can be burning, electric, shooting or constant.

Persistent Dentoalveolar Pain

Persistent pain in a tooth or tooth-bearing region when local dental findings do not adequately explain the symptoms.

Headache-Related Facial Pain

Certain headache disorders may present partly within facial or oral regions.

Burning Mouth Symptoms

May require evaluation of local, systemic, medication-related and neurological factors.

Referred Pain

Pain perceived away from the structure where it originates. A known cause of misdiagnosis.

These descriptions are educational and are not intended for self-diagnosis. A clinical assessment is required to evaluate your specific symptoms.

TMJ & Jaw

TMJ Disorders Are Only One Part of Orofacial Pain.

Temporomandibular disorders are a group of conditions involving the jaw joints, chewing muscles and associated structures. Symptoms can include jaw pain, painful clicking, restricted opening, locking, muscle tenderness and headache associated with jaw function.

TMD is not a single condition — it is a group of related conditions with different causes and different treatments. Accurate classification matters because different subtypes respond to different approaches.

A Clicking Jaw Without Pain Does Not Automatically Require Treatment.

Clicking or popping sounds from the jaw joint are common in the general population. When clicking is not associated with pain, restriction or functional difficulty, active treatment may not be indicated. Assessment determines whether intervention is appropriate./p>

Key Principle

“Not every jaw that clicks needs treatment. Not every TMJ patient has the same condition. Individual assessment determines what is required.”

Oral Appliances

Does Every Jaw-Pain Patient Need a Splint?

No.

Clicking or popping sounds from the jaw joint are common in the general population. When clicking is not associated with pain, restriction or functional difficulty, active treatment may not be indicated. Assessment determines whether intervention is appropriate.

An oral appliance may be considered when clinically appropriate based on the specific diagnosis and treatment objective.

Reversible treatment where appropriate — splints should not permanently alter the patient’s bite or be used as a substitute for diagnosis.

What a Splint Should Not Be Used For

Avoid“Splints cure TMJ disorders.”

Avoid“Splints place every jaw into an ideal position.”

Avoid“Splints are required for almost all TMD patients.”

Avoid“Splints should permanently alter the patient’s bite.”

Learn about Splint Therapy at GardenCity Smiles

Treatment Approach

Start Conservatively. Escalate Only When Necessary.

Not every patient needs every step. Treatment depends on the diagnosis.

01

Understand the Diagnosis

Identify what is actually causing the pain before choosing any treatment.

02

Understand the Diagnosis

Understanding the pain mechanism reduces fear and supports self-management.

03

Self-Management

Rest, load modification, posture awareness and awareness of parafunctional habits.

04

Behaviour & Habit Modification
Reduce contributing factors such as clenching, bruxism and jaw strain.

05

Jaw Exercises / Physical Therapy

Where appropriate, guided jaw exercises can support muscle and joint recovery.

06

Medication When Clinically Appropriate

Short-term pharmacological support, carefully selected for the diagnosis.

07

Oral Appliance Therapy

For selected patients where an appliance is clinically justified by the diagnosis.

08

Multidisciplinary Care

Co-management with medical, neurological, psychological or physiotherapy colleagues when indicated.

09

Invasive Management
Only for selected diagnoses where conservative care has been appropriately trialled.

Unexplained Tooth Pain

"My Tooth Still Hurts — But the Dentist Says Everything Looks Normal."

Not every pain perceived as toothache originates in the tooth itself. When examination and appropriate dental investigations do not explain persistent symptoms, muscle-related, neuropathic, referred or headache-related sources may need to be considered before further irreversible dental treatment.

This applies particularly when dental treatment has been completed and pain continues. In such situations, the pain may not be arising from the treated tooth at all — and further treatment of that tooth may not help.

Another Root Canal Is Not Automatically the Answer to Persistent Tooth Pain.
Pain moves from tooth to tooth

Often suggests a non-dental source such as muscle-referred pain.

Normal X-ray with persistent pain

Warrants evaluation beyond the tooth itself.

Pain after root canal treatment

May indicate a different pain source — not necessarily treatment failure.

Pain after extraction

Pain persisting in the socket region requires reassessment.

Post-Treatment Pain

Pain That Persists After a Root Canal, Extraction or Dental Procedure

Pain after dental procedures can arise from several different sources. Identifying which is responsible guides what should be done next.

Adjacent tooth pathology, incomplete treatment or periapical infection at a different site.

Some discomfort during the healing phase is expected. Complications such as dry socket may cause persistent pain..

Pain may arise from a neighbouring tooth, sinus, gum or bone rather than the treated site.

Jaw muscles can be strained by prolonged opening during dental treatment.

Dental procedures occasionally trigger persistent neuropathic pain in susceptible patients.

Conditions unrelated to the dental treatment may produce symptoms in the same region.
Nerve-Like Symptoms

Electric, Shooting, Burning or Tingling Facial Pain?

Symptoms described as electric-shock-like, shooting, burning, tingling, numbness or altered sensation in the face, lips, tongue or gums may suggest involvement of the nerve supply to these structures.

Not every facial pain condition should be treated inside the dental chair.

Where indicated, medical or neurological referral forms part of appropriate care.

Headache & Jaw

Can Jaw Problems Be Associated With Headache?

Not every pain perceived as toothache originates in the tooth itself. When examination and appropriate dental investigations do not explain persistent symptoms, muscle-related, neuropathic, referred or headache-related sources may need to be considered before further irreversible dental treatment.

Headache Related to Jaw Function

Headache that consistently worsens with jaw use, morning jaw tightness or clenching may have a musculoskeletal component that benefits from jaw-focused management.

Primary Headache Disorders

Migraine and tension-type headache are common in the general population and may coexist with jaw problems without being caused by them. Primary headache disorders require their own assessment and treatment.

Referred Facial Pain

Pain from jaw muscles can sometimes be referred to the temples, forehead or other facial regions, resembling headache. The pattern and clinical findings help differentiate this from primary headache.

Not Assuming Causation

The presence of both jaw pain and headache does not mean one causes the other. A careful orofacial pain evaluation considers all contributing factors before attributing headache to the jaw.

Medical Alert

When Facial Pain Needs Urgent Medical Attention

This webpage cannot diagnose emergencies. If you experience any of the above symptoms, seek immediate emergency medical attention.

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Clinical Lead

Complex Pain Requires Diagnostic Depth.

Dr. Deepthi Kalahasti

American Board Certified in Orofacial Pain

“Dr. Deepthi Kalahasti’s training in Orofacial Pain brings a broader diagnostic perspective to symptoms involving the teeth, jaw, chewing muscles, temporomandibular joints and related facial structures. This becomes particularly important when symptoms have persisted despite previous treatment, when the source of pain is unclear, or when the symptoms do not behave like a straightforward dental problem.”

Your First Appointment

What Happens During an Orofacial Pain Assessment?

A structured process to understand your pain before recommending any treatment.

01

Your Pain Story
Where it hurts, how it started, how long it has lasted and what makes it better or worse.

02

Previous Treatment
Review previous dental, medical and pain treatment — what was done, what helped and what did not.

03

Medical & Dental History
Understand factors that may influence symptoms, including medications, medical conditions and lifestyle.

04

Clinical Examination

Evaluate relevant teeth, muscles, jaw joints, jaw movement and craniofacial structures.

05

Existing Records
Review useful radiographs, scans or reports already available.

06

Additional Investigation

Ordered only when clinically justified — not routinely.

07

Working Diagnosis
Explain what appears likely and what may need further investigation.

08

Treatment Plan

Choose the least invasive appropriate approach for the working diagnosis.

09

Review

Assess response before escalating therapy. Not every patient needs every step.

Questions & Answers

Questions Patients Ask About Facial & Jaw Pain

Orofacial pain is pain experienced in the mouth, jaw, face and related structures. It may arise from teeth and gums, chewing muscles, temporomandibular joints, nerves, headache disorders or other medical conditions. Because several conditions can produce similar symptoms, identifying the source of pain is often more important than immediately treating the location where the pain is felt.

An orofacial pain specialist evaluates the pattern, possible source and contributing factors of persistent or complex pain involving the teeth, jaw, face and related structures. This involves a detailed pain history, clinical examination of teeth, muscles, jaw joints and jaw movement, review of previous treatment, and development of a management strategy based on the working diagnosis.

No. Temporomandibular disorders are one category within the broader field of orofacial pain. Orofacial pain also includes dental and dentoalveolar pain, myofascial muscle pain, neuropathic conditions, burning mouth symptoms, headache-related facial pain and persistent pain conditions. TMD is one part of orofacial pain — not the whole field.
 
Orofacial pain can affect the teeth and gums, jaw muscles, temporomandibular joints, jaw, face, cheeks, temples, ears, lips, tongue and palate. Pain may also spread to the neck or head depending on the source. Because structures share nerve pathways, pain from one area can sometimes be perceived in another.
 
Diagnosis involves a detailed pain history — where it is, how it started, its character, duration, frequency, triggers and what helps. Clinical examination of teeth, muscles, jaw joints and jaw movement follows. Existing radiographs are reviewed. Additional imaging or investigation is arranged only when clinically indicated.
 
Several different conditions can produce similar symptoms in the same area. Nerve pathways allow pain to be felt away from where it originates. Some conditions do not produce visible or radiographic changes. Symptoms from different structures can overlap. Thorough evaluation of multiple possible sources is often necessary.
 

Related at GardenCity Smiles

TMJ & Splint Therapy

Tooth Pain

Jaw Pain (TMJ)

Root Canal Treatment

Dental Emergency

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Take the First Step

You've Had the Pain. Now You Need an Explanation.

Bring us the history — where it hurts, when it started, what treatment you have already had and what has or has not helped.

The first goal is not to choose a procedure.

The first goal is to understand the pain.

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Diagnosis-led · Conservative care · No treatment pressure.

Diagnosis before treatment · GardenCity Smiles · Yelahanka

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Clinically reviewed by: Dr. Deepthi Kalahasti, Founder & Director, GardenCity Smiles — American Board Certified Orofacial Pain Specialist · Authorised Invisalign® Provider
Last reviewed: August 2026
Medical information disclaimer: This page is intended for general educational purposes and does not constitute clinical advice. Individual suitability for any dental treatment must be determined after an in-person clinical examination. Consult a qualified dental professional for personalised guidance.
Internal links: Jaw Pain & TMJ · Forward Teeth · Our Technology · About Dr. Deepthi · Your Patient Journey · Smile Stories
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