Due to the complex nature of pain in the head and face, the initial examination and consultation visit at Columbia Center for Sleep Apnea and TMJ usually takes 1.5-2 hours. Since orofacial pain has multiple contributing factors, it is vital that we have your complete information available at your initial appointment. This includes things like health history, medication, and previous treatments. We have provided a link to the information that will allow us to better respect your time and ours at your first appointment. Download here.
This time with Dr. Bloxham is necessary to accurately diagnose your pain and/or dysfunction concerns and develop the most appropriate course of treatment.
The initial visit serves four main purposes:
- Dr. Bloxham will gather the necessary information to make an accurate, informed diagnosis of your concern.
- He is then able to provide you information as to the nature and cause of your pain and/or dysfunction concern, and
- develop the most appropriate treatment strategies specific to your situation.
- Begin treatment! The sooner treatment is started, the sooner you can feel better!
The visit begins with a consultation to explore in detail the history of your pain and/or dysfunction concerns, review your general health history and body systems, evaluate your sleep history, review past medical and dental treatments, review previous and current medications, and a discussion of previous treatments for the current concern.
The clinical evaluation:
Additionally, we do an oral status examination, a thorough muscle palpation of the head, neck and facial muscles and a sleep breathing disorder assessment. These examinations are necessary to determine the cause or source of the pain and suggest the most effective treatment protocols. A CT or MRI and blood tests may also be ordered as part of this comprehensive evaluation. Diagnosis and treatment of orofacial pain and sleep apnea requires medical codes and is not covered by dental insurance.
The clinical evaluation usually includes:
- evaluation of blood pressure, temperature and pulse
- eye, ear, nose and throat exam
- neurological screening
- vascular assessment
- muscle function, strength and tone evaluation
- joint mobility assessment for the jaw and neck
- muscle provocation test
- evaluation of jaw joint sounds
- Orthopedic TMJ evaluation
- parafunctional habits evaluation
- intraoral hard & soft tissue assessment, including an oral cancer screening
The post examination consultation and initiation of treatment:
- a discussion of normal anatomy and how it compares to your current condition
- If indicated a discussion of further diagnostic testing such as radiological imaging (CBCT, MRI) or blood work etc.
- appropriate treatment strategies and expectations including self-care modalities
- a discussion of diagnosis, treatment options, including risks, benefits and alternatives
- potential escalated treatment strategies, should they become necessary
- Initiation of treatment– we purposely allow time in the schedule to start treatment and get you feeling better! The best time to start treatment is when the pain started, the next best time to start treatment is now!
Remember to bring with you:
- An updated list of your current medications (including dose and frequency).
- Any important information regarding the condition we are seeing you for (lab results, imaging, sleep study results, etc.).
- Any oral appliances that you currently use or have stopped wearing.
We understand that people have busy lives and that chronic pain may affect you to varying degrees. If you should need to cancel or reschedule your visit with us, please do so 48 hours prior to your visit so that we may make your appointment available to someone else in need of care.