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When to Refer

When to Refer

The following guidance is intended to help referring providers identify patients who are likely to benefit from an orofacial pain or dental sleep medicine evaluation. When in doubt, we welcome a provider-to-provider conversation before a formal referral.

For Dentists

  • Patients with jaw pain, limited mouth opening, or joint sounds that are not resolving with standard dental care
  • Patients with significant tooth wear from bruxism, particularly when accompanied by pain or headache
  • Patients with chronic facial pain, tooth pain, or jaw symptoms following dental procedures when dental pathology has been ruled out
  • Patients who report ear pain, tinnitus, or facial pressure in the absence of dental findings
  • Patients who have failed or poorly tolerated CPAP and are candidates for oral appliance therapy
  • Patients with suspected burning mouth syndrome or soft tissue pain without identifiable oral pathology
  • Any patient in whom a neuropathic pain condition is suspected

For Primary Care Physicians

  • Patients with chronic facial pain, jaw pain, or head and neck pain that has not responded to standard management
  • Patients with frequent headaches that may have a musculoskeletal component
  • Patients with diagnosed obstructive sleep apnea who have failed or are intolerant of CPAP
  • Patients with significant snoring or suspected upper airway resistance syndrome
  • Patients with complex chronic pain conditions involving the face, head, or neck
  • Patients with suspected burning mouth syndrome, trigeminal neuralgia, or other cranial nerve pain
  • Post-traumatic patients with facial nerve symptoms following injury or surgery

For ENT / Otolaryngologists

  • Patients with ear fullness, otalgia, or tinnitus in whom otologic pathology has been excluded
  • Patients with facial pain not attributable to sinus, salivary gland, or other otolaryngologic pathology
  • Patients with sleep-disordered breathing who are CPAP-intolerant or prefer an oral appliance
  • Patients with suspected upper airway resistance syndrome or primary snoring
  • Patients with jaw symptoms following neck dissection or other head and neck surgery

For Sleep Physicians & Pulmonologists

  • Patients with OSA who have failed, refused, or have a contraindication to CPAP
  • Patients with OSA who prefer oral appliance therapy as a primary treatment
  • Patients with positional OSA who may benefit from a combined oral appliance and behavioral approach
  • Patients with OSA and comorbid TMD, jaw pain, or bruxism requiring coordinated management
  • Patients with primary snoring or upper airway resistance syndrome for oral appliance evaluation

For Neurologists

  • Patients with facial pain that does not fit a classic trigeminal neuralgia pattern and may represent a TMD or neuropathic pain condition
  • Patients with headache and suspected jaw, muscle, or cervical musculoskeletal contributions
  • Patients with oromandibular dystonia or other oral movement disorders
  • Post-traumatic patients with trigeminal nerve symptoms following facial or dental trauma
  • Patients with burning mouth syndrome for co-management

Unsure Whether to Refer?

We are happy to discuss complex cases before a formal referral.

Call 414-476-9400.