It began in junior high—after he got braces—and persisted into his 40s despite tooth extractions, root canals, and oral surgery. “Sometimes it felt like, instead of a molar in the back of my mouth, I had a nail there,” describes Williamson. “It’s hard to focus when you’re in pain. I’d forget things. I was moody.”

In 2014, he was referred to Gary Heir, clinical director of the Center for Temporomandibular Disorders and Orofacial Pain at Rutgers School of Dental Medicine, part of Rutgers Health. He diagnosed Williamson with post-traumatic trigeminal neuropathy, a chronic pain condition that follows initial trauma.

In Williamson’s case, it probably began as complications from orthodontia and eventually began to fray his nervous system, a condition that likely was exacerbated by unnecessary dental and surgical procedures.

For Dr. Heir, Williamson’s case is not uncommon. His patients who live with chronic pain have often received multiple misdiagnoses before finding appropriate treatment. Often, the failed treatments only make things worse.

From his first appointment with Dr. Heir, says Williamson, he felt as though he’d come to the right place. “Dr. Heir asked a lot of questions. Other people weren’t listening. But it was like he knew me. He knew the pain; he knew where it was coming from. He understood,” notes Williamson. “It was the opposite of what I was getting with other doctors.”

Dr. Heir prescribed a treatment that had been developed through research at the center: a mouthpiece that delivers a topical combination of medications to the site of Williamson’s nerve injury.

This groundbreaking form of treatment, created at the dental school, finally eliminated Williamson’s pain. Although he still experiences small flare-ups, his pain level has decreased from a nine, at its worst, to a one. “Since I started seeing Dr. Heir, it’s been the best three months I can remember,” he declares.


This Rutgers Health article is an edited version of a story that first appeared in the August 2015 edition of Rutgers School of Dental Medicine's RSDM News. [Read the full story]