Dr. James Fricton is a Professor Emeritus in the Schools of Dentistry, Medicine, Public Health, and Health Informatics at the University of Minnesota Academic Health Center. His past research has resulted in 6 textbooks and over 150 journal and book publications and abstracts. As a principal investigator and co-investigator, he has received many grants from National Institutes of Health and industry with a principle focus on chronic pain and health informatics. His most recent NIH-sponsored research developed and testing the Personalized Activated Care and Training (www.PACTforPain.com) to help health professionals and patients prevent chronic pain, disability, and addiction.

He graduated with a B.S. and D.D.S. from the University of Iowa, graduate studies in computer science, and completed postgraduate residency training in pain management in the Department of Anesthesiology at UCLA School of Medicine. He also received a M.S. in research from UCLA during the same period. He has held top leadership positions in the American Academy of Orofacial Pain, American Board of Orofacial Pain, the American Board of Dental Specialties, the American Pain Society, and the International Myopain Society. He had taught many courses on chronic pain with his most recent On-line Course on Preventing Chronic Pain: A Human Systems Approach at www.coursera.org/learn/chronic-pain with over 50,000 participants from 176 different countries.

He also has several textbooks on TMJ and Craniofacial Pain; Myofascial Pain and Fibromyalgia; Orofacial Disorders: Current Therapies in Orofacial Pain and Oral Medicine; and a fiction novel entitled; The Last Scroll. He is married to Dr. Delia Dall’Arancio, an orthodontist at Minnesota Orthodontics and has 4 children and 4 grandchildren. His hobbies include spending time with his family, golf, swimming, and running as well as writing fiction and non-fiction, making stainglass windows, and traveling.

The National Commission for Recognition of Dental Specialties and Certifying Boards (NCRDSCB) was created by the American Dental Association for independent assessment and recognition of new dental specialties to expand the profession of Dentistry into new fields of healthcare. In response, the American Academy of Orofacial Pain (AAOP) submitted a proposal to establish Orofacial Pain as a new dental specialty. To best understand this new Orofacial Pain specialty, it is helpful to review the definition and rationale for the dental specialty and how it can both improve care for patients and expand the profession of Dentistry.
Definition of Orofacial Pain. Orofacial Pain is the specialty of Dentistry which includes the assessment, diagnosis and treatment of patients with orofacial pain disorders, including temporomandibular disorders including masticatory muscle and joint disorders, oromotor and jaw behavior disorders, neuropathic and neurovascular pain disorders, orofacial sleep disorders, and chronic orofacial, head and neck pain, as well as the pursuit of knowledge of the underlying pathophysiology and mechanisms of these disorders.

Rationales for a Specialty in Orofacial Pain. Chronic pain is the most significant problem in health care today. It is the leading reason to seek care, the dominant cause of disability and addiction, and the primary driver of healthcare utilization, resulting in greater expenditures than for cancer, heart disease, and diabetes. As a result, the nationwide chronic pain and opioid crisis is having a devastating personal effect on individuals, families, and communities, and imposing enormous financial costs on federal, state, and local governments. While, the estimated costs to our communities and governments is at least $80 billion annually, the personal toll on individuals and families is enormous and lamentable.

The 3 rationales for this specialty include;

1. Improving Access to Care to Orofacial Pain Care. These issues highlight both the complexity and need for high quality evidence-based integrative care for these problems. However, the lack of practical training in the care of these disorders within both medical and dental training programs motivate most health care providers to choose to refer these patients to a specialist. Nationally, there is less than 100 full-time board-certified Orofacial Pain Specialists in private clinical practice to care for a population of 27.4 million people with orofacial conditions. Furthermore, there are virtually no specialists in many states and outreach areas.

2. Improve Standards of Care in Orofacial Pain. Support for clinical practices in the specialty of Orofacial Pain will ensure that clinicians will be properly trained, knowledgeable, experienced, and provide the highest quality standards of care in this field. In turn, successful practices will attract sufficient number of high quality candidates to apply for advanced education programs and receive training beyond that which is provided in the undergraduate dental curriculum. This in turn will improve access to quality care and provide a referral source for professional colleagues.

3. Improve Business Model of Orofacial Pain Clinics. Access to quality evidence-based care for orofacial pain disorders is often limited because of the complex business model presented to an orofacial dental specialist who bills through medical health plans. The inconsistent coverage by health plans, the lack of awareness of the specialty among both consumers and health professionals, and the lack of a defined clinical model with economic success motivate few Orofacial Pain Specialists to go into clinical practice.

As the new Specialty of Orofacial Pain evolves, these goals will be addressed by both leadership in the field and individual specialists. This presentation discusses how this can occur within evolution of the new Specialty in Orofacial Pain and how it will both improve care for patients and expand the profession of Dentistry.