Tara Renton (Specialist in Oral Surgery). She completed her dentistry at Guys (1984), Oral and Maxillofacial surgical training in Melbourne (1991), undertook a PhD in Trigeminal Nerve injury at KCL (1999-2003).

Currently there is insufficient evidence base for effective treatment for many OFP conditions resulting in multiple medical and surgical interventions failing on our patients rendering many with persistent pain. When a condition is termed idiopathic does that render that condition ‘refractory’ due to its non-responsive nature? ‘Refractory’ is a term loosely used in most of the orofacial pain literature. It is often used inter-changeably with persistent, resistant or intractable orofacial pain. What does the term refractory mean when applied chronic pain? The term ‘refractory pain’ is often used to refer patients for high risk and/or costly interventions otherwise unavailable to them. There are recent agreed criteria and definitions for resistant and refractory migraine and refractory Cluster headache. No other orofacial pain condition has these agreed published criteria for refractory pain. The insufficient evidence underpinning clear diagnostic criteria and proven treatments for many of the conditions we see also undermines the effective management of these conditions. In addition, we often fail to phenotype the patients pain sufficiently and or holistically endotype the patient, which thus undermining any clear relationship between supposed diagnosis and treatment outcomes. There may be many reasons for poor or non-response to treatment are many, however, the often over looked factors are; significant AXIS 2 issues, comorbid pain conditions, sleep disorders, medication overuse, medication sensitivity, lack of treatment compliance and using a multidisciplinary approach. Many patients also provide a diagnostic challenge due previous multiple medications and interventions masking the original pain phenotype. In future we may also look to assessing genetics and epigenetic and microbiome variants which will substantiate our patient endotype. By using a stratified holistic approach, we will optimise the patient’s pain management and provide the necessary evidence base for future improved care. However, there will always be some patients with pain that does not respond to conventional approaches, which we must acknowledge and define what other high risk and costly interventions may assist this group. and as a specialty we need to identify what approaches may benefit this group. Thus, there is a need for clearer definitions for Refractory states in Orofacial pain.

• Education programmes
UG teaching of dental students modern Oral Surgical. Pain and modern LA techniques.
Academic oral surgery training programme.
Supervised 8 PhDs

• Research
Collaboration with Imperial College, UCL, Oxford University, Institute of Psychiatry and Psychology & Neurology Published over 200 peer reviewed articles Grants MRC and NIHR.

• Editorial
Associate editor for Journal Orofacial pain and headache, she is on the Dental Update and British Society for Dental Hygienists and Therapist Editorial Boards
Co-editor the BDA clinical manuals for Oral Surgery Books I and II and Editor of Nature pub OFP book (2021).

• Service
Leads Kings Health Partners Orofacial Pain Service Orofacial pain multidisciplinary service
Leads 2 patient facing websites Trigeminalnerve.org.uk and (www.orofacialpain.co.uk).

• Policy and Awards
Chair National patient safety for dentistry -prevention wrong site surgery in dentistry
Chair M3M patient care guidance for FDS RCS
Honorary AAOMS fellowship 2017
Noel Martin visiting Chair Sydney University 2018-
Steve Graff Radford Award American Headache Society 2020
Tara was an elected member RCS England FDS Board 2010-2019
Chair of Oral Surgery SAC
Invited member National Advisory Board for human factors in dentistry
Past President of the British Association Oral Surgery.