LAUSR

OBJECTIVE The objective of this study is to introduce the format of a telemedicine examination for a new patient with orofacial pain as well as describe the success and utility of a telemedicine consultation in a hospital-based orofacial pain practice. DESIGN A retrospective review was performed of all new telemedicine consults performed by the Orofacial Pain Clinic in the Department of Oral and Maxillofacial Surgery at Massachusetts General Hospital for one year following the onset of the COVID-19 pandemic from April 2, 2020, to March 29, 2021. Medical records were reviewed for patient demographics, clinical findings from the telemedicine consult and initial diagnosis, as well as the definitive diagnosis from the in-office follow up. RESULTS 270 new patients were seen. The three most common diagnoses were myofascial pain of the masticatory muscles (37%), an articular disc disorder of the TMJ (21%), and TMJ arthralgia (16%), followed by obstructive sleep apnea (9%), and neuropathic orofacial pain (6%). Treatment recommendations given at the time of telemedicine consultation include jaw stretching exercises, prescription of muscle relaxants or anti-inflammatory medications, as well as initiating administrative action such as obtaining a prior authorization for a medical necessary oral appliance. 146 patients returned to the clinic for an in-office follow up, 78.8% of which had an accurate telemedicine diagnosis. Difficulty discerning between masticatory myofascial pain and TMJ arthralgia was the most common reason for inaccuracy during the telemedicine diagnosis. CONCLUSIONS Telemedicine consultation for patients with orofacial pain can help facilitate an accurate diagnosis and expedite treatment for patients who face challenges presenting for an in-office consultation.