ADA Bookshop

Bell's Orofacial Pains - The Clinical Management of Orofacial Pain

Updated to reflect the latest research in orofacial pain, this revised edition of Dr Welden Bell's classic text is designed to assist the practising dentist in managing orofacial pain disorders, from diagnosis to treatment selection. It presents an updated classification system for orofacial pain disorders, especially in the complicated area of neuropathic pain conditions, and describes the differential diagnostic and therapeutic considerations for each classification. Many new photographs illustrate the concepts and techniques that are discussed, and a new section on injection techniques for the diagnosis and management of orofacial pain has been added. The book also includes 35 case reports to help the clinician better understand orofacial pain disorders and how to treat them effectively.


Author's note:
In the early spring of 1982, I first had the opportunity to listen to Dr Welden E. Bell lecture on the subject of orofacial pain. Through his written work I had already known him as an international authority on this subject. I will never forget the first words from his mouth: “Pain is not a sensation,” he proclaimed. I remember squinting slightly, thinking that I had misheard his statement, but then he repeated the seemingly ridiculous remark. I thought, why, of course pain is a sensation. How could such an authority make such a misleading statement? He then went on to say that “pain is far more than a simple sensation; pain is an experience.” I must admit that at that time in my professional development I really did not appreciate what he was saying. Following that course and after much further reading of his and other texts, I began to better appreciate his words. There is an old saying that “when the student is ready, the teacher will appear.” At that moment, Dr Bell became my teacher and later my mentor.

As my career progressed, I learned more and more from Dr Bell. He continued to write even after his retirement from practice, completing seven editions of his two classic texts on orofacial pains and temporomandibular disorders. As I grew to know him personally, my admiration grew even stronger.
In 1985, I published my first textbook on occlusion and temporomandibular disorders. The first letter that I received commenting on this new text came from Dr Bell.

In October 1989, I received a letter from Dr. Bell informing me that he had just finished the fourth edition of Orofacial Pains. He was then 79 years old and asked if I would consider coauthoring the fifth edition of this text when the time came. His letter presented me with two very different emotions. I immediately felt that I had just received the greatest professional compliment of my career; yet at the same time, I was confronted with the most difficult task I had ever been asked to accomplish. I dared to say yes, but I certainly could not say no. I immediately called Dr Bell to discuss his proposal. I told him of my feelings and he comforted me by explaining that although he would like for me to take the major responsibilities, he would be there for direction and continuity.
In the spring of 1990, I had the privilege to meet with Dr Bell on three occasions; two were during meetings that were dedicated to him for his outstanding contributions to the professions.
In May of 1990, shortly after the publication of the third edition of his textbook on temporomandibular disorders, Dr Bell became suddenly ill and died. His death was a tragic loss to his family and especially his wonderful wife of 58 years, Lucy. His passing was also a tremendous loss to the profession. During the next year I considered and reconsidered how I would accomplish the monumental task of rewriting this text. At times I even considered not attempting it at all, but my admiration for Dr Bell would not let me linger long on such thoughts. As such, the fifth edition was published in 1995.

My goal in writing the sixth edition of this text is an attempt to update the clinician with the latest findings related to pain. This text is divided into three major sections. The first section presents the normal neuroanatomy and function of the trigeminal system. With a clear understanding of normal function, the clinician can begin to understand and manage dysfunction. The second major section presents a classification of the various orofacial pain disorders and describes the history and examination procedures that can be used to differentiate each disorder. This process, called diagnosis, is the most important aspect of orofacial pain management. The third major section presents management considerations for each orofacial pain disorder. It is hoped that this sequence of information will allow the reader to improve his or her skills in the complicated field of orofacial pain.