Debra Fitzpatrick, 78th Dental Squadron lead dental assistant, takes dental impressions from Wilber, during an exam August 7, 2014. The dental technician will create a dental splint to relieve the patient’s pain.. (US. Air Force photo by Misuzu Allen)
8/15/2014 - ROBINS AIR FORCE BASE, Ga. -- After being hit in the jaw while playing sports in high school, Airman 1st Class Daniela Trujillo figured the ongoing pain she suffered was something she'd just have to deal with - even if it meant chronic discomfort at times.
But one day about five months ago, she found that her jaw wouldn't open quite wide enough for her to eat.
"Usually it would hurt just a little, but that day I couldn't eat at all. I knew then I finally had to do something," said Trujillo, a Robins contract specialist.
Through a referral,, she paid a visit to Lt. Col. (Dr.) Stephen Chartier, 78th Dental Squadron commander. A board-certified specialist in comprehensive dentistry, he transferred to Robins in 2013 and recognized an important need on the installation for military patients suffering from various orofacial conditions that extend beyond just the teeth and gums.
He helped establish an orofacial pain and chronic headache clinic, and has since treated nearly 120 active duty patients.
"The people I see are generally in chronic pain, meaning this problem has existed for a while," said Chartier. "We call it orofacial because a lot of times these types of pains can manifest after the jaw has been hurting for an extended period of time."
The clinic can address such issues as joint, disc, muscle or headache pain.
Patients such as Trujillo visit the clinic due to past facial trauma or surgeries, many suffering from such conditions as temporomandibular dysfunction.
TMD occurs as a result of problems with the jaw, jaw joint and the surrounding facial muscles that control chewing and other movements.
While the cause of TMD is not always clear, symptoms include teeth grinding, and most notably, clicking or popping sounds in the jaw joint when closing or opening the mouth, often associated with pain.
To help patients in need of specialized care, Chartier uses a comprehensive approach on a first visit, evaluating and discussing problem areas and habits that can help position pieces of information into a meaningful diagnosis.
But it's what happens next that has proven life-changing for many.
Chartier fabricates a custom-made splint, or occlusal appliance, patients wear to protect and re-establish jaw muscle and joint functionality. The splint is created by a technician onsite in the dental lab after a dental impression is made from the patient.
"Worn often at night, the splint keeps the teeth slightly apart," he said. "That protects both the upper and lower teeth from damaging each other and prevents trauma to the disc and retrodiscal tissue."
The splint may sound similar to what is already available on the market; however, they're individually constructed based on a specific patient's teeth and are carefully adjusted as needed.
"The treatment goal with the splint is to produce even biting pressure across all the teeth," said Chartier. "It's when that starts to happen that things can quickly change for the better. Patients realize once their bite is in harmony, the pain and other problems tend to fade."
Muscle spasms on the right side of her face and the experience of an unusual, different pain from a prior surgery finally led Master Sgt. Lerona Sandiford to the dentist's chair.
After trying out the splint with a few adjustments, the Airman Leadership School commandant had high praise as a result of her treatment plan.
"I'm not a fan of the dentist, but Lt. Col. Chartier assured me he could help," she said. "I'm so happy with this splint."
Sgt. Catalina Wiley, a logistician with Marine Light Attack Helicopter Squadron 773, was also experiencing popping sounds in her jaw, resulting in headaches.
After only a week of wearing the splint, she too noticed a difference.
"Think of the sound when you crack your knuckles, only it's in your face," she said. "I thought it was normal - a minor annoyance - until the dentist explained it shouldn't be happening."
Chartier has received many calls from the dental community to talk about the service performed at Robins.
He presented a lecture on orofacial pain management during the Robins-sponsored Central District Dental Society meeting in February.
"This is something that unfortunately goes misdiagnosed, mistreated and avoided," he said. "My goal was to return the quality of life to as many of our patients as possible.
"When someone has been dealing with pain for many years and you can make them comfortable again, then you have made a friend for life."