In this episode Dr. Karen Raphael shares her research on the areas of psychological comorbidities in chronic pain, the relationship of sleep bruxism and temporomandibular disorders as well as the use of botulinum toxin in the management of orofacial pain conditions.Dr. Karen Raphael is a PhD-level psychologist and epidemiologist whose work over the last 35 years has focused on the role of psychosocial and stress-related factors in medically unexplained pain. As she was completing postdoctoral training in psychiatric epidemiology at Columbia University, she met Dr. Joseph Marbach, an orofacial pain specialist and renowned clinical researcher. Most of their close collaboration for a dozen years until his passing in 2001 involved studying processes underlying chronic temporomandibular disorders. After serving on faculty at Columbia University (in Public Health, Psychiatry and the Dental School), she continued research on orofacial pain and other forms of medically unexplained pain at Rutgers/Newark Medical and Dental Schools, where she was promoted to Professor. Her work broadened to encompass areas ranging from translational pain psychophysics to pain epidemiology. She continued methodologically-driven work on biases in both patient reporting and clinical observation. Since 2009, Dr. Raphael has held a primary appointment at New York University College of Dentistry, serving as Professor in the Department of Oral & Maxillofacial Pathology, Radiology and Medicine. Her research on stress and muscle activity expanded to include use of polysomnographic studies and awake stress-reactivity studies to examine the role of bruxism in temporomandibular disorders. Dr. Raphael’s writings inspired an international consensus committee of orofacial pain experts to reconsider whether bruxism is a disorder requiring treatment.In addition to serving as Principal Investigator on a dozen grants funded primarily by the NIH, Dr. Raphael has published approximately 100 peer-reviewed manuscripts and has served on numerous editorial boards and grant review committees. Her most recent funded research has examined potential bone-related risk from use of Botulinum Toxin to treat temporomandibular disorders.