Can Occlusal Adjustment Really Fix my Bite Problems or Do I Need Orthodontic Work?

You mentioned movement of teeth because retainers were not worn for a long period of time. You mentioned that you are having facial nerve issues POSSIBLY  trigeminal nerve pain which is becuase of your bite. First of all I would find a dentist that specializes in neuromuscular dentistry if possible and book an appointment for a consultation regarding your facial pain. They have far more training in this area than either an orthodontist or general dentist. If your dentist thinks it is your bite, why not start with diagnosing how far it is off or if it is off. This can be easily done with an simple little device called the Best Bite Discluder.  It will immediately tell you if your bite is off or not and most dentists are very familar with this gadget.  If your facial pain goes away, it is your bite. Most dentists guess at your bite being off off by using  occlusal paper alone. Do not let them start filing down teeth from just guessing. There is also a T Scan Computerized Occlusal Analysis Systen developed in the 80's which allows the dentist to really see the cause of jaw muscle pain. This scan detects fraction of seconds of excessive tooth contact that you can not find any other way.  So try some of these suggestions and I would go this route before thinking about orthodontics.  Also make sure it is trigeminal nerve because that usually not a dental related problem. Do your research before you make a decision!

You may need to talk to several people but one of the first I would talk to is someone who specializes in head and neck pain.  They have a TMJ and Pain program up at UCLA dental school thay you might contact. and there used to be a program at UCSD  that was run by Dr. Terry Tanaka, a dentist  who is very highly regarded in treating problems like yours. Look him up on the web.  He may be in private practice in your area but I am not certain.  Equilibration and or orthodontic treatment may not solve your issues but might be of some assistance if properly planned and coordinated with someone who treats problems like yours.  Unfortunately, TMJ and head and neck pain problems have all sorts of purveyors of "I have just the right solution for you" and a lot od them don't really work and some can be counterproductive.  You REALLY have to do your homework and get the right person on problems like this.

Great question. It never hurts to get as much information about your condition as you possibly can. While bite adjustments can resolve discrepancies in a person's bite it can not resolve a bad bite. Sometimes, all that is needed for a bite to be completely out of balance and cause severe trauma to the TMJ is a slightly misaligned tooth. Gather as much information as you can and then make a decision regarding your treatment based on what makes the most sense. Invariably, you will have multiple doctors agreeing on the appropriate treatment plan.

Good luck!

Bad bite won't cause trigeminal nerve inflamation.  I would see an orthodontist to check your bite problem.  But I don't see your bite and trigeminal  nevrve as related issues.

The scientific view now is that MOST of the time, occlusion is not the major factor in your type of problem so neither equilibration nor orthodontics will help you.  Make sure you get multiple opinions before letting someone grind on your teeth or do major orthodontic work