Dental and allied health professionals are on occasion confronted with patients who exhibit abnormal facial movements. These patients may be seeking a diagnosis or may relate a specific problem resulting from the uncontrolled and involuntary orofacial movements. A complete description of the various conditions associated with abnormal facial movements is beyond the scope of this article. Instead, these authors present a case with dental symptoms that were masking a more serious underlying progressive neurologic disorder. Appropriate referral to the neurology service is essential so that treatment of the underlying cause may precede, rather than follow, empiric management of these patients' symptoms.