5 Orofacial Pain Flashcards
what are the general types of orofacial pain
nociceptive and neuropathic
what is caused by inflammation, irritation, and neural compression
neuropathic pain
what is chronic/persistent pain initiated by lesions/dysfunctions of nS
neuropathic pain
what occurs when activity in neural pathway is caused by tissue damage or potentially damaging stimuli
nociceptive pain
what is a reaction to painful stimuli
nociceptive pain (thru nociceptors)
can neuropathic and nociceptive pain overlap to affect both nerves and tissues?
YES
what are the types of nociceptive pain
odontogenic, mucosal, and musculoskeletal
stimuli for odontogenic pain
- heat - dull, long lasting
- cold - short, sharp
fibers for odontogenic pain
a-delta, a-beta, or C
the hydrodynamic theory falls under what type of pain
odontogenic pain
what is the dental fluid movement within dental microtubules that act as a transducer, stimulating mechanoreceptors and their nerve fibers surrounding the odontoblast
hydrodynamic theory
type of pain and describe:
reversible pulpitis
nociceptive orofacial odontogenic pain
pulp remaind viable, short/quick bursts of pain, ceases immediately upon removal
type of pain and describe:
irreversible pulpitis
nociceptive orofacial odontogenic pain
pulp damage beyond repair, inflammation causes breakdown of cellular organization
type of fibers for irreversible pulpitis
- early pain on a-delta and C
- as inflammation progresses, C-fibers become dominant and pain becomes diffuse and difficult to localize
where can prolonged pain from irreversible pulpitis radiate to?
ear, temporal area, and cheek
type of pain and describe:
necrotic pulp
nociceptive orofacial odontogenic pain
nociceptors in pulp can be damaged, may not respond o thermal stimuli. if partially affected, some response my be present
type of pain and describe:
periapical pain
nociceptive orofacial odontogenic pain
infection spread thru apical foramen into periodontal region
type of pain and describe:
exposed dentin and cementum
nociceptive orofacial odontogenic pain
sharp and short pain
type of pain and describe:
incomplete fractures
nociceptive orofacial odontogenic pain
sharp pain upon biting or release from biting
what type of infection is a periodontal abscess
acute infection (periodontal pocket) causing pain
type of pain and describe:
periodontal disease
nociceptive orofacial odontogenic pain
chronic inflammation but not chronic pain disorder
type of pain and describe:
alveolar osteitis “dry socket”
nociceptive orofacial odontogenic pain
pain is dull and throbbing, smoking is a major factor and is most common in mandible
what type of pain is typiclly associated with mucosal lesions and pain can be localized or diffuse
mucosal pain
what forms with local pain association with breaks in mucosa
ulcer
___ pain is associated with infection or systemic pathologies
diffuse mucosal
acute mucosal pain is typically related to what? does it respond to treatment? does it heal quickly?
related to tissue damage, yes, yes
how long does chronic mucosal pain last
months to years without an obvious stimuli
___ are a common source of mucosal pain
mucosal lesions
___ is a superficial break in mucus membrane
mucosal erosion
describe what happens during mucosal erosion
- loss of superficial epithelium
- none to minimal damage to lamina propria
describe what happens during mucosal ulcer
- loss of surface tissue
- degeneration of epithelium and lamina propria
- usually involves submucossa
- can involve muscle or periosteum
type of pain and describe:
odontogenic origin
nociceptive orofacial mucosal pain
dental issues primarily affecting gingiva, abscesses in mucosa, gingivitis
type of pain and describe:
poorly fitting dentures
nociceptive orofacial mucosal pin
acute and chronic irritation
type of pain and describe:
trauma
nociceptive orofacial mucosal pain
biting, rubbing and restoratios, thermal and chemical burns
appearance is similar to carinomatous lesions
type of pain and describe:
recurrent aphthous ulcers (canker sores)
nociceptive orofacial mucosal pain
common, typically heal within 1 week, can be genetic but most develop randomly
type of pain and describe:
mucocutaneous lesions
nociceptive orofacial mucosal pain
linchen planus and pemphigus vulgaris are autoimmune conditions that are not exclusive to oral cavity
what is the most common non-dental cause for orofacial pain
TMD
type of pain and describe:
TMD
nociceptive orofacial musculoskeletal pain
primarily extraoral, localizing around TMJ and MOM
type of pain and describe:
myalgia
nociceptive orofacial musculoskeletal pain
caused by jaw movement or palpation of masseter or temporalis
dull aching pain that is typically acute but can be chronic
type of pain and describe:
myositis
nociceptive orofacial musculoskeletal
inflammation of muscles, but in dentistry it is a localized, transient swelling involving facial muscles and tissues
type of pain and describe:
articular displacement
nociceptive orofacial musculoskeletal pain
acute displacement associated with pain, often produces crepitus/clicking
associated with osteoarthritis
type of pain and describe:
pain is felt in area that is remote from location where nociceptors are stimulated
nociceptive referred orofacial pain
T/F: dental patients often seek medical attention for referred pain rather than dental pain
TRUE
what does neuropathic orofacial pain result from
abnormal signaling due to:
1. injury
2. dysfunction of peripheral nociceptive neurons
hallmark symptoms of neuropathic orofacial pain
- hyperalgesia (nociceptive sensitization)
- allodynia (central sensitization)
- paroxysmal shooting pain or constant burning
- contstant aching
- pressure pain
- some may have no pain but altered taste or paresthesia
does neuropathic orofacial pain have an inflammatory component? does it respond well to tx?
yes, and needs to be addressed to effectively treat. typically chronic and can escalate over time
no, does not respond well to treatment
what can result from neuropathic orofacial pain with NEUROVASCULAR ORIGINS
classical migraines and cluster headaches
occular migraines may not be present with pain
what can result from neuropathic orofacial pain NEURALGIAS
- trigeminal neuralgia
- glossopharyngeal neuralgia
- herpetic neuralgia
what can result from neuropathic ATYPICAL orofacial pain
burning mouth syndrome
what type of pain is persistent pain that does not fit any of the diagnosit criteria associated with specific disorders and is characterized by aching, burning or nagging pain
atypical orofacial pain
neuropathic orofacial pain from CANCER can be symptomatic of what?
local, regional or distant cancer
OR the result of cancer treatment (oral mucositis, xerostomia)
what type of pain is felt in neuropathic orofacial pain from CANCER
dull, stabbing, shooting and throbbing
