5 Orofacial Pain Flashcards by Marian Pacho

what are the general types of orofacial pain

nociceptive and neuropathic

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what is caused by inflammation, irritation, and neural compression

neuropathic pain

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what is chronic/persistent pain initiated by lesions/dysfunctions of nS

neuropathic pain

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what occurs when activity in neural pathway is caused by tissue damage or potentially damaging stimuli

nociceptive pain

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what is a reaction to painful stimuli

nociceptive pain (thru nociceptors)

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can neuropathic and nociceptive pain overlap to affect both nerves and tissues?

YES

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what are the types of nociceptive pain

odontogenic, mucosal, and musculoskeletal

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stimuli for odontogenic pain

heat - dull, long lasting
cold - short, sharp

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fibers for odontogenic pain

a-delta, a-beta, or C

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the hydrodynamic theory falls under what type of pain

odontogenic pain

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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

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type of pain and describe:

reversible pulpitis

nociceptive orofacial odontogenic pain

pulp remaind viable, short/quick bursts of pain, ceases immediately upon removal

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type of pain and describe:

irreversible pulpitis

nociceptive orofacial odontogenic pain

pulp damage beyond repair, inflammation causes breakdown of cellular organization

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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

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where can prolonged pain from irreversible pulpitis radiate to?

ear, temporal area, and cheek

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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

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type of pain and describe:

periapical pain

nociceptive orofacial odontogenic pain

infection spread thru apical foramen into periodontal region

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type of pain and describe:

exposed dentin and cementum

nociceptive orofacial odontogenic pain

sharp and short pain

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type of pain and describe:

incomplete fractures

nociceptive orofacial odontogenic pain

sharp pain upon biting or release from biting

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what type of infection is a periodontal abscess

acute infection (periodontal pocket) causing pain

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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

1. loss of superficial epithelium 2. none to minimal damage to lamina propria

describe what happens during mucosal ulcer

1. loss of surface tissue 2. degeneration of epithelium and lamina propria 3. usually involves submucossa 4. 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

1. hyperalgesia (nociceptive sensitization) 2. allodynia (central sensitization) 3. paroxysmal shooting pain or constant burning 4. contstant aching 5. pressure pain 6. 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

1. trigeminal neuralgia 2. glossopharyngeal neuralgia 3. 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

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5 Orofacial Pain Flashcards

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