6 Pain Management in Dentistry Flashcards
what tract is responsible for localization of pain
spinothalamic tract
what tract is responsible for emotional aspect of pain
spinoreticular tract
etiology of dental pain
- bacteria - toxins, metabolic by-product
- trauma - physical, chemical, thermal
- hosts response - to insult - inflammation, infection
majority of “tooth” pain is truly ___
odontogenic
types of odontogenic pain
pulpal and periodontal
pulpal types of tooth pain
- hypersensitivity
- reversible pulpitis
- irreversible pulpitis
- pulpal necrosis
periodontal type of tooth pain
- gingival abscess
- periodontal abscess - impaction BUT bone loss is present
- pericornitis
- occlusal trauma
data collection pathway
- interview
- clinical examination
- radiograph examination
- reproduce the pain in the office
what should you do during a clinical examination
extraoral examination AND intraoral examination WITH palpation
examples of radiographicc examination
periapical PA
what should you do when reproducing pain
do what patient say is causing pain
symptoms of hypersenitivity
sharp, non-lingering, intense pain to stimuli
symptoms of reversible pulpitis
non-lingering pain to thermal stimuli, biting, percussion
symptoms of irreversible pulpitis
lingering/spontaneous pain to (esp. HEAT) thermal, biting, percussive, palpation stimuli
symptom of pulpal necrosis
spontaneous throbbing with no response to testing OR asymptomatic, no reponse to testing, fistula, radiolucency
symptoms of gingival abscess
pain (duller than pulpal), edema, erythema, bleeding
symptom of periodontal abscess
pain, edema, erythema, bleeding BUT bone loss (abscess is usually localized)
symptom of pericornitis
extremely painful, trismus (bilateral restriction of mouth opening)
symptom of occlusal trauma
pain or tenderness on biting, cusp fracture, abfraction
for managing dental pain, what is the most important thing to remember
treatment plan must be based on diagnosis x3
NSAIA
nonsteroidal anti-inflammatory agent
different of mechanism of action of NSAIA vs. opioids
NSAIA: produces pain, inflammation, fever as part of healing process
OpioidS: perception of pain is altered
when is it appropriate to uses antibiotics?
when local measures cannot be carried out immediately and the patient has SYSTEMIC INVOLVEMENT
