Acute orofacial pain Flashcards
What are five causes of orofacial pain?
- Local disease
- Neurological
- Vascular
- Referred pain
- Psychogenic (usually chronic pain)
What is the definition of pain?
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
How do you take a good pain history?
Sight Onset Character Radiation Associated factors; systemic; weight loss Time; periodicity; duration Exacerbating factors; precipitating; relieving Severity
What are the local causes of orofacial pain?
- teeth
- supporting tissues and oral mucosa
- sinuses
- salivary glands
- TMJ
What are some examples of referred orofacial pain?
- pharyngeal
- throat
- neck
Give a description of dentinal pain.
- sharp pain
- evoked by external stimulus
- subsides within seconds of removal of stimulus
What is the treatment for dentinal pain?
Block/cover/disrupt tubules
What does the broad term ‘odontogenic pain’ cover?
- dentinal
- pulpa
- periodontal
- periapical
- abcess
- pericoronal
- gingival
- mucosal
- cracked tooth
Give a description of pulpal pain.
- spontaneous
- poorly localised
- strong, often throbbing pain
- typically exacerbated by temperature change
- may increase on lying down
- often wakes pt from sleep
Give a description of periodontal pain.
- more localised and less severe than pulpal pain
- not temperature sensitive
- mobility may be a feature
- lateral peiodontal abcess: well localised pain with pus/swelling at a more gingival level
Give a description of acute apical periodontal pain.
- long-lasting, severe
- spontaneous
- well localised
- exacerbated by biting/apical percussion
- vitality questionable
- vestibular tenderness +/- facial swelling
- may have associated sinus
What are some examples of associated/systemic factors?
- pyrexia
- regional lymphadenopathy
- weight loss
- gross, uncontrolled swelling
- trismus
- malaise
When checking for an abscess sinus, what should you bear in mind?
The infection follows the path of least resistance - take into account the thinnest bone when looking for a draining sinus.
Give a description of pericoronitis pain.
- relates to incompletely erupted teeth with an operculum covering (esp lower 8s)
- pain is spontaneous and may be exacerbated by biting
- consider XLA guidelines
- irrigate and debride under operculum
Give a a description of cracked tooth pain.
- often severe
- exacerbated by biting
- often precipitated by thermal stimuli
- diagnosis can be made with a tooth sleuth or removal of the restoration and examination with high intensity light for fracture lines
