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Oral Med > Facial Pain > Flashcards

Facial Pain Flashcards

1
Q

What aspects of pain history are important in facial pain? (7)

A
  • Timing: onset, duration and periodicity
  • Location and radiation
  • Quality and severity
  • Relieving and aggravating factors
  • Associated factors
  • Other pain conditions
  • Impact of pain
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2
Q

What questionnaires are used in assessing facial pain?

A
  • Brief Pain Inventory
  • Beck Depression Inventory
  • Hospital Anxiety and Depression Scale
  • McGill Pain Questionnaire
  • Oral Impacts on Daily Performance
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3
Q

When are laboratory investigations important in facial pain?

A

For cranial arteritis and auto-immune disorders.

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4
Q

What imaging is used to investigate facial pain?

A
  • X-rays
  • OPG – bony lesions and cysts
  • Ultrasound – salivary glands
  • MRIs and CBCT
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5
Q

How would you know acute facial pain has a dental or oral cause?

A

Most likely unilateral and located within the mouth.

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6
Q

What causes maxillary sinusitis-related facial pain?

A
  • Acute and chronic form unlikely to be associated with pain
  • Most frequently caused by viruses or bacteria, but can occur after dental infection or after treatment to upper premolars/molars
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7
Q

What are common causes of salivary gland pain?

A
  • Tumours
  • duct blockages
  • infection
  • salivary stones.
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8
Q

Where are salivary stones most frequent

A

Salivary stones most frequent in submandibular gland

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9
Q

what type of pain suggests salivary gland tumours

A
  • Pain intermittent and occurs just before eating
  • Salivary flow will be slow or absent
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10
Q

What is the most common non-dental cause of facial pain?

A

TMJ disorders (TMJD).

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11
Q

How can a salivary stone be located

A

Bimanual palpation enables stone to be located

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12
Q

What psychological factors increase the risk of chronic TMJD?

A
  • Depression
  • catastrophising
  • other psychological factors.
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13
Q

What is TMJD linked with

A

Linked with back pain, fibromyalgia and headaches

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14
Q

What is the most common form of acute TMJD?

A

Prolonged opening (e.g., during treatment or trauma).

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15
Q

what is limited opening defined as

A

Limited opening defined as <40mm

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16
Q

How is TMJD managed?

A

Reassurance, soft diet, analgesics, occlusal guard, and possibly amitriptyline.

17
Q

What drug interventions for TMJD

A

Amitriptyline may have some benefit, no benefit of Botox in RCTs

18
Q

What is trigeminal neuralgia?

A

Sudden, unilateral severe stabbing pain in the distribution of one or more branches of the trigeminal nerve.

19
Q

What symptom can differentiate trigeminal neuralgia from dental pain?

A

It does not disturb sleep.
Pts may complain about pain on shaving

20
Q

What is the most common cause of trigeminal neuralgia?

A

Neurovascular compression of the trigeminal nerve in or around route of entry zone whereas type 2 might be more central

21
Q

What condition should be suspected in a young patient with trigeminal neuralgia?

A

Multiple sclerosis (needs MRI).

22
Q

What is the treatment in severe cases

A

Surgery is an option in severe cases however most patients are pain free within 5-10y

23
Q

What is glossopharyngeal neuralgia?

A

Similar to trigeminal neuralgia but with pain in the ear and posterior tongue, triggered by swallowing.

24
Q

How is glossopharyngeal neuralgia managed

A

same as trigeminal neuralgia

25
Q

What are symptoms of giant cell arteritis?

A

Unilateral pain, severe headache, and swelling of the temporal artery.

26
Q

What is the most serious consequence of untreated giant cell arteritis?

A

Blindness.

27
Q

What is the management for giant cell arteritis?

A

Immediate referral for systemic steroids.

28
Q

What is persistent idiopathic facial pain (PIFP)?

A

Facial pain that does not fulfil any specific diagnostic criteria.
- often a history of other chronic pain, poor coping skills, and mood disturbance

29
Q

How is persistent idiopathic facial pain managed?

A

Antidepressants combined with cognitive behavioural therapy (CBT).

30
Q

How does PIFP differ from trigeminal neuralgia?

A

No trigger points and a dull ache rather than sharp pain.
and quality of pain

31
Q

What might a progressive headache indicate?

A

Subarachnoid haemorrhage.

32
Q

symptoms suspicious of giant cell arteritis

A

Unilateral pain, severe headache, swelling of temporal artery

Oral Med (10 decks)

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