Facial Pain 3 Flashcards

1
Q

what is oral dysaesthesia

A

abnormal sensory perception in absence of abnormal stimulus

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2
Q

what type of oral sensation can be felt with oral dysaesthesia

A

burning
dysgeusia
paraesthesia
dry mouth

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3
Q

what are the predisposing factors for oral dysaesthesia

A

deficiency states
fungal and viral infection
anxiety and stress
gender (women)

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4
Q

what is burning mouth syndrome likely to be associated with

A

haematinic deficiency

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5
Q

if a patient has burning mouth syndrome in lips/tongue what is this likely to be caused by

A

parafunction

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6
Q

what is dysgeusia

A

bad taste/smell

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7
Q

what can the causes of dysgeusia be

A

ENT causes (sinusitis), perio infection, GORD

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8
Q

what is touch dysaesthesia

A

pins and needles

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9
Q

if a patient has touch dysaesthesia what investigations are needed

A

cranial nerve exam
MRI for demyelination/tumour

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10
Q

what is dry mouth dysaesthesia associated with

A

anxiety disorders

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11
Q

how do you manage dysaesthesia

A

explain condition to patient (pins and needles in mouth)
assess degree of anxiety
treat to empower patient

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12
Q

what medication is used for dysaesthesia patients

A

anxiolytic medication:
nortriptyline
mirtazapine
vortioxetine

neuropathic medication:
gabapentin/pregabalin
clonazepam

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13
Q

what are the 3 classifications of TMD

A

joint degeneration (arthritis with crepitus)
internal derangement (locking)
no joint pathology

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14
Q

what is the cause of TMD issues

A

occlusion
grinding
clenching
stress

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15
Q

what are the physical signs in TMD

A

clicking joint
locking with reduction
limitation of opening mouth
tenderness of masticatory muscles
tenderness of cervico-cranial muscles

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16
Q

what does the history of TMD look for

A

acute pain in face and neck
chronic face, head and neck pain
periodicity (worse in morning and evening)
parafunctional clenching
other systemic problems

17
Q

what does examination of TMD patients find

A

focal muscle tenderness
tenderness over TMJ itself
joint noise
deviation on opening
dental occlusion upset

18
Q

what investigations are used for TMD

A

none for functional disorders
ultrasound for disc displacement
CBCT if bone problem
MRI for disc
arthroscopy for disc

19
Q

how do you manage TMD

A

information
physical therapy
biomechanical manipulation (tricyclics)
physiotherapy
acupuncture
clinical psychology

20
Q

why would children have TMD

A

anxiety neurosis (anxious parents make anxious children, maladaptive response to change)
reaction to abuse (school, home)