Facial Pain 3 Flashcards
what is oral dysaesthesia
abnormal sensory perception in absence of abnormal stimulus
what type of oral sensation can be felt with oral dysaesthesia
burning
dysgeusia
paraesthesia
dry mouth
what are the predisposing factors for oral dysaesthesia
deficiency states
fungal and viral infection
anxiety and stress
gender (women)
what is burning mouth syndrome likely to be associated with
haematinic deficiency
if a patient has burning mouth syndrome in lips/tongue what is this likely to be caused by
parafunction
what is dysgeusia
bad taste/smell
what can the causes of dysgeusia be
ENT causes (sinusitis), perio infection, GORD
what is touch dysaesthesia
pins and needles
if a patient has touch dysaesthesia what investigations are needed
cranial nerve exam
MRI for demyelination/tumour
what is dry mouth dysaesthesia associated with
anxiety disorders
how do you manage dysaesthesia
explain condition to patient (pins and needles in mouth)
assess degree of anxiety
treat to empower patient
what medication is used for dysaesthesia patients
anxiolytic medication:
nortriptyline
mirtazapine
vortioxetine
neuropathic medication:
gabapentin/pregabalin
clonazepam
what are the 3 classifications of TMD
joint degeneration (arthritis with crepitus)
internal derangement (locking)
no joint pathology
what is the cause of TMD issues
occlusion
grinding
clenching
stress
what are the physical signs in TMD
clicking joint
locking with reduction
limitation of opening mouth
tenderness of masticatory muscles
tenderness of cervico-cranial muscles
what does the history of TMD look for
acute pain in face and neck
chronic face, head and neck pain
periodicity (worse in morning and evening)
parafunctional clenching
other systemic problems
what does examination of TMD patients find
focal muscle tenderness
tenderness over TMJ itself
joint noise
deviation on opening
dental occlusion upset
what investigations are used for TMD
none for functional disorders
ultrasound for disc displacement
CBCT if bone problem
MRI for disc
arthroscopy for disc
how do you manage TMD
information
physical therapy
biomechanical manipulation (tricyclics)
physiotherapy
acupuncture
clinical psychology
why would children have TMD
anxiety neurosis (anxious parents make anxious children, maladaptive response to change)
reaction to abuse (school, home)
