Facial Pain 3 Flashcards
1
Q
What is oral dysaesthesia?
A
- abnormal sensory perception in absence of abnormal stimulus
- burning/ nipping feeling
- dysgeusia
- paraesthesia feeling
- dry mouth feeling
2
Q
What is dysgeusia?
A
- foul, salty, rancid/ metallic taste sensation that persists in mouth
- bad taste, bas smell, halitosis
- ENT causes- chronic sinusitis
- perio/ dental infection
- GORD
3
Q
Predisposing factors of Oral Dysaesthesia?
A
Deficiency in
- haematinics
- zinc
- Vit B1 and B6
Fungal and viral infections
Anxiety and stress
Gender- might be because more women present to OM than men
4
Q
Burning Mouth Syndrome
A
- dysaesthesia most likely associated with haematinics deficiency
- SITE IS IMPORTANT
- lips, tongue tip/ margin - parafunction
- Multiple sites - dysaesthesia
5
Q
Touch Dysaesthesia
A
- pins and needles
- tingling sensation
- must exclude organic neurological disease
- must exclude local causes: infection/ tumour
- MRI essential- demyelination/ tumour
6
Q
Dry Mouth Dysaesthesia
A
- very common
- C/O debilitating dry mouth/ sjogrens
- eating okay
- wrose when waken at night
- usually associated with anxiety
7
Q
Management of Dysaesthesia
A
- explain the condition to the pt “pins and needles”
- assess degree of anxiety, ie: anxiolytic medication & clinical psychology
8
Q
Medication for Dysaesthesia
A
Anxiolytic based medication
- Nortriptyline
- Mirtazepine
- Vortioxetine
Neuropathic medication
- Pregabalin
- Gabapentin
- Clonazepam as topical
9
Q
Classifying pt for TMJ
A
- Joint degeneration
- pain on use & crepitus
- rest pain - Internal derangement
- Locking open/ close - no joint pathology
10
Q
Causes of TMJ
A
- occlusion
- grinding
- clenching
- stress
11
Q
Physical Signs in TMD
A
- clicking joint
- locking with reduction
- limitation of opening mouth
- tenderness of masticatory muscles
- tenderness of cervico-cranial muscles
12
Q
Examination findings
A
- focal muscle tenderness, ie: masticatory, trapezius, sternomastoid muscle
- tenderness over TMJ
- limitations of opening
- joint noises
- deviation when opening
- might be due to high dental occlusion upsetting TMJ
13
Q
Investigations for TMD
A
- usually none for functional disorders
- ultrasound scan-> if functional visualisation of disc movement is needed
- CBCT if bony problem suspected
- MRI- best image of disc
- Arthroscopy to directly visualise disc
13
Q
Management of TMD
A
- how to self- help
- soft diet and analgesia
- bite splint
- biochemical manipulation with Tricyclic (not SSRI)
- physiotherapy
- acupuncture
14
Q
Children with TMD
A
- tendency to anxiety neurosis
- if parents anxious, then child may be too
- reaction to abuse/ bully in school
- physical abuse