L1- Defining the Problem

Question 1

percentage of people that avoid seeing the dentist because of fear of pain

Answer 1

somewhere between 6% and 14%of entire population

14,000,000 - 34,000,000) voluntary avoid

Question 2

definition of pain

Answer 2

‘unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’

Question 3

dentist must differentiate pain that stems from?

Answer 3

• dental
• oral
• masticatory
• elsewhere

Question 4

Orofacial Pain - overview

Answer 4

look at slide and be able to recognize these *

Question 5

Classification of Orofacial Pain

Answer 5

Somatic

Neuropathic

Question 6

Somatic Pain

- definition

Answer 6

Pain orginating in any body structure other than neurogenous structures

Question 7

inflamation with somatic pain? and what happens to central inhibitory control?

Answer 7

inflammation increases the receptivity of the neural structures

reduction in central inhibitory control will increase pain sensation

Question 8

Somatic pain breakdown

Answer 8

Superficial pain

Deep pain

Question 9

superficial somatic pain - general

Answer 9

the superficial surface of the body is richly innervated with receptors and sensory fibers of different types

Question 10

superficial somatic pain clinical characteristics

Answer 10

• bright stimulating quality
• excellent localization
• the site of the pain identifies the correct localization of its source
• response to provocation at the site of pain is faithful in incidence, intensity, and location

Question 11

breakdown of the superficial pain (from somatic) and examples

Answer 11

mucogingival - like aphatea (oral lesion in mouth or at base of gum) and cutaneous - like a skin ulcer

Question 12

deep somatic pain

Answer 12

sensory innervation of the deeper structures of the body supplies the somatosensory cortex with constant inflow of information monitoring all the internal functioning of the body

Question 13

deep somatic pain clinical characteristics

Answer 13

dull, depressing quality
subjective localizaton of pain is variable and diffuse
site of pain may or may not be the correct localization of its true source

Question 14

breakdown of deep somatic pain

Answer 14

muscoloskeleton and visceral

Question 15

musculoskeletal pain

Answer 15

branch of deep somatic pain

relates to biomechanical function
protective contraction
gradual response

Question 16

visceral pain

Answer 16

branch of deep somatic pain
no relation to biomechanical function
is not usually felt until the threshold is reached

Question 17

muscle is what type of pain

Answer 17

muscoloskeletal (deep somatic)

Question 18

TMJ is what type of pain?

Answer 18

muscoloskeletal (deep somatic)

Question 19

Periodontal is what type of pain?

Answer 19

muscoloskeletal (deep somatic)

Question 20

Pulpal is what type of pain?

Answer 20

Visceral pain (deep somatic pain)

Question 21

neuropathic pain

Answer 21

neuropathic pain are those that are generated within the nervous system itself

Question 22

in neuropathic pain - is stimulation of receptors and nerve fibers necessary?

Answer 22

no this is unnecessary - neuropathic pains are those that are generated within the nervous system itself

Question 23

general branches of neuropathic pain

Answer 23

episodic pain and continous pain

Question 24

breakdown of episodic pain

Answer 24

Paroxismal neuralgia –> trigeminal neuralgia and glossopharyngeal neuralgia

Question 25

episodic neuropathic pain

Answer 25

from neuropathic pain - characterized by periods of very intense pains follow by total remission

1. patient is able to localize the site of pain
2. the site does not identify the correct source
3. response to provocation at the site of pain s unfaithful

Question 26

paroxysmal neuralgia

Answer 26

branch of episodic
is characterized by sudden burst of electric-like pain that projects heterotopically along the course of a nerve.
1. presents at a peripheral site on the face, that when lightly touched triggers the paroxysmal pain
2. unilateral location

Question 27

continuous neuropathic pain

Answer 27

continous neuropathic pain presents as an ongoing, unremiting pain condition

1. may have some fluctuating in intensity but no periods of total remision
2. will show enlargment of the receptive field and diminished central inhibitory activity
3. secondary to trauma or some other damage to the neuron

Question 28

neuritis and examples

Answer 28

pain is manifested as an ongoing, unremitting, burning sensation in the peripheral distribution of the affected nerve

*the assumed cause is an inflammatory process along the course of a nerve trunk secondary to traumatic, bacterial, viral, or toxic causes

• peripheral neuritis
• herpes zoster

Question 29

psychological conditions

Answer 29

mood disorders, bipolar disorders, depressive disorders

Question 30

mood disorders

Answer 30

type of psychological conditions
mental disorders that are characterized by disturbances in the patients mood

bipolar
depressive
mood disorders due to medical conditions
anxiety

Question 31

bipolar disorders

Answer 31

type of physiological mood disorder

are characterized by alternating anic and depressive periods

Question 32

depressive disorders

Answer 32

type of psychological conditions - mood disorder

characterized by markedly diminished interest or pleasure in activities most of the day

Question 33

mood disorder due to medical condition

Answer 33

psychological condition - due to a medical condition
- characterized by patients who experience a prominent and persistent disturbance in mood that is a direct psychological consequence of a general medical condition

Question 34

musculoskeletal pain relates to what??

Answer 34

biomechanical function
protective contraction
gradual response