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Endo II > L10 - Odontogenic and Non odontogenic pain > Flashcards

L10 - Odontogenic and Non odontogenic pain Flashcards

1
Q

what is odontogenic pain

A
  • tooth pain
  • originates from tooth or surrounding periodontal structures
  • originates from a dental pathology
  • has a typical dental history profile of endo or perio pathology
  • direct testing and manipulation usually reproduces symptoms
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2
Q

what are the pulpal nociceptors

A
  • A-beta
  • A- delta
  • C fibers
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3
Q

where are the nociceptors located

A
  • periapical
  • osseous
  • sinus nociceptors
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4
Q

how is tooth pain mitigated

A
  • treatment and medication
  • pulpotomy, pulpectomy
  • I and D to drain abscess
  • analgesics for pain
  • AB for infection with swelling/fever
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5
Q

what is referred pain caused by

A

the convergence of multiple primary afferent nerve fibers into single second order projection fiber in the medullary horn

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6
Q

what is hypersensitivity due to

A

an increase in local neural activity or due to increased stimulation (reduced threshold) of secondary nerve fibers centrally due to a barrage of primary fiber stimulation (central sensitization)

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7
Q

what nerve transmits tooth pain

A

the trigeminal nerve

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8
Q

what is allodynia

A

pain to what would normally be a non painful stimulus

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9
Q

where can referred pain be found

A

maxillary molar pain referred to mandibular tooth and jaw

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10
Q

what are examples of hypersensitivity

A
  • exaggerated cold response
  • other teeth also very sensitive to percussion
  • pulpal testing
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11
Q

what are examples of allodynia

A
  • severre percussion sensitivity
  • adjacent tooth percussion sensitivtiy
  • sun burn sensitivity
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12
Q

what is the tx for abscessed teeth

A

pulpectomy
- Ca(OH)2
- I and D

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13
Q

what is the prescription for analgesics

A
  • IBU 400mg q6h
  • acetominophen 1000mg q6h
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14
Q

what is the “triple whammy” in primary care

A

ACE inhibitor/ARB + diruetic and NSAID

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15
Q

what percentage of pain is resolved with endo

A

90%

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16
Q

what is 10% of persistent pain after endo tx from

A
  • 5% untreated canals, fractures, persistent infection
  • 5% neuropathic, neurovascular
17
Q

apical fenestration may occur in _____ of cases and may be considered an anatomic predisposing factor for:

A

9%; persistent pain after root canal treatment

18
Q

______ of americans have experienced at least one of five types of facial pain

A

22%

19
Q

of the 22% of americans that have experience one type of facial pain ____ was a toothache

A

12.5%

20
Q

what is peripheral sensitization

A

increased responsiveness and reduced thresholds of nociceptors to stimulation of their receptive fields

21
Q

what is central sensitization

A

increased responsiveness of nociceptive neurons in the CNS to their normal or subthreshold afferent input

22
Q

what is heterotopic pain

A

any pain that is felt in an area other than its true source

23
Q

heterotopic pain cannot be provoked by:

A

stimulation of the area where the pain is felt

24
Q

heterotopic pain cannot be arrested unless:

A

the primary source of pain is anesthetized

25
Q

what are the types of non- odontogenic pain

A
  • TMD, muscle pain
  • neuropathic (neuritis, neuroma, neuralgia)
  • referred pain (sinusitis, cancer)
  • neurovascular
26
Q

what is the most common non odontogenic dx

A

TMD

27
Q

myofascial pain emanates from:

A

small foci of hyperexcitable muscle tissue

28
Q

myofascial pain areas feel like:

A

taut bands or knots and are termed trigger points

29
Q

the pain in myofascial pain is described as:

A

diffuse, constant, dull, aching sensation which may lead the clinician to a misdiagnosis of pulpal pain

30
Q

another potentially misleading characteristic of masticatory muscle pain is that:

A

patients may report pain when chewing

31
Q

what is the tx for myofascial pain

A

muscle relaxants every 24 hours at night
- cyclobenzaprine/flexeril

32
Q

______ get persistent pain after surgical procedures, and up to ____ are severely affected.

A

30%; 10%

33
Q

what are the neuropathic red flags

A
  • no apparent etiology
  • migration of pain, no improvement
  • does not change with time
  • atypical (burning, electric shock)
  • cant be reproduced or provoked
  • local anesthesia and analgesics ineffective
  • doesnt respond to dental treatment
34
Q

what is persistent post procedural pain

A
  • consequence of surgery
  • lasts at least 2 months
  • no other explanation for pain
  • not a continuation of preexisting chronic pain condition for which the surgery was performed
35
Q

what can referred pain be from

A

sinusitis or cancer

36
Q

to dx ODS:

A

otolaryngologists should confirm sinusitis mainly based on nasal endoscopic findings

37
Q

what are the causes of physical damage to the nerve

A
  • post herpetic nerve damage
  • post surgical nerve damage
  • post traumatical event nerve damage
38
Q
A

Endo II (11 decks)

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