Lecture 11: Odontogenic & Non-odontogenic pain

Question 1

Where people perceive their pain:

Answer 1

Site of the pain

Question 2

The location of pathophysiologic process giving rise to the pain (may to may not be in the same region):

Answer 2

Source of the pain

Question 3

The attribution of pain to an anatomic region that is different from the location of the etiologic process:

Answer 3

referred pain

Question 4

Two types of pain that occur in our patients:

Answer 4

1. odontogenic
2. non-odontogenic

Question 5

an unpleasant sensory and emotion experience associated with, or resembling that associated with, actual or potential tissue damage:

Answer 5

pain

Question 6

Pain arising from activation of nociceptors:

Answer 6

nociceptive pain

Question 7

Pain arising as a direct consequence of a lesion or disease affecting the somatosensory system:

Answer 7

neuropathic pain

Question 8

Tooth pain:

Answer 8

odontogenic pain

Question 9

Non-tooth pain:

Answer 9

non-odontogenic pain

Question 10

Non-odontogenic pain is pain resulting from:

Answer 10

non-dental structures

Question 11

List the characteristics of odontogenic pain:

1. originates from _____ or surrounding _____
2. originates from a ______
3. has a typical _______
4. direct testing and manipulation usually ____

Answer 11

1. tooth or surrounding periodontal structures
2. dental pathology
3. dental history profile of endo or perio pathology
4. reproduces symptoms

Question 12

What must FIRST BE RULED OUT before considering other causes when a patient comes in with tooth pain?

Answer 12

Pulpal/periapical origin

Question 13

What fibers are found in pulpal nociceptors?

Answer 13

A-beta
A-delta
C-fibers

Question 14

List the types of nociceptors that can all be responsible for pulpal/periapical tooth pain:

Answer 14

1. pulpal nociceptors
2. periapical nociceptors
3. osseous nociceptors
4. sinus nociceptors

Question 15

Tooth pain of pulpal/periapical origin is mitigated by treatment & medication. Give some examples:

Answer 15

1. pulpotomy
2. pulpectomy
3. I&D to drain abscess
4. Analgesics for pain
5. Antibiotics for infection (with swelling & fever)

Question 16

When would antibiotics be given to a patient with pulpal/periapical tooth pain?

Answer 16

When swelling & fever are present

Question 17

Due to convergence of multiple primary AFFERENT nerve fibers into a SINGLE SECOND ORDER PROJECTION FIBER in the medullary horn

Answer 17

Referred pain

Question 18

Due to 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):

Answer 18

Hypersensitivity

Question 19

Pain to what would normally be a non-painful stimulus:

Answer 19

allodynia

Question 20

Maxillary molar pain causing pain in mandinunlar tooth and jaw is an example of:

Answer 20

referred pain

Question 21

Exaggerated cold response, other teeth also very sensitive to percussion and pulpal testing are all examples of:

Answer 21

Hypersensitivity

Question 22

Severe percussion sensitivity is an example of:

Answer 22

Allodynia

Question 23

Adjacent tooth percussion sensitivity is an example of:

Answer 23

Allodynia

Question 24

Sun burn sensitivity is an example of:

Answer 24

allodynia