Non Odontogenic Facial Pain Flashcards
List some differential diagnosis of oro facial pain
- Reversible/irreversible pulpitis
- Chronic apical periodontitis
- Dry socket
- Denture pain or sensitivity
- Maxillary sinusitis
- Pericoronitis
- Persistent idiopathic facial pain
- Atypical odontalgia
- Post traumatic neuopathy
- Trigeminal neuralgia
- Giant cell temporal arteritis
- Chronic tension headache or migraine
- Glossopharyngeal neuralgia
Describe the signs and symptoms of reversible pulpitis
- Well localised to a tooth
- Lasts 10-30 mins after sugar
- Sharp stabbing throbbing dull
- Mild to severe pain
Describe the signs and symptoms of irreversible pulpitis
- Poor localisation intraorally
- Pain last intermittently for hours
- Mild full or throbbing pain
- Occasionally set off my heat or laying down
What might be seen intraorally in a patient with reversible pulpitis
Caries in tooth
What might you see intraorally in a patient with irreversible pulpitis
Large restoration or caries with TTP
Describe the signs and symptoms of a patient with chronic apical periodontitis
- Pain poorly localised
- Pain last intermittent for mins to hours
- Mild, dull or throbbing pain
What might you see intra orally in a patient with chronic apical periodontitis
Gingivitis Large restoration Sinus may be visible Base taste Affected tooth TTP
Describe the signs and symptoms of a patient with periodontitis
- generalised or localised pain
- pain last intermittent for mins to hours
- Mild, dull or throbbing pain
What might we see inter orally in a patient with periodontitis
- Mobile teeth
- Gingival recession
- Poor OH
Describe the signs and symptoms of dry socket
- Localised pain intra orally
- Pain is continuous and throbbing
- Severe pain
What might we see intraorally in a patient with dry socket
- Touching or pressure on extraction socket
- Trismis
- Swelling
- Unhealed socket with exposed bone
Describe the signs and symptoms of denture pain
- Localised intraorally
- Pain is daily and intermittent
- Pain may be aching or sharp over mental nerve
What might we see intra orally in a patient with denture pain
- Often redness
- Ulceration I’m area of pressure
Describe the signs and symptoms of denture sensitivity
- Localised area of exposed dentine
- Pain lasts second/mins
- Sharp pain
What might we see intra orally in a patient with denture sensitivity
Defects at dental enamel junction
Describe the signs and symptoms of maxillary sinusitis
- Pain or discomfort over maxillary antrum
- Zygomatic and dental tenderness
- Continuous pain
- Dull ache
- Patient may sense fullness in cheeks
What might we see intra orallly in a patient with maxillary sinusitis
- Purple to secretions
- Recent URTI that cleared and retuned
- Rhinorrhoea
- Tooth in antrum
Describe the signs and symptoms or pericoronitis
- Pain localised to a partially erupted tooth (usually 8)
- Continuous pain
- Dull ache that becomes throbbing as worsens
- Eating chewing affexted
What might be see intraorally in a patient with pericoronitis
- Limited mouth opening
- Trismus
- Soft tissue erythema
- Presence of operculum around affected tooth
Describe the signs and symptoms of persistent idiopathic facial pain
- Usually unilateral
- Deep and poorly localised
- Continuous pain
- Nagging aching dull pain occasionally sharp at time
What can we also see in a patient with persistent idiopathic facial pain
- Chronic widespread pain
- HA
- Back pain
- Anxiety and depression
- Stress and fatigue
How common is persistent idiopathic facial pain
Rare
Describe the signs and symptoms of atypical odontalgia
- Localised pain to a specific dentoalveolar site
- Persistent pain
Describe the signs and symptoms of post traumatic neuropathy
- Continuous pain
- Burning shock like pain
- Pricking, tingling, pins and needles
- moderate severity
Describe the signs and symptoms of trigeminal neuralgia
- Episodic pain lasting seconds to minutes
- Sharp, shooting electric pain
- Moderate to severe pain
Describe the signs and symptoms of atypical trigeminal neuralgia
- Sharp attacks for seconds to minutes
- Constant background pain with little remission
- Sharp shooting pain
- Moderate to severe
- Burning continuous mild background pain
Describe the signs and symptoms of Glossopharyngeal neuralgia
- Episode of pain lasts for seconds to 2 mins
- Sharp stabbing pain
- Severe
Describe the signs and symptoms of postherpetic neuralgia
- Continuous pain
- Burning, testing, itching
- moderate pain
Describe the signs and symptoms of giant cell arthritis
- Pain may be bilateral mostly over temporal areas
- Continuous new sudden onset
- Aching, throbbing sharp pain
- Moderate to severe
What might be see systemically in a patient with giant cell arthritis
- Neck pain
- Anorexia
- Visual symptoms
- Scalp tenderness
- Systemic symptoms
- Decreased pulse in temporal artery
Describe the signs and symptoms of recurrent oral ulcerations
- Pain Localised to areas of ulceration
- intermittent pain that lasts for hours
- Sharp, stabbing of throbbing
Describe the signs and symptoms of burning mouth syndrome
- Pain in tip and lateral borders or tongue
- Continuous pain
- Burning tender tiring nagging pain
- Pain varies in intensity
- Dry mouth
