Odontogenic and Non-odontogenic pain

Question 1

Site of the pain

Answer 1

Where people sense their pain

Question 2

Source of the pain

Answer 2

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

Question 3

Referred pain

Answer 3

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

Question 4

Pain

Answer 4

An unpleasant sensory and emotional
experience associated with, or resembling that
associated with, actual or potential tissue
damage

Question 5

Nociceptive
Pain

Answer 5

Pain arising from activation of nociceptors

Question 6

Neuropathic
Pain

Answer 6

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

Question 7

as emergency treatments for teeth having signs of irreversible pulpitis, pulpotomy, partial pulpectomy and total pulpectomy were comparable with respect to relieving clinical symptoms. — may be preferred because it requires significantly less time and is a simple technique that relieves symptoms quickly and effectively

Answer 7

pulpotomy

Question 8

can pain be achieved by a single drug method ?

Answer 8

not without significiant side effects

Question 9

effect of NSAIDs (?)

Answer 9

1.Vasoconstriction
2.Inhibition of
depolarization
3. Analgesic effect

Question 10

COLD-INDUCED
NEURAPRAXIA

Answer 10

ANTI EDEMA
EFFECT
10ºC
4 MINUTES

Question 11

Diagnostic yield of conventional radiographic and cone-beam computed
tomographic images in patients with atypical odontalgia
PERSISTENT INTRAORAL PAIN
— increased the amount of detected osseous destructive lesions

Answer 11

CBCT

Question 12

A nonodontogenic
toothache has a
source of pain that
is

Answer 12

not the tooth the
patient has
indicated

Question 13

—% OF PAIN “resolved with endo”

Answer 13

90

Question 14

–% persistent pain
- –% untreated canals, fractures, persistent infection
- –% neuropátic, neurovascular… etc.

Answer 14

10
5
5

Question 15

Non-dental Pain?
* —% (44 / 78) of cases with persistent pain had a nondental cause Meta analysis, 10 articles 1125 teeth, 78 with persistent pain

• —% (39 / 63) cases with persistent pain
  had a non-dental cause

Answer 15

56
62

Question 16

6-month period
–% of Americans
experienced at least one
of five types of facial pain
–% was
toothache

Answer 16

22
12.2

Question 17

Peripheral Sensitization

Answer 17

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

Question 18

Central Sensitization

Answer 18

Increased responsiveness of nociceptive neurons in
the central nervous system to their normal or
subthreshold afferent input

Question 19

Heterotopic Pain
(3)

Answer 19

Any pain that is felt in an area other than its true source is
heterotopic pain.
Cannot be provoked by stimulation of the area where the pain is felt.
Cannot be arrested unless the primary source of pain is anesthetized

Question 20

types of pain (4)

Answer 20

TMD, muscle pain
Neuropathic (Neuritis,
Neuroma, Neuralgia)
Referred pain (sinusitis,
cancer)
Neurovascular

Question 21

PTS REPORTING TOOTH PAIN 6 mo after RCT had a nonodontogenic pain dx accounting for some of this pain, with — being the most frequent nonodontogenic dx

Answer 21

TMD

Question 22

Myofascial pain (MFP) emanates from

Answer 22

small foci of hyperexcitable
muscle tissue

Question 23

Clinically these areas feel like

Answer 23

taut bands or knots and are termed
trigger points.

Question 24

The pain is described as

Answer 24

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

Question 25

Another potentially misleading characteristic of masticatory muscle
pain is that patients may report pain when

Answer 25

chewing

Question 26

Muscle relaxants

Answer 26

(ciclobenzaprine/flexeril) every 24 hrs. night!

Question 27

— is a rare type of chronic intractable endodontic pain and that careful dx of – is important

Answer 27

NTP

Question 28

—% get persistent pain,
* Up to —% are severely affected

Answer 28

30
10

Question 29

NEUROPATHIC RED FLAGS
- No apparent —
- — of pain, no improvement
- Does not change with —
- Atypical (2)
- Can’t be (2)
- (2) ineffective
- Doesn’t respond to —

Answer 29

etiology
Migration
time
(Burning, electric shock)
reproduced or provoked
Local anesthesia and analgesics
dental treatment

Question 30

What is persistent post-procedural
pain (PPSP)?
(4)

Answer 30

*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

Question 31

dental tx for patients with neuropathic orofacial pain

Answer 31

Don’t touch them!

Question 32

skipped
Odontogenic sinusitis
3 questions

Answer 32

Should we be diagnosing it?
How often are mucositis and
periodical periostitis
symptomatic?
How fast can these entities
heal?

Question 33

ODS generally requires — to confirm sinusitis and dental providers to confirm —

Answer 33

otolaryngologists
maxillary odontogenic pathology

Question 34

Paroxysmal Hemicrania
— Female: Male
Onset — years old
Severe unilateral orbital, supraorbital, and or
temporal pain lasting —

Answer 34

2:1
20-30
10 to 30 minutes

Question 35

HA is accompanied by at least one of the following
(5)

Answer 35

1.Ipsilateral conjuctival injection and/or lacrimation
2.Ipsilateral nasal congestion and/or rhinorrhoea
3.Ipsilateral eyelid edema
4.Ipsilateral horehead and facial swelling
5.Ipsilateral miosis and/or ptosis

Question 36

CLUSTER
— Male: Female
Onset — years old
Severe unilateral orbital, supraorbital, and or
temporal pain lasting

Answer 36

3:1
20-29
15 to 180 minutes if untreated

1.Ipsilateral conjuctival injection and/or lacrimation
2.Ipsilateral nasal congestion and/or rhinorrhoea
3.Ipsilateral eyelid edema
4.Ipsilateral horehead and facial swelling
5.Ipsilateral miosis and/or ptosis
6.Sense of restlessness or agitation

Question 36

Cluster-Unilateral pain

Answer 36

patients dont want to sleep
+ nasal liquid discharge
+ tears