Odontogenic vs Non-odontogenic Toothaches

Question 1

Odontogenic Toothache

Answer 1

• Pain felt in offending tooth
  
  • local provocation ⇡
  • might be referred pain
• LA of offending tooth eliminates everything (Tooth pain and referred)

Question 2

Non-Odontogenic Toothache

Answer 2

• Pain not in offending tooth (Felt in other tooth)
  
  • not increased by local provocation
  • referred from other adjacent structure
• LA of offending tooth does not eliminate
  
  • at different location (primary source) eliminates

Question 3

Pulpal Pain

Answer 3

• Dull, achy, throbbing, occasionally sharp (Depends on pulp condition)
• unilateral
• Pain gets better or worse
• easy to provoke w/thermal test

Question 4

Periodontal Pain

Answer 4

• Dull, aching, occasionally throbbing
• Pain increased with loading
• easy to provoke w/percussion

Question 5

Myofascial Toothache

Answer 5

• Non-odontogenic TA
  
  • most prevalent
• ⇡ Pain with:
  
  • muscle movement
  • Palpate trigger point

Question 6

Sinus/Nasal Mucosal Toothache

Answer 6

• Maxillary Posterior teeth
• Increased pain when:
  
  • lowering head
  • pressure to involved sinus
• Diagnostic tooth
  
  • intranasal lidocaine spray

Question 7

Neurovascular Toothache

Answer 7

• Migraine
  
  • Maxillary premolar or canine
  • comes after episodes
  • Photophobia
    
    • phonophobia
    • N&V
• Trigeminal Autonomic Cephalgia (TAC)
  
  • Maxillary Premolar or canine
  • Cyclical Pain
    
    • same time each day
  • Pulsating
    
    • resembles pulpal pain

Question 8

Episodice Neuralgic Toothache

Answer 8

• Trigeminal Neuralgia
  
  • Severe pain
  • Episodic
    
    • lasts 5-10 seconds
  • Provoked by trigger zone
• Glossopharyngeal Neuralgia
  
  • Unilateral
  • in throat, ear, jaw, tooth
  • provoked by swallowing, chewing, talking

Question 9

Continuous Neuralgic Toothache

Answer 9

• result from:
  
  • physical, chemical or thermal trauma
• Middle Aged F=most common
• Max molars & premolars
• Location changes but same nerve

Question 10

Cardiac Toothache

Answer 10

• Referred Pain
  
  • caused by ischemic heart disease
  • tight, burning, pulsates at times
• Hx of cardiovascular disease
• associated with pain in:
  
  • chest
  • anterior neck
  • throat
  • shoulder
• Aggravated by exercise
  
  • improved by rest
• Sublingual Nitroglycerin: ⇣ pain

Question 11

Psychogenic Toothache

Answer 11

• No source
  
  • no response to dental tx
• Chronic
  
  • changes locations and intensity
• Last diagnosis