Oral med - idiopathic orofacial pain Flashcards
describe idiopathic orofacial pain
unilateral or bilateral intraoral or facial pain in the distribution of one or more branches of the trigeminal nerve for which the aetiology is unknown
what are symptoms of idiopathic orofacial pain?
the pain is usually persistent, of moderate intensity, poorly localised and described as a dull, pressing or of burning character
what are 3 types of idiopathic orofacial pain?
persistent idiopathic facial pain
persistent idiopathic dentoalveolar pain
burning mouth syndrome
what are the basic features of idiopathic orofacial pain?
daily pain
>2 hours duration per day
for >3 months
no apparent abnormality to account for symptoms
what are conventional analgesics for idiopathic orofacial pain?
paracetamol
NSAIDs
opioids usually ineffective
what are conditions related to idiopathic orofacial pain?
chronic pain elsewhere in the body
current/ past contact with pain services
depression/ anxiety
what medications are associated with idiopathic orofacial pain?
analgesics/ neuromodulators e.g., amitriptyline
may be overusing over the counter analgesics, abusing tobacco, alcohol or drugs to escape from pain
what are psychosocial aspects of idiopathic orofacial pain?
stress
anxiety
depression
mental health issues
significant life events
social isolation
cancerphobia
what is the role of the GDP in idiopathic orofacial pain?
good pain history
exclude dental causes
check cranial nerves, urgent referral if any abnormalities
refer
what are other names for burning mouth syndrome?
oral dysaesthesia
glossodynia (only tongue affected)
describe burning mouth syndrome?
intraoral burning or dysaesthetic sensation, recurring daily for more than 2 hours per day for more than 3 months, without evident causative lesions on clinical examination and investigation
what is the diagnostic criteria for burning mouth syndrome?
a. oral pain fulfilling criteria B and C
b. recurring daily for >2 hours per day for >3 months
c. pain has both of the following characteristics:
1. burning quality
2. felt superficially in the oral mucosa
d. oral mucosa is of normal appearance, and local or systemic causes have been excluded
e. not better accounted for by another ICOP or ICHD-3 diagnosis
there may be accompanying taste disturbance
what is the incidence of burning mouth syndrome?
1-15% general population
18-33% post menopausal women
F>M 3:1
where are the sites of burning mouth syndrome?
tongue
palate
lips
what would you find on examination of burning mouth syndrome?
NAD - no mucosal abnormality to account for symtpoms
