Oral Medicine Flashcards
What term describes orofacial pain attributed to lesion or disease of the cranial nerves?
Trigeminal neuralgia
What is the term given to small, very slightly raised yellow/white sebaceous glands which become prominent on the mucosa with age?
Fordyce spots
What papillae is hyperplastic and affected in black hairy tongue?
Filiform papillae
What type of mouthwash can induce black hairy tongue?
Chlorohexidine mouthwash
Define, a group of conditions affecting the TMJ and/or the muscles of mastication.
TMD
At what age range is TMD at peak incidence?
18 to 44 years of age
What are the common sites for pain associated with TMD?
Jaw
Ear
In front of ear
temple
What brings about TMD pain?
- Jaw movement
- Function
- Parafunctional habits
What muscles should be examined upon TMJ examination?
Masseter and temporalis
How would you palpate the temporalis muscle?
Ask patient to clench
Palpate along muscle
How would you palpate the masseter muscle?
Bimanual palpation
What are three common co-morbidities of TMD?
- Fibromyalgia
- Chronic pain
- Psychological factors (e.g. stress, anxiety)
What are three common intra-oral signs of bruxism/ clenching associated with TMD?
- Ridging buccal mucosa at level of occlusal plane
- Scalloping of borders of tongue
- Tooth wear
What are the two types of pain related TMD’s?
- Myalgia
- Arthralgia
What are the 6 types of intra-articular TMD’s?
- Disc displacement with reduction
- Disc displacement with reduction with intermittent locking
- Disc displacement without reduction with limited opening
- Disc displacement without reduction without limited opening
- Degenerative joint disease
- Subluxation
Which type of intra-articular TMD only allows very limited Jaw opening and why?
Disc displacement without reduction, as disc does not reduce into glenoid fossa upon opening
Define, a degenerative disorder involving the joint characterised by deterioration of the articular tissue with concomitant osseous changes in the condyle and/or articular eminence.
Degenerative joint disease
What sound is often associated with palpation if the patient has degenerative joint disease?
Crepitus
Define, where a patient is able to manoeuvre locked anterior displaced disc back into its position within the condyle.
Subluxation
Define, where assistance of a clinician is required to be able to manoeuvre locked anterior displaced disc back into its position within the condyle.
Luxation
What medication can be prescribed for conservative management of TMD accompanied by muscle spasm or disc displacement without reduction with limited opening?
Diazepam 5 day course
If a patient has a white patch on their buccal sulcus that can not be wiped off, what is your provisional diagnosis?
Epithelial hyperkeratosis
Define, pain attributed to a lesion or disease of the trigeminal nerve.
Trigeminal neuralgia OR Painful trigeminal neuropathies
Define, pain attributed to a lesion or disease of the Glossopharyngeal nerve.
Glossopharyngeal neuralgia OR painful Glossopharyngeal neuropathies
What is trigeminal neuralgia?
A disease characterised by recurrent unilateral brief electric shock-like pains limited to the distribution of one or more divisions of the trigeminal nerve.
What is the diagnostic pain criteria for trigeminal neuralgia?
Pain with all following characteristics:
1. Lasting from a fraction of a second to 2 minutes
2. Severe intensity
3. Electric shock-like, shooting, stabbing or sharp in quality.
What is the common age group to experience trigeminal neuralgia?
50-60 years old
What are the three types of trigeminal neuralgia?
- Classical TN
- Secondary TN
- Idiopathic TN
What causes classical trigeminal neuralgia?
Neurovascular compression (causes morphological changes in trigeminal nerve)
What is the cause of secondary trigeminal neuralgia?
Underlying disease
Name two underlying diseases likely to be associated with trigeminal neuralgia?
- Multiple sclerosis
- Space occupying lesion
What patients typically present with secondary TN and what characteristics are usually present?
Patients tend to be younger (<30 years), have trigeminal sensory deficits (e.g. tingling or complete numbness), have bilateral TN.