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DEN2025 - Dental Public Health and Behavioural Science > Pain and Pain Management > Flashcards

Pain and Pain Management Flashcards

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1
Q

What are 2 reasons pain is necessary?

A
  1. Protects an individual from harm

2. Helps healing

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2
Q

Name 4 types of pain

A
  1. Neuroplastic
  2. Neuropathic
  3. Inflammatory
  4. Nociceptive
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3
Q

What is neuroplatic pain?

A

Nervous system sensitisation pain

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4
Q

What is neuropathic pain?

A

Nerve injury pain

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5
Q

What is inflammatory pain?

A

Tissue injury pain

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6
Q

What is nociceptive pain?

A

Early warning of pain

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7
Q

Name 2 theories of pain

A
  1. Gate Control Theory (Melzack and Wall, 1965)

2. Neuromatrix Theory (Melzack, 2001)

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8
Q

Describe the gate control theory of pain

A
  • Spinal central sensitisation and CNS plasticity
  • Pain is processed in integrated matrix throughout neuroaxis
  • Pain controlled by gate at spinal cord and brain by interference with perception of pain
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9
Q

Describe the neuromatrix theory of pain

A
  • Pain is multidimensional experience produced by the “body-self neuromatrix” in the brain
  • May be set of by sensory inputs or independent of them
  • Useful in understanding chronic pain
  • Neuromatrix is genetically determined by also modified by sensory experienced
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10
Q

Describe the gate in the gate control theory of pain

A
  • Neural gate through which pain signals pass
  • Gate can be opened or closed in response to pain
  • Gate responds to nerve signals from site, brain and peripheral neural activity
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11
Q

What are nociceptors?

A

Specialized receptors in skin and internal organs sensitive to painful stimuli

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12
Q

What is nociception?

A

Response of the nervous system to painful stimuli

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13
Q

What size are nociceptive fibres?

A

Small

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14
Q

What is the main advantageous evolution of nociceptive pain reception?

A
  • The system can block pain from an injury so delay onset when it is advantageous e.g. attack / accident
  • Cognitive mechanisms can inhibit reflex loop
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15
Q

What are 3 features of the psychology of the gate control theory of pain?

A
  1. Pain is perception and experience rather than simple physical sensation
  2. Role of the individual is reflected in the degree of pain experienced
  3. The individual does not passively respond to painful stimuli but interprets and appraises stimuli
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16
Q

Name 2 physical conditions which open the neural gate

A
  1. Extent of the injury

2. Inappropriate activity levels

17
Q

Name 2 physical conditions which close the neural gate

A
  1. Medication

2. Counter-stimulation e.g. massage

18
Q

Name 3 emotional conditions which open the neural gate

A
  1. Anxiety
  2. Tension
  3. Depression
19
Q

Name 3 emotional conditions which close the neural gate

A
  1. Positive emotions
  2. Relaxation
  3. Rest
20
Q

Name 2 mental conditions which open the neural gate

A
  1. Focusing on pain

2. Boredom

21
Q

Name 2 mental conditions which close the neural gate

A
  1. Intense concentration / distraction

2. Involvement in life activities

22
Q

Name 3 signals which affect the neural gate’s ability to open or close

A
  1. Nociceptor activity opens gate
  2. Large sensory nerves cause gate to be closed
  3. Messages from the brain
23
Q

What 4 variables can affect a person’s perception of pain?

A
  1. Genetic
  2. Environmental
  3. Psychological
  4. Cognitive
24
Q

What is the difference between psychological and cognitive variables?

A

Emotion is a psychological variable whereas attention, beliefs and expectations are cognitive variables

25
Q

How can pain expectations influence pain felt?

A

Pain is influenced by expectations of both pain intensity of stimuli and effect of treatments

26
Q

What is the definition of pain?

A

Unpleasant sensory and emotional experience associated with actual or potential tissue damage or describes in terms of such damage

27
Q

What are 3 types of pain, classified by their duration?

A
  1. Acute (short term)
  2. Recurrent / Intermittent (comes and goes)
  3. Persistent / Chronic (long term)
28
Q

What are 3 characteristics of acute pain?

A
  1. Results from disease, inflammation or injury to tissues
  2. Comes on suddenly and may be accompanied by anxiety or emotional distress
  3. Usually diagnosed and treated, and self-limiting
29
Q

What are 4 characteristics of chronic pain?

A
  1. Persists over a longer period of time than acute pain
  2. Can be made worse by environmental and psychological factors
  3. Often resistant to medical treatments
  4. Can cause severe problems for patients
30
Q

What are 4 new problems that can be caused by chronic pain?

A
  1. Change of posture
  2. Reduced mobility
  3. Anxiety / depression
  4. Unresolved pain re-wires brain causing more pain
31
Q

What is the alternative to pain being immeasurable?

A
  • Use patient’s own description
  • Word definitions e.g. sharp / dull may give best clues to cause
  • Pain history
  • Observational skills
32
Q

What are 5 parts of a pain history?

A
  1. Site, quality and radiation
  2. Factors aggravating / relieving pain
  3. Frequency of pain throughout the day
  4. Impact of pain on function / mood
  5. Patient’s understanding of pain
33
Q

What is the pain stress cycle?

A
  • An event is associated with pain
  • Perception of pain creates anxiety
  • Anxiety increases actual pain experience
  • Pain experience increases future anxiety
  • Higher anxiety increases pain experience further
34
Q

Describe pain hyper vigilance

A
  • People with vigilant tendencies tend to experience more pain
  • Inability to disengage from pain experience amplifies intensity
  • Focusing on pain, pain levels will get worse
  • Distracting someone’s attention away from pain is difficult
35
Q

Name 5 things which experience of pain depends on

A
  1. Context
  2. Attention
  3. Anxiety
  4. Learned pain
  5. Expectations
36
Q

What are 5 types of dental pain?

A
  1. Toothache
  2. Gum infection
  3. Jaw disorders
  4. Burning Mouth Syndrome
  5. Orofacial Neuropathy
37
Q

What are 3 characteristics of TMJ disorder?

A
  1. Painful jaw
  2. Clicking noises
  3. Facial pain
38
Q

Name 4 methods of pain relief in the dental surgery

A
  1. Pharmacological pain relief
  2. Sedation
  3. Reduced anxiety
  4. Distraction
39
Q

What may happen if a patient presents with persistent severe pain with no clinical or radiographic abnormalities?

A

The patient can be referred for psychological assessment or specialist

DEN2025 - Dental Public Health and Behavioural Science (25 decks)

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