Pain history Flashcards
When taking a pain history, what does S mean in socrates?
Site - where about’s in the mouth is the pain?
When taking a pain history, what does O mean in socrates?
Onset:
• When did the pain start?
• Is the pain spontaneous or stimulated? eg: provoked by stimuli (hot/cold/sweet)
When taking a pain history, what does C mean in socrates?
Character: what does the pain feel like?
• Sharp (usually sign of decay/crack/fracture)
• Dull/throbbing (could be sign of bacterial infection to periodontal/periapical tissues
When taking a pain history, what does R mean in socrates?
Radiation: does the pain spread to other areas?
When taking a pain history, what does A mean in socrates?
Associated factors:
• swellings?
• sinus?
• systemic involvement (fever/bad breath/bad taste)
When taking a pain history, what does T mean in socrates?
Timing:
• how long does the pain last? (seconds/hrs/minutes)
• worse at particular time of day?
• does it keep you awake at night?
When taking a pain history, what does E mean in socrates?
Exacerbating/relieving factors?
• Does anything make it better or worse?
• Are you taking painkillers? Do they help?
When taking a pain history, what does the last S mean in socrates?
Severity: on a scale of 1-10 how bad is the pain?
What are the 3 sources of dental pain?
dentinal tubular fluid flow
raised pulpal pressure
periodontal inflammation
What can cause exposure of dentinal tubules can cause sensitivity?
Gingival recession
Caries
Trauma
Erosion, abrasion, attrition
What are some features of reversible pulpitis?
- sharp pain
- lasts a few seconds
- worse with hot/cold/sweet foods
What are some features of irreversible pulpitis?
- spontaneous dull pain
* pain lasts several mins
Why can a restoration not treat irreversible pulpitits?
the pulp will remain inflamed and continue to cause pain
If the pain is keeping the pt up at night it would likely indicate which type of pulpitits?
Irreversible
If pain killers help which type of pulpitis is it likely to be?
Reversible
If cold drinks alleviate the pain which type of pulpitis is it likely to be?
Irreversible
If irreversible pulpitis is left untreated, what can it progress to?
pulpal necrosis
What has happened to the infection in acute apical periodontitis?
the bacteria will travel to the periapical tissues
Why would a pt get pain on biting with acute apical periodontitis?
periodontal ligament is inflamed and biting stimulates the pain and pressure sensitive fibres in the area
What happens if toxins are leached through the apex?
causes a chronic inflammatory response which leads to bone resorption
(may be seen as apical radiolucency)
If symptomatic apical periodontitis is left to progress, what can it become?
chronic apical periodontitis
(chronic inflammation and destruction of the periodontium)
• visible on x-ray as larger well defined radiolucency
–> can become symptomatic apical periodontitis again!!
Once an infection has the potential to go through the apex what can form?
Abscess (pus filled swelling which can cause severe, spontaneous pain and extreme tenderness to touch)
Why does abscess cause pain?
it is causing there to be a lot of pressure in the area which is why draining the abscess can lead to pt feeling less pain
Why does abscess cause pain?
it is causing there to be a lot of pressure in the area which is why draining the abscess can lead to pt feeling less pain
what are some features of dentine hypersensitivity?
• short sharp pain
• worse with hot/cold/sweet things
• hard to locate
• only present when stimulus is present
look for exposed dentine (lost restorations, gingival recession or fractured teeth)
• tooth should be +ve to tests and not TTP
