Pain history Flashcards
Explain how you would take a history for a pt in pain
- Introduce yourself
- Explain
I’m going to ask a few questions about the pain you’ve been having to give me a better idea of what might be causing it and how we can help you, is that ok? - SOCRATES
Site- Where is the pain coming from? Can you point to it?
Onset- When did the pain start? Does the pain start on its own or is it when you do something specific? Is it worse at a particular time of day?
Character- How would you describe the pain?
Radiation- Does the pain spread at all?
Associations- Do you feel well in yourself? Have you noticed any swellings in the area in the past?
Timing and duration- How long does the pain last?
Exacerbating factors- Does anything make the pain worse? Does anything relieve the pain?
Severity- How severe is the pain on a scale of 1-10? Is it keeping you awake at night? - Interpret radiograph along with the clinical findings
- Suggest provisional diagnosis
My provisional diagnosis is ______ but I would like to do further tests and look clinically too.
Reversible pulpitis
SOCRATES?
Pulp test?
Radiographically?
S- poorly localised
O- not spontaneous
C- sharp
R- no radiation
A- caries/large restorations
T- short, disappears when no stimulus
E- hot, cold, sweet
S- not severe
Pulp test- exaggerated response
Radiographically - no PAP
Irreversible pulpitis
SOCRATES?
Pulp test?
Radiographically?
S- poorly localised
O- spontaneous
C- dull, throb
R- radiation
A- caries/large restorations
T- persistent
E- hot
S- v severe
Pulp test- exaggerated response
Radiographically- no PAP but probably caries
Acute periapical periodontitis
SOCRATES?
Pulp test?
Radiographically?
S- well localised
O- not spontaneous
C- sharp
R- no
A- possibly caries
T- short
E- biting and percussion
S- not severe
Pulp testing- exaggerated and eventually non vital
Radiographically- widening of PDL due to loss of LD
Chronic periapical periodontitis
SOCRATES?
Pulp test?
Radiographically?
S- well localised
O- not spontaneous
C- dull ache, may be asymptomatic
R- no
A- caries/large restorations
T- long
E- biting and percussion
S- not severe
Pulp testing- non vital
Radiographically- widening of PDL due to loss of LD
Acute periapical abscess
SOCRATES?
Pulp test?
Radiographically?
S- well localised
O- spontaneous
C- throbbing ache
R- no
A- swelling, mobility, ill feeling
T- long
E- biting and percussion
S- v severe
Pulp testing- non vital
Radiographically- periapical radiolucency (granuloma) and PDL space widening
Chronic periapical abscess
SOCRATES?
Pulp test?
Radiographically?
S- well localised
O- not spontaneous
C- dull ache, may be asymptomatic
R- no
A- swelling, mobility, ill feeling
T- long
E- biting and percussion
S- not v severe
Pulp testing- non vital
Radiographically- periapical radiolucency (granuloma) and PDL space widening
Acute periodontal lateral abscess
SOCRATES?
Pulp test?
Radiographically?
S- well localised
O- spontaneous
C- throbbing ache
R- no
A- swelling, mobility, deep pockets
T- long
E- biting
S- severe
Pulp testing- can be vital
Radiographically- some alveolar bone loss
