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ICS1 > Final: Dental and Orofacial Pain > Flashcards

Final: Dental and Orofacial Pain Flashcards

1
Q

how common is sinusitis in the US and toothache related?

A

12% of US population has sinusitis and 10% of people with sinusitis report maxillary toothache
-maxillary nerve (mddle branch of trigeminal nerve) splits off from sinus region and breaks into posterior superior alveolar nerve, middle superior alveolar nerve, and anterior uperior alveolar nerve which supply maxillary teeth

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2
Q

how common is it for sinus pain vs odontogenic pain to experiece : tender to tapping/percusion?

A

both will experience pain (often) for this

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3
Q

how common is it for sinus pain vs odontogenic pain to experiece : cold sensitivity?

A

both will experience it often

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4
Q

how common is it for sinus pain vs odontogenic pain to experiece :intraoral mucosal tendernous, edema and erythema?

A

both will experience this SOMETIMES with sinus/ tooth pain

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5
Q

how common is it for sinus pain vs odontogenic pain to experiece : worsen pain when bending forward

A

sinus: OFTEN
odontogenic: SOMETIMES

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6
Q

how common is it for sinus pain vs odontogenic pain to experiece : recent history of cold/flu/allergies

A

Sinus: USUALLY, odontogenic: sometimes

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7
Q

how common is it for sinus pain vs odontogenic pain to experiece : nasal /sinus symptoms

A

sinus: USUALLY, odontogenic: sometimes

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8
Q

how common is it for sinus pain vs odontogenic pain to experiece : multiple teeth involved

A

sinus: USUALLY
odontogenic: RARELY

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9
Q

how common is it for sinus pain vs odontogenic pain to experiece : relief with injected anasthetic

A

sinus: NOINE to partial
odontogenic: usually complete relief

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10
Q

how common is it for sinus pain vs odontogenic pain to experiece : foul odor or taste

A

sinus: SOMETIMES, odontogenic: SOMETIMES

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11
Q

how common is it for sinus pain vs odontogenic pain to experiece : large dental lesion

A

sinus: never
odontogenic: usually

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12
Q

what are the most common dental causes for sinus pain? other less common ones?

A

MOST:

  • pariapical abscess
  • periodontal disease
  • dental extraction
  • foreign body in sinus

others:

  • osteomyelitis
  • endodontic instrumentation
  • over-obturation
  • incorrectly positioned implant
  • incorrectly performed sinus augmentation
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13
Q

what can be odontogenic sinus infections side effects

A
  • polyps
  • mucous retention cyst (treatment not always recommended but could get large)
  • mucocoele (could cause bony expansion)
  • -OROANTAL FISTULA : most common OMFS omfs related sinus complication
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14
Q

what is the most common OMFS related sinus complication? what is it usually due to usually?
-what can it result in?

A

OROANTRAL FISTULA

  • 80% are due to maxillary posterior tooth extraction
  • results: chronic rhinosinusitis, purulent discharge through fistula, especially with drinking or blowing nose
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15
Q

how will oroantral fistulas self close

A
  • oral epithelium
  • granulation tissue
  • polyps of sinus mucosal membrane
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16
Q

how will oroantral fistula be closed surgically

A
  • direct closure
  • flaps
  • buccal fat pad
  • absorbable membranes
17
Q

how do you treat a odontogenic maxillary sinusitis?

A
  • resolve offending dental infection

- sinus treatment : irrigation/decongestants

18
Q

where does dentinal hypersnsitivity tend to occur

A

in the less obvious recession areas ?

19
Q

what will usually be present with odontogenic pain and if not how can you find out

A

explanatory lesion (or pulp testing can detect it. hypersensitivity is often in less obvious recession areas)

20
Q

what is usually present with periodontal pain? if you can’t tell, what methods can rule it out?

A

usually its visible, but if its not clear , SRP and chlorhexidine are simple, safe and conservative methods for ruling it out

21
Q

what causes neuropathic pain?

A

dysfunction of neurons

  • usually no physical alteration of the neurons!! so no visible findings or lesions!!
  • almost always results in multiple diagnoses and mistreatment
22
Q

who manages neuropathic pain and what role does dentist play

A

orofacial pain or neurology!
-dentist plays important role in diagnosis: knowing what a healthy mouth looks like (dental clinical exam and radiograph exam), knowing what symptoms each dental condition could case, intraoral anesthesia?

23
Q

how to go about dental procedures with neuropathic pain

A
  • only perform necessary
  • explain pain may worsen, usually temporary
  • consider preemptive NSAIDs
  • profound anaesthesia
24
Q

what can occur occlusally due to arthritis

A
  • posteriors may wear on occlusals to compensate

- teeth may compensate too slowly as more teeth become involved

25
Q

Right side dejenerative joint diseaes on TMJ : what will occur atnerior, right posterior/left posterior and symptoms?

A
  • anterior: hypo-occlusion or open bite. possible madibular midline shift to the right.
  • right posterior: hyper-occlusion on posteriormost tooth.
  • left posterior: normal or hypo-occlusion
    symptoms: Right TMJ may be painful!
26
Q

Bilateral DJD tmj: anterior, right posterior and left ? symtpoms

A

anterior: hypo-occlusion or open bite
right posterior: hyper occlusion on posteriormost tooth
left posterior: hyper occlusion on posteriormost tooth

symptoms: bilateral TMJ may be painful

27
Q

what can cause temporary occlusion alteration

A

spasm (injury, long dental procedure..)

28
Q

what can cause permanent malocclusion

A

fixed prosthodontics or occlusal equilibration (fixing occlusion by adjusting teeth)

29
Q

what can a right lateral pterygoid spasm cause anterior, right posterior, left posterior and symptoms?

A

anterior: early contact between teeth
right posterior: hypo-occlusion!!!!
left posterior: normal

painful right lateral pterygoid is symtpom!

30
Q

bilateral lateral pterygoid spasm- anterior, r/l posterior and symtpoms?

A

anterior: early contact
right and left posteriors: hypoocclusion
symptoms: painful bilateral lateral pterygoid

31
Q

what is capsulitis/synovitis

A

tmj swelling

32
Q

what can right capsulitis/synovitis lead to for anterior, right post, left post and symptoms

A

anterior: normal (midline shift usually imperceptible)
right posterior: HYPOOCCLUSION!
left posterior: normal
symptoms: painful right tmj

33
Q

what is edentulous

A

lacking teeth

34
Q

what occurs to occlusion with severe periodontal disease or edentulous

A
  • muscles and ligaments tighten with shorter resting length (due to shorter VDO- vertical dimension of occlusion)
  • muscles and ligaments tighten with shorter maximum opening due to a liquid diet (?)

treatment; gentle and regular stretches

35
Q

what types of prolonged/intense forces can cause TMD

A

wide opening, long dental appointments

ICS1 (23 decks)

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