Final: Dental and Orofacial Pain Flashcards
(35 cards)
how common is sinusitis in the US and toothache related?
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
how common is it for sinus pain vs odontogenic pain to experiece : tender to tapping/percusion?
both will experience pain (often) for this
how common is it for sinus pain vs odontogenic pain to experiece : cold sensitivity?
both will experience it often
how common is it for sinus pain vs odontogenic pain to experiece :intraoral mucosal tendernous, edema and erythema?
both will experience this SOMETIMES with sinus/ tooth pain
how common is it for sinus pain vs odontogenic pain to experiece : worsen pain when bending forward
sinus: OFTEN
odontogenic: SOMETIMES
how common is it for sinus pain vs odontogenic pain to experiece : recent history of cold/flu/allergies
Sinus: USUALLY, odontogenic: sometimes
how common is it for sinus pain vs odontogenic pain to experiece : nasal /sinus symptoms
sinus: USUALLY, odontogenic: sometimes
how common is it for sinus pain vs odontogenic pain to experiece : multiple teeth involved
sinus: USUALLY
odontogenic: RARELY
how common is it for sinus pain vs odontogenic pain to experiece : relief with injected anasthetic
sinus: NOINE to partial
odontogenic: usually complete relief
how common is it for sinus pain vs odontogenic pain to experiece : foul odor or taste
sinus: SOMETIMES, odontogenic: SOMETIMES
how common is it for sinus pain vs odontogenic pain to experiece : large dental lesion
sinus: never
odontogenic: usually
what are the most common dental causes for sinus pain? other less common ones?
MOST:
- pariapical abscess
- periodontal disease
- dental extraction
- foreign body in sinus
others:
- osteomyelitis
- endodontic instrumentation
- over-obturation
- incorrectly positioned implant
- incorrectly performed sinus augmentation
what can be odontogenic sinus infections side effects
- 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
what is the most common OMFS related sinus complication? what is it usually due to usually?
-what can it result in?
OROANTRAL FISTULA
- 80% are due to maxillary posterior tooth extraction
- results: chronic rhinosinusitis, purulent discharge through fistula, especially with drinking or blowing nose
how will oroantral fistulas self close
- oral epithelium
- granulation tissue
- polyps of sinus mucosal membrane
how will oroantral fistula be closed surgically
- direct closure
- flaps
- buccal fat pad
- absorbable membranes
how do you treat a odontogenic maxillary sinusitis?
- resolve offending dental infection
- sinus treatment : irrigation/decongestants
where does dentinal hypersnsitivity tend to occur
in the less obvious recession areas ?
what will usually be present with odontogenic pain and if not how can you find out
explanatory lesion (or pulp testing can detect it. hypersensitivity is often in less obvious recession areas)
what is usually present with periodontal pain? if you can’t tell, what methods can rule it out?
usually its visible, but if its not clear , SRP and chlorhexidine are simple, safe and conservative methods for ruling it out
what causes neuropathic pain?
dysfunction of neurons
- usually no physical alteration of the neurons!! so no visible findings or lesions!!
- almost always results in multiple diagnoses and mistreatment
who manages neuropathic pain and what role does dentist play
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?
how to go about dental procedures with neuropathic pain
- only perform necessary
- explain pain may worsen, usually temporary
- consider preemptive NSAIDs
- profound anaesthesia
what can occur occlusally due to arthritis
- posteriors may wear on occlusals to compensate
- teeth may compensate too slowly as more teeth become involved
