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OEQ Flashcards

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1
Q

How many hours within a 24 hour period will you advise your patient that they may wear their occlusal splint?

A

8-12 hours

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2
Q

What is the function of occlusal splints?

A
  1. decreases loading of the TMJ
  2. reduce trauma in the masticatory muscles caused by bruxism
  3. protect teeth from attrition
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3
Q

Which type of splint is LEAST likely to create occlusal changes?

A

stabilization splint

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4
Q

What are some complications associated with incorrect or excessive use of splints?

A
  1. occlusal changes
  2. speech difficulty
  3. psychological dependence
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5
Q

Which type of appliance is indicated in an 8 year old child experiencing jaw pain due to bruxism?

A

soft splint

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6
Q

Which painful disorders are treated with a stabilization splint?

A
  1. myalgia/myofacial pain
  2. capsulitis/synovitis
  3. osteo/rheumatoid arthritis
  4. anterior disc displacement with reduction
  5. attrition prevention
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7
Q

How frequently should you evaluate stabilization splints:

A

-Evaluate every 2-4 weeks for the first three months
-Evaluate every three months after that
-Once stable, assess every 6 months

(she mentioned seeing 1 week after delivery to check in & having them bring it to their hygiene appts which would be every 6 mo)

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8
Q

Goals of anterior repositioning splint:

A
  1. decrease loading of the posterior attachment
  2. decrease jaw catching
  3. decrease severe TMJ pain
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9
Q

What is NOT a goal of anterior repositioning splint?

A

To recapture the articular disc (we can’t guarantee this will happen)

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10
Q

Paroxysmal or constant pain typically with sharp, stabbing, itching or burning character in the distribution of a nerve:

A

Neuralgia

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11
Q

Dull, continuous, aching, or burning pain in the oral cavity or teeth or jaw, evolving eventually into trigeminal neuralgia:

A

Pre-trigeminal neuralgia

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12
Q

Sudden, usually unilateral, severe, brief, stabbing or lancinating, recurrent episodes of pain in the distribution of one or more branches of the fifth cranial (trigeminal) nerve:

A

trigeminal neuralgia

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13
Q

Differential diagnosis for trigeminal neuralgia:

A
  1. SUNCT
  2. Cluster-tic syndrome
  3. Giant cell arteritis
  4. MULTIPLE SCLEROSIS
  5. Other neuralgia
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14
Q

When should MRI or MRA be considered in a trigeminal neuraligia case?

A
  1. patient is younger than 40
  2. patient is experiencing
  3. patients with bilateral symptoms
  4. patients who do not respond to conservative therapy
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15
Q

What medication might you prescribe for chronic neuropathic pain:

A

Carbamazepine (400-1200mg/day)

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16
Q

Surgical therapy for trigeminal neuralgia:

A
  1. microvascular decompression
  2. Radiofrequency rhizotomy
  3. Glycerol rhizolysis
  4. balloon compression
  5. Gamma-knife radiosurgery (NON-INVASIVE)
  6. Peripehral neurectomy
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17
Q

Destroys portions of the nervous system to block transmission of noceiceptive information:

A

Gamma-knife radiation (neuroablative procedure)

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18
Q

A complex series of electrochemical events that occurs between a site of active tissue damage and the perception of pain:

A

Nociception

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19
Q

Your patient is experiencing sharp, electric shock-like pain in the maxillary left teeth and left face. You diagnose your patient with trigeminal neuralgia. What is the medication that is considered to be the “gold standard” prescribed to control this pain?

A

Tegretol (Carbamazepine)

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20
Q

-Severe paroxysmal, lancinating pain that radiates to the throat, ear, teeth and tongue.

-Rare and unilateral

-Triggered by tonsilar movement (swallowing or coughing)

-Due to lesion in CN-IX

A

Glossopharyngeal neuralgia

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21
Q

Multiple sclerosis is a demylenating disease that can present as toothache in one or more quadrants. The pain can be sharp, electric pain, lasting for minutes. Which image would best helo with your diagnosis?

A

MRI of the brain

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22
Q

Which of the following conditions should be ruled out and treated before diagnosing your patient with burning mouth syndrome?

A
  1. Xerostomia
  2. Candidiasis
  3. Iron & vitamin B12 & B6 deficiency
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23
Q

All of the following are diagnostic criteria for burning mouth syndrome:

A
  1. daily oral pain persists for most of the day time
  2. oral mucosa appears normal clinically
  3. primarily affects the anterior 2/3 of tongue

(NOT affects males as BMS affects females in fourth to fifth decades due to estrogen decrease)

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24
Q

Neuropathic pain can be caused by which of the following?

A
  1. Herpes Zoster virus
  2. Multiple sclerosis
  3. RCT & dental extractions
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25
Which of the following is false regarding atypical odontalgia?
False- it commonly affects the maxillary anterior teeth
26
What is true about atypical odontalgia?
1. more prevalent in post-menopausal females 2. pain is present for hours during the day time 3. light touch can induce or worsen pain
27
Elongation or ossification of the stylohyoid ligament:
Eagles syndrome
28
Symptoms of eagle syndrome:
-sore throat -dysphagia -otalgia -glossodynia -headache -vague pain in neck
29
Eagle syndrome is usually ____ Radiograph usually reveals:
unilateral enlongated stylohyoid ligament
30
Eagles syndrome is associated with:
1. elongated calcified stylohyoid ligament (radiograph) 2. neck pain induced by turning head 3. ear pain (NOT vertigo)
31
5-HT agonist drugs (Triptans) are considered to be which of the following categories of migraine meds?
Abortive medications
32
Preventative migraine medication categories include:
1. Calcitonin gene related peptide (CGRP antagonist) 2. Calcium channel blockers 3. Anti-depressants (Triptans are abortive medication NOT preventive)
33
Which of the following diagnostic criteria MUST BE present for a diagnosis of migraine headache?
1. attacks last 4-72 hours untreated or with failed treatment 2. must have at least one of the following: -nausea -vomiting -photophobia -phonophobia 3. must have at least two of the following -unilateral -pulsating -moderate to severe pain -worsened by physical activity
34
Migraine headaches are comorbid with which of the following medical conditions?
1. Stroke 2. Epilepsy 3. Depression 4. Anxiety disorders
35
Common food triggers for migraines include:
1. chocolate 2. alcohol (especially red wine) 3. caffeine 4. Aged cheese (especially cheddar) 5. Citrus fruits 6. MSG, Nitrates, Aspartate
36
Migraines can cause facial pain and toothache due to activation of which nerve?
Trigeminal
37
All of the following features are associated with migraine headaches except:
Except: primarily affects males -Migraines are associated with: 1. primarily affects post-menopausal women 2. affects first degree relatives 3. chromosome 19 is associated
38
Prophylactic migraine medications should be prescribed if all the following criteria are met:
1. Patients has to take Triptans for more than 3 days per week 2. Quality of life has been significantly affected 3. The disability causes the patient to miss work more than 7 days a month
39
When the migraine headache pain begins to diminish, this phase is called:
Resolution
40
List some examples of pathophysiology of migraines:
1. activation of trigeminovascular system 2. trigeminovascular system releases neuropeptides (inflammatory chemical mediators) 3. serotonin receptor (5HT) gets activated 4. serotonin activation causes increased vasoconstriction *CGRP is also believed to pay a major role
41
List some features for chronic paroxysmal hemicrania:
1. severe pain is localized to temporal, ocular, maxillary or frontal regions 2. toothache may be a symptom but rare 3. attacks are ALWAYS unilateral & occur multiple times a day 4. female predilection
42
Tension type headache is associated with which of the following signs or symptoms?
1. pressure or vise-like pain 2. Bilateral pain location 3. Physical exercise improves the headache (No vomiting or nausea or photophobia+phonophobia)
43
Features of cluster headache:
1. severe unilateral, supraorbital and/or temporal pain 2. headache attack frequency ranges up to 8 attacks per day 3. 15-180 min in duration 4. at least one autonomic feature present (lacrimation, eyelid edema, miosus) 5. headache attacks occur at same time of day following circadian pattern
44
Trigeminal autonomic cephalgias (TAC's) include:
ALL TAC'S ARE UNILATERAL HEADACHES ACCOMPANIED BY AUTONOMIC FEATURES 1. Cluster headaches 2. Paroxysmal hemicrania 3. Short-lasting unilateral neuralgiaform headache attacks (SUNCT) 4. Hemicrania continua 5. Probable autonomic trigeminal cephalgia
45
All of the following are true for SUNCT headaches:
1. pain is moderate to severe 2. pain location is in the head, orbital, temporal or trigeminal distribution 3. pain duration is 1-600 seconds
46
What is the reccommended treatment for tension-type headaches?
1. NSAIDS- not more than 2-3x/week 2. Aspirin and/or acetaminophen with caffeine 2-3/per week 3. muscle relaxants
47
Absence of airflow despite respiratory efforts:
OSA
48
A syndrome of respiratory disturbances due to upper airway obstruction:
sleep apnea
49
Types of sleep apnea:
1. Obstructive 2. Central 3. Compex/mixed
50
Sleep apnea due to absence of airflow with respiratory effort due to air way obstruction:
OSA
51
Sleep apnea caused by NO RESPIRATORY EFFORT; brain does NOT send signal to diaphragm. Usually secondary to underlying condition:
Central sleep apnea
52
Sleep apnea that is both obstructive and central in nature:
Complex/mixed sleep apnea
53
What is the only type of sleep apnea dentist can treat?
OSA
54
Primary cause of OSA:
Relaxation of the throat muscles during sleep which leads to narrowing or complete closure of the airway
55
Risk factors for OSA include:
-OBESITY -AGING -MALE GENDER -family history of OSA -endocrine disorders (esp. hyperthyroidism) -neurological disorders (stroke, neuromuscular disorders) -alcohol use -smokine -chronic nasal congestion/allergies -increased neck circumference (men 17 in, females 15.5 in) -waist size over 40 in (male) and 35 in (females) medications that can relax the airway (muscle relaxants, sedatives, opioids, hypnotics)
56
Medical conditions associated with OSA:
-cardiovascular disease -HTN -stroke -diabetes type II -GERD -dep/anx -ADHD (esp. in children)
57
As a general dentist, you cannot order the ______ sleep study but if you are certified in OSA treatment you can order the ______ sleep study
initial; treatment
58
What medical/dental conditions are associated with narrowing of the airway space?
1. aging 2. obesity 3. class 2 skeletal 4. elongated soft palate/uvula 5. enlarged (kissing) tonsils 6. enlarged tongue
59
Patients diagnosed with OSA are at high risk for developing:
1. CVD/CAD 2. Diabetes 3. Behavioral/cognitive problems 4. Sudden death 5. HTN (NOT hyperthyroidism)
60
Complete or almost complete (90%) cessation of airflow for at least 10 seconds:
Apnea
61
Reduction in airflow (30%) for atleast 10 seconds: (must be atleast a 3% decrease in oxygen saturation)
Hypoapnea
62
Mild to moderate OSA responds well to treatment with an:
Oral mandibular advancement sleep apnea appliance
63
Moderate to severe OSA is best treated with:
Continous positive airway pressure (CPAP)
64
CPAP is gold standard of treatment for:
OSA
65
-A sleep study done in a sleep laboratory monitored by a licensed respiratory therapist -gold standard for OSA testing -report is written by physician trained in sleep medicine
Polysnomogram study (PSG)- initial study
66
A polysomnogram study is important to determine if a patient has obstructive sleep apnea because it monitors:
1. Oxygen saturation levels 2. respiration 3. sleep stages 4. HR & rhythm
67
If a patient is a candidated for a mandibular advancement device, if present, what conditions must first be treated prior to fabricating the mandibular advancement device?
1. severe myalgia 2. myofascial pain 3. myospasm 4. intermittent jaw locking/anterior disc displacement 5. osteoarthritis with pain in TMJ 6. arthralgia of TMJ
68
An oral sleep apnea appliance (mandibular advancement device) is effective in treating obstructive sleep apnea by what mechanisms?
1. advancing mandible forward (provides stable anterior position of the tongue) 2. increasing VDO at the oropharynx 3. advancing the tongue forward so it does not occlude the airway space (creates anterior displacement of tongue) 4. enlarges upper airway space & decreases collapsability
69
FITB: You look in a patients mouth wihat is one thing you could see in the oropharynx region that would cause obstructive sleep apnea?
-Elongated soft palate/uvula -enlarged tonsils (kissing/touching tonsils)
70

Orofacial Pain (4 decks)

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