Oral Pain and Its Management

Question 1

_____ is the most prevalent type of pain in the orofacial region

Answer 1

Toothache (odontalgia)

Question 2

T/F: Not all pains are the same, not all toothaches are the same

Answer 2

True

Question 3

Pulpal and Periodontal pain are categorized as ______ orofacial pain

Answer 3

Odontogenic pain

Question 4

Myofascial, Sinus/nasal, Neurovascular, Neuropathic, Idiopathic, Cardiogenic (rare), and Systemic (rare) pain are categorized as ______ orofacial pain

Answer 4

Non-Odontogenic pain

Question 5

Temporomandibular Disorders are more common in males or females?

Answer 5

Females

Question 6

Temporomandibular Disorders need treatment what percent of the time?

Answer 6

3.6-7%

Question 7

Unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

Answer 7

pain

Question 8

_____ Instills protective behavior but if unabated, pain can be harmful

Answer 8

pain

Question 9

________: It is always subjective; It may or may not be tied to a stimulus; It is always a consequence of an emotional experience and psychological state

Answer 9

pain

Question 10

Environmental stimulus (thermal, mechanical, chemical, polymodal), Receptor activation•Generation of action potential, Transmission through primary afferent to dorsal horn, and Projection from dorsal horn to brain for perception and interpretation are ways we experience _____

Answer 10

pain

Question 11

____ is not pain until it reaches and is processed by higher centers (supraspinal structures)

Answer 11

nociception

Question 12

_____ is a symphony - a complex response that includes not just a distinct sensation but also motor activity, a change in emotion, a focusing of attention, a brand new memory

Answer 12

pain

Question 13

____ and ____ are descending pathways of pain modulation

Answer 13

supraspinal and spinal pathways

Question 14

The _____ pathway (descending) are influenced by psychological factors; neurons from the cortex and amygdala; periaqueductal gray and rostroventral medulla

Answer 14

supraspinal

Question 15

The ____ pathway (descending) are associated with endogenous opioid signaling and non-opiod inhibitory neurotransmitters

Answer 15

spinal

Question 16

Serotonin, noradrenaline, GABA, and glycine are _________ neurotransmitters

Answer 16

non-opioid inhibitory

Question 17

_____ is a dynamic process that can occur at multiple levels of the ascending and descending pathways

Answer 17

pain modulation

Question 18

_____ is characterized by an increased responsiveness of nociceptive neurons under normal input and by a recruitment of a response (APs) under subthreshold input

Answer 18

sensitization

Question 19

Nociceptive neurons at periphery of receptive field; Increased responsiveness of nociceptive neurons; Reduced threshold to stimulation.(Primary hyperalgesia)

Answer 19

Peripheral sensitization

Question 20

Increased pain response to a painful stimulus

Answer 20

Hyperalgesia

Question 21

Nociceptive neurons in the central nervous system; Increased responsiveness to normal or subthreshold afferent input; may also result from dysfunctional endogenous pain control (Primary and secondary hyperalgesia) (Allodynia)

Answer 21

Central sensitization

Question 22

Pain resulting from a stimulus that does not normally provoke pain

Answer 22

Allodynia

Question 23

Myelinated (fast) non-nociceptive afferent fiber can activate inhibitory interneurons modulating nociceptive transmission•Reason you instinctively wave, hold, clench your fingers when they burn•Reason why TENS helps relieve pain

Answer 23

Revised gate control theory

Question 24

The threshold for nociception can be raised when another noxious stimulus is provoked in another area.“Pain inhibits pain”

Answer 24

Diffuse noxious inhibitor control

Question 25

Psychological; Leads to release of endogenous analgesic substances

Answer 25

Placebo effect

Question 26

What are the 3 different ways to categorize pain?

Answer 26

neurophysiology, structures involved, and timing

Question 27

Pain resulting from damage or threatened damage to non-neural tissue; Activation of nociceptors; Sharp

Answer 27

Nociceptive pain

Question 28

Pain resulting from the presence of a lesion or disease of the somatosensory nervous system

Answer 28

Neuropathic pain

Question 29

Pain that arises from altered nociception •Does not satisfy the definitions of nociceptive or neuropathic pain•It is possible for a patient to present with nociceptive and this pain at the same time

Answer 29

nociplastic pain

Question 30

Craniofacial pain that is characterized by throbbing, wakes patient, and autonomic and systemic signs

Answer 30

neurovascular

Question 31

Craniofacial pain that is characterized by pressure, deep pain, muscle tenderness, and dysfunction

Answer 31

musculoskeleton

Question 32

Craniofacial pain that is characterized by sensory dysfunction, dermatomal pain, and burning or electric pain

Answer 32

neuropathic

Question 33

Pain with close temporal relationship to an stimulus, injury, disease; Tends to respond to treatment in a linear dose-dependent fashion

Answer 33

Acute Pain

Question 34

Pain that has lasted >3 months•Does not typically respond to treatment in in a linear dose-dependent fashion•Presence of other/multiple ongoing pains is a predictor for transition from acute to chronic•More influence of psychosocial factors•More difficult to treat

Answer 34

Chronic Pain

Question 35

What are the 3 type of heterotopic pain?

Answer 35

Central, projected, and referred pain

Question 36

Anxiety•Major depression•Personality disorders•Pain distress are the most common _______ disorders

Answer 36

psychosocial disorders

Question 37

Perceived control•Self-efficacy•Catastrophic thinking•Hypervigilance•Fear avoidance are ____ for psychosocial disorders

Answer 37

coping mechanisms

Question 38

Pain intensity, Pain distress, Pain-related interference (Functional limitation, disability), and Oral Habits are ____ of pain

Answer 38

assessments

Question 39

Can you treat site of pain in homotopic pain?

Answer 39

Yes

Question 40

Can you treat site of pain in heterotopic pain?

Answer 40

No

Question 41

____ pain: site = source

Answer 41

homotopic pain

Question 42

___ pain: site does not equal source

Answer 42

heterotopic pain

Question 43

Heterotopic pain where Source is central but perceived peripherally

Answer 43

Central Pain

Question 44

Heterotopic pain where Pain follows same nerve distribution as primary source•Dermatome or motor distribution•Hyperalgesia may be present

Answer 44

Projected pain

Question 45

Heterotopic pain where Pain occurs in different nerve than primary source and is spontaneous (non-provoked)•Sensitization of interneurons –central sensitization•Not aggravated by palpation•Does not respond to anesthesia at site of pain –must block primary site•Typically does not cross midline (only if generated at midline)•Refers upward: cervical to trigeminal, mandibular to maxillary

Answer 45

referred pain