Acute and chronic facial pain must be differentiated and it is widely accepted that chronic pain refers to pain of 3 months or greater duration. Jun 20, 2018 differential diagnosis of orofacial pain 1. Most of the headache treatments are symptomatic so doctors always suggest you the pain medications which include antianalgesics mostly paracetamol. Department of endodontics, dental school at the lebanese university, beirut, lebanon abstract koyess e, fares m. Differential diagnosis of facial pain and guidelines for. Differential diagnosis of pulpitis academy of dental.
Dental update march 2002 89 trismus aetiology and differential diagnosis intraarticular 1. Otalgia ear pain is a common presentation in the primary care setting with many diverse causes. From the perspective of a dental pain emergency, practitioners need to establish a differential diagnosis of dental pain versus non dental pain. At least two reasons account for these observations. Certainly temporomandibular joint pain has a long history, for ruffer1 found evidences of temporomandibular joint pathology in the skulls of early modern man. The focus here is on the role of clinical neurophysiologic and psychophysical tests in the diagnosis, differential diagnosis, and pathophysiological mechanisms of definite trigeminal neuropathic pain and other chronic orofacial pain conditions excluding headache and.
Correct diagnosis is the key to managing facial pain of nondental origin. Sep 16, 2015 a customized decision tree is designed, which will help clinicians to keep a broad view when formulating a differential diagnosis of localized isolated, discrete, regional or generalized gingival enlargement and arrive at a particular diagnosis is an easy and systematic manner. Nondental pain without minimizing its importance, nondental pathology is not the most common cause of orofacial pain. A thorough dental examination must be performed to rule out odontogenic sources of pain and avoid unnecessary dental treatments figure 523. Meniscus pathology infection trauma dentaltreatment tmd tumours and drugs radiotherapy and. Oct 27, 2017 the diagnosis and management of orofacial pain may be challenging due to complex histories, pathophysiology and associated psychosocial comorbidities such as depression and anxiety. A final diagnosis, even in the presence of typical clinical features, must depend on demonstration of the virus, either by. Classification and differential diagnosis of oral and maxillofacial pain article pdf available in oral and maxillofacial surgery clinics of north america 283.
Dental diagnosis need for wisdom tooth extraction because of damage to the adjacent second molar and pain symptoms. A detailed description of pain and the complete diagnostic sequence are mandatory, including adequate clinical and radiographic examination. Mitchell, dds, med dental pain diagnosis chart symptomsign dentin sensitivity cracked cusp tooth reversible pulpitis irreversible necrotic. Orofacial pain an update on diagnosis and management. Differential diagnosis and management of oral ulcers. A dentoalveolar abscess is an acute lesion characterized by localization of pus in the structures that surround the teeth. Thus dental knowledge is crucial in order to exclude common and easily treated odontogenic causes of pain.
This article revises the existing knowledge of different types of enlargements and highlights some. Differential diagnosis of orofacial pain linkedin slideshare. Jul 01, 20 the diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. A note on orofacial pain and differential diagnosis. This website we provide free medical books for all this website provides over 0 free medical books and more for all students and doctors this website the best choice for medical students during and after learning medicine. Special section on diagnosis based on the laboratory findings has been updated to help the practitioners and the students alike. Feb 06, 2014 68 differential diagnosis of dental diseases mechanics of pain at one time pain was considered to be evoked by noxious stimulation of neural structures, with the pain reaction involving a cerebral level modified by prior conditioning such as memory, emotional response and evaluative significance of pain. However, the vast majority of toothache is caused by dental, rather than non dental, sources 40 consequently, the saying horses, not zebras has been applied to the differential diagnosis of orofacial pain. Ramandeep singh gambhir reader and head, gian sagar dental college and hospital, rajpura, punjab, india tel. Pdf classification and differential diagnosis of oral. The initial assessment of patients with a suspected dental abscess or odontogenic infection is no different from other dental patients, except there is a need to be highly vigilant for signs of airway compromise. This usually has a local cause, mainly the sequelae of dental caries. Jan 02, 2018 american academy of family physicians. Here are some simplified examples of what a differential diagnosis may look like for some common conditions.
Dental diseases differential diagnosis pdf free pdf epub. Differential diagnosis of toothache to prevent erroneous and. Differential diagnosis for orofacial pain, including sinusitis, tmd, trigeminal neuralgia abstract. The examination, differential diagnosis, and management of. Differential diagnosis of toothache to prevent erroneous and unnecessary dental treatment. Meniscus pathology infection trauma dentaltreatment tmd tumours and drugs radiotherapy and congenital miscellaneous related oral care chemotherapy.
Scraping or chiseling the dentin produces similar pressure and pain. Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. However, the vast majority of toothache is caused by dental, rather than nondental, sources 40 consequently, the saying horses, not zebras has been applied to the differential diagnosis of orofacial pain. At least one confirming, reproducible test that corroborates radiographic or clinical evidence of pathology is necessary to make a diagnosis of odontogenic etiology. The diagnosis and management of orofacial pain may be challenging due to complex histories, pathophysiology and associated psychosocial comorbidities such as depression and anxiety. Abdul basit is a final year medical student at bolan university of medical and health. Aim a case of a patient with a confusing referred pain is reported that emphasizes the. Differential diagnosis of dental diseases pdf author. While in some cases they first treat the underlying cause. Differential diagnosis of dental pain sciencedirect. View the article pdf and any associated supplements and figures for a period of 48 hours. Differential diagnosis of oral facial pain a consultation visit may be advised to determine whether or not root canal treatment is indicated. Unfortunately, some dentists are not familiar with the differential diagnosis of tn. Unlabelled correct diagnosis is the key to managing facial pain of nondental origin.
Differential diagnosis of toothache to prevent erroneous. Guideline american society of temporomandibular joint surgeons. Children who have dental pain, fractures, luxation, discoloration, or abscess should have dental radiographs taken to assess trigeminal neuralgia view in chinese phase of pretrigeminal neuralgia characterized by atypical symptoms eg, jaw or. Differential diagnosis of chronic neuropathic orofacial pain. Differentiating the many causes of facial pain can be difficult for busy practitioners, but a logical approach can be beneficial and lead to more rapid diagnoses. An investigation into differential diagnosis of pulp and periapical pain. A pennendo database study mian iqbal, dmd, ms, sara kim, dmd, and frank yoon, ma abstract nine hundred fiftyone emergency and 997 nonemergency patients seeking endodontic treatment were the basis of this study. Thus dental knowledge is crucial in order to exclude common and. A structure for accurate diagnosis is proposed beginning with a very careful history. Differential diagnosis of poliomyelitis jama jama network. Pain chronicity and central sensitization have significant implications for the differential diagnosis of a reported toothache. But not always if your diagnosis just isnt falling into any of our usual dental bins, back up and think about the rest of the. A very significant additional feature in this edition is incorporation of sub section on causes of common dental diseases. May 11, 2018 here are some simplified examples of what a differential diagnosis may look like for some common conditions.
In most clinical practice, the referring general dentist or clinician will have diagnosed the most common. Dental pain toothache is the most common presenting symptom. Pdf the painful tooth mechanisms, presentation and. The common categories of non dental pain and speciic examples are provided in table 1. The painful tooth mechanisms, presentation and differential diagnosis of odontogenic pain article pdf available in oral surgery february 2020 with 150 reads how we measure reads. Non dental pain without minimizing its importance, non dental pathology is not the most common cause of orofacial pain. Pdf differential diagnosis of facial pain and guidelines. Mitchell, dds, med dentalpaindiagnosischart symptomsign dentin sensitivity cracked cusp tooth reversible pulpitis irreversible necrotic. The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. Laboratory studies and imaging should only be obtained after a thorough history and physical examination and, in the case of impending airway compromise, should not delay securing the airway or emergent operative intervention. Differential diagnosis of orofacial pain sailesh kumar.
Dental diagnosis includes symptoms and exam nyc dentist. The diagnosis of these lesions is essential for their successful management and of the patient as a whole. Table 1 presents the differential diagnosis of acute low back pain. Sep 02, 2011 a note on orofacial pain and differential diagnosis. Odontogenic pain management fdi world dental federation. In most clinical practice, the referring general dentist or clinician will have diagnosed the most common entities that cause pain. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis. Differential diagnosis headache made easy with mnemonics. Priya verma gupta differential diagnosis of dental diseases it is a book of the art and science of distinguishing one disease from another. Often in patients with chronic orofacial pain there will be multiple causes of discomfort including inflammatory odontogenic pain alongside a neuropathic, neurovascular or idiopathic cause. Usually, orofacial pain has either periodontal or dental causes.
Knowledge of the differential diagnosis expedites the process of reading a correct diagnosis thus avoiding lot of suffering to the patient. Pdf differential diagnosis for orofacial pain, including. Vesiculobullous lesions pemphigus vulgaris pemphigus vulgaris pv belongs to a family of disorders that form bullae on the skin or mucous membrane. From the perspective of a dental pain emergency, practitioners need to establish a differential diagnosis of dental pain versus nondental pain. Pulp pain produced by cold is a similar phenomenon. In clinical dentistry, patients frequently report with isolatedregional or generalized gingival enlargements, which could fall under varied presentations. The commonest acute causes of pain are dental and these are well managed by dentists. Dental abscess differential diagnoses medscape reference. Children who have dental pain, fractures, luxation, discoloration, or abscess should have dental radiographs taken to assess trigeminal neuralgia view in chinese phase of pretrigeminal neuralgia characterized by atypical symptoms eg, jaw or tooth pain that might mimic dental pain. Management of chronic pain differs from acute pain of tooth origin the presentation of chronic pain and acute pain differ greatly. Dental diseases differential diagnosis pdf for free. The history can provide invaluable clues to the diagnosis and guide the evaluation to discover the source and severity of the infection.
Dental pain can simulate virtually any facial pain syndrome. It is startling that the diagnosis of a disease on which so much professional effort and interest has been focused is suspected far more frequently than it is definitely made. Orofacial pain is the main reason why many patients seek dental advice. A differential diagnosis of dental pain is needed before any intervention. The common categories of nondental pain and speciic examples are provided in table 1. Its origin is mostly odontogenic, but several other conditions may mimic dental pain or present themselves as such.
Differential diagnosis for orofacial pain, including. They include thermal cold, heat and electric pulp tests ept. Diagnosis and management of nondental orofacial pain article pdf available in dental update 343. Several tests along with radiographic interpretation will be used to determine the diagnosis, or the condition. John visits his doctor complaining of pain in his chest. Pain is a complex experience encompassing a specific sensation and the reactions to that sensation.
Most patients are treated easily with analgesia, antibiotics, drainage, andor referral to a dentist or oralmaxillofacial surgeon. Jan 22, 2019 a dentoalveolar abscess is an acute lesion characterized by localization of pus in the structures that surround the teeth. The differential diagnosis of toothache pain starts with a thorough history, clinical and radiographic exams, and a battery of tests. Differential diagnosis and treatment of dental pain261 the same phenomenon is produced by the dental drill, the frictional heat and surface pressure displacing the tubule. Pdf diagnosis and management of nondental orofacial pain. Chronic facial pain can be unilateral or bilateral and. Dec 11, 2016 pain chronicity and central sensitization have significant implications for the differential diagnosis of a reported toothache. Jan 01, 2018 otalgia ear pain is a common presentation in the primary care setting with many diverse causes. Orofacial pain syndromes encompass several clinically defined and classified entities. Differential diagnosis of dental diseases it has been thought that the primary teeth are capable of a greater inflammatory response to insult because of the greater blood supply. That is, everyday dental causes such as pulpitis should always be. Unlabelled correct diagnosis is the key to managing facial pain of non dental origin.
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