Pdf differential diagnosis of facial pain and guidelines. Unfortunately, some dentists are not familiar with the differential diagnosis of tn. Knowledge of the differential diagnosis expedites the process of reading a correct diagnosis thus avoiding lot of suffering to the patient. 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. 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.
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. 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. Thus dental knowledge is crucial in order to exclude common and easily treated odontogenic causes of pain. Differential diagnosis of oral facial pain a consultation visit may be advised to determine whether or not root canal treatment is indicated. Temporomandibular joint syndrome differential diagnoses. Jan 22, 2019 a dentoalveolar abscess is an acute lesion characterized by localization of pus in the structures that surround the teeth. 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.
Pdf diagnosis and management of nondental orofacial pain. Dental diagnosis includes symptoms and exam nyc dentist. Table 1 presents the differential diagnosis of acute low back pain. Differential diagnosis of toothache to prevent erroneous and unnecessary dental treatment. Dec 11, 2016 pain chronicity and central sensitization have significant implications for the differential diagnosis of a reported toothache.
Aim a case of a patient with a confusing referred pain is reported that emphasizes the. Here are some simplified examples of what a differential diagnosis may look like for some common conditions. A final diagnosis, even in the presence of typical clinical features, must depend on demonstration of the virus, either by. 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. 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. Dental update march 2002 89 trismus aetiology and differential diagnosis intraarticular 1. Thus dental knowledge is crucial in order to exclude common and. Differential diagnosis of poliomyelitis jama jama network. View the article pdf and any associated supplements and figures for a period of 48 hours.
The differential diagnosis of toothache pain starts with a thorough history, clinical and radiographic exams, and a battery of tests. 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 dental pain sciencedirect. Scraping or chiseling the dentin produces similar pressure and pain. They are also considered to be less sensitive to pain because of incomplete development of the neural network. That is, everyday dental causes such as pulpitis should always be. Correct diagnosis is the key to managing facial pain of nondental origin. Mitchell, dds, med dentalpaindiagnosischart symptomsign dentin sensitivity cracked cusp tooth reversible pulpitis irreversible necrotic.
Pain that originates from the ear is called primary otalgia, and the most common causes are otitis. Pdf the painful tooth mechanisms, presentation and. Dental pain can simulate virtually any facial pain syndrome. Dental diseases differential diagnosis pdf free pdf epub. An investigation into differential diagnosis of pulp and. 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. Dental diagnosis need for wisdom tooth extraction because of damage to the adjacent second molar and pain symptoms. Differential diagnosis of dental diseases pdf author. A note on orofacial pain and differential diagnosis. Pain chronicity and central sensitization have significant implications for the differential diagnosis of a reported toothache.
Unlabelled correct diagnosis is the key to managing facial pain of non dental origin. 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. Vesiculobullous lesions pemphigus vulgaris pemphigus vulgaris pv belongs to a family of disorders that form bullae on the skin or mucous membrane. Differential diagnosis of toothache to prevent erroneous.
Most patients are treated easily with analgesia, antibiotics, drainage, andor referral to a dentist or oralmaxillofacial surgeon. Pdf differential diagnosis for orofacial pain, including. Pulp pain produced by cold is a similar phenomenon. Differential diagnosis of toothache to prevent erroneous and.
The commonest acute causes of pain are dental and these are well managed by dentists. Jan 02, 2018 american academy of family physicians. The history can provide invaluable clues to the diagnosis and guide the evaluation to discover the source and severity of the infection. Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. In most clinical practice, the referring general dentist or clinician will have diagnosed the most common entities that cause pain. From the perspective of a dental pain emergency, practitioners need to establish a differential diagnosis of dental pain versus non dental pain.
Diagnosis and management of nondental orofacial pain article pdf available in dental update 343. 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. A thorough dental examination must be performed to rule out odontogenic sources of pain and avoid unnecessary dental treatments figure 523. Dental pain toothache is the most common presenting symptom. Abdul basit is a final year medical student at bolan university of medical and health. Most of the headache treatments are symptomatic so doctors always suggest you the pain medications which include antianalgesics mostly paracetamol. A differential diagnosis of dental pain is needed before any intervention. At least one confirming, reproducible test that corroborates radiographic or clinical evidence of pathology is necessary to make a diagnosis of odontogenic etiology. Jun 20, 2018 differential diagnosis of orofacial pain 1. Meniscus pathology infection trauma dentaltreatment tmd tumours and drugs radiotherapy and. A dentoalveolar abscess is an acute lesion characterized by localization of pus in the structures that surround the teeth. Orofacial pain is the main reason why many patients seek dental advice.
Unlabelled correct diagnosis is the key to managing facial pain of nondental origin. Differential diagnosis for orofacial pain, including sinusitis, tmd, trigeminal neuralgia abstract. A very significant additional feature in this edition is incorporation of sub section on causes of common dental diseases. The differential diagnosis of temporomandibular joint pain. Its origin is mostly odontogenic, but several other conditions may mimic dental pain or present themselves as such. Usually, orofacial pain has either periodontal or dental causes. This article revises the existing knowledge of different types of enlargements and highlights some. Several tests along with radiographic interpretation will be used to determine the diagnosis, or the condition.
Management of chronic pain differs from acute pain of tooth origin the presentation of chronic pain and acute pain differ greatly. 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. At least two reasons account for these observations. They include thermal cold, heat and electric pulp tests ept.
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. Department of endodontics, dental school at the lebanese university, beirut, lebanon abstract koyess e, fares m. Mitchell, dds, med dental pain diagnosis chart symptomsign dentin sensitivity cracked cusp tooth reversible pulpitis irreversible necrotic. An investigation into differential diagnosis of pulp and periapical pain.
John visits his doctor complaining of pain in his chest. The diagnosis of these lesions is essential for their successful management and of the patient as a whole. 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. Nondental pain without minimizing its importance, nondental pathology is not the most common cause of orofacial pain.
Chronic facial pain can be unilateral or bilateral and. Guideline american society of temporomandibular joint surgeons. Odontogenic pain management fdi world dental federation. 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. 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. Differential diagnosis and management of oral ulcers. From the perspective of a dental pain emergency, practitioners need to establish a differential diagnosis of dental pain versus nondental 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. A detailed description of pain and the complete diagnostic sequence are mandatory, including adequate clinical and radiographic examination. Dental abscess differential diagnoses medscape reference. In clinical dentistry, patients frequently report with isolatedregional or generalized gingival enlargements, which could fall under varied presentations. The common categories of nondental pain and speciic examples are provided in table 1. Otalgia ear pain is a common presentation in the primary care setting with many diverse causes. 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.
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. Dental diseases differential diagnosis pdf for free. Orofacial pain syndromes encompass several clinically defined and classified entities. Differential diagnosis of orofacial pain sailesh kumar. 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. Certainly temporomandibular joint pain has a long history, for ruffer1 found evidences of temporomandibular joint pathology in the skulls of early modern man. 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. Differential diagnosis of chronic neuropathic orofacial pain. 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. Differential diagnosis headache made easy with mnemonics.
Meniscus pathology infection trauma dentaltreatment tmd tumours and drugs radiotherapy and congenital miscellaneous related oral care chemotherapy. Priya verma gupta differential diagnosis of dental diseases it is a book of the art and science of distinguishing one disease from another. Orofacial pain an update on diagnosis and management. A structure for accurate diagnosis is proposed beginning with a very careful history. Differential diagnosis of pulpitis academy of dental. Differential diagnosis of facial pain and guidelines for. Sep 02, 2011 a note on orofacial pain and differential diagnosis. Classification and differential diagnosis of oral and maxillofacial pain article pdf available in oral and maxillofacial surgery clinics of north america 283. Differential diagnosis of orofacial pain linkedin slideshare. Jan 01, 2018 otalgia ear pain is a common presentation in the primary care setting with many diverse causes. Pain is a complex experience encompassing a specific sensation and the reactions to that sensation. Pdf classification and differential diagnosis of oral.
Special section on diagnosis based on the laboratory findings has been updated to help the practitioners and the students alike. Ramandeep singh gambhir reader and head, gian sagar dental college and hospital, rajpura, punjab, india tel. The diagnosis and management of orofacial pain may be challenging due to complex histories, pathophysiology and associated psychosocial comorbidities such as depression and anxiety. 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. Non dental pain without minimizing its importance, non dental pathology is not the most common cause of orofacial pain. The examination, differential diagnosis, and management of. The common categories of non dental pain and speciic examples are provided in table 1.