Ive seen tons of teeth that test non vital but are normal to percussion. Odontogenic and nonodontogenic pain pocket dentistry. Nonodontogenic oral and maxillofacial infections, a textbook of advanced oral and maxillofacial surgery, mohammad hosein kalantar motamedi, intechopen, doi. What is used to come up with a diagnosis of odontogenic cyst.
Introduction pain is an unpleasant, subjective, sensational and emotional experience as. Non odontogenic facial pain can be caused by inflammation due to tumour, infection, or trauma. Paracetamol or a nonsteroidal antiinflammatory drug is the recommended analgesic in the initial treatment of dental pain. There are many possible nondental causes, but the vast majority of toothache is dental in origin 1 both the pulp and periodontal ligament have nociceptors. May 30, 2018 odontogenic pain is one of the most common forms of orofacial pains. There are many possible non dental causes, but the vast majority of toothache is dental in origin 1 both the pulp and periodontal ligament have nociceptors. Most patients can attain satisfactory relief of odontogenic pain through an. A mild vestibular space infection may not require anti. Combining btxa injections with other treatments for traumatic trigeminal neuropathic pain that does not respond to conventional medication and. Most patients can attain satisfactory relief of odontogenic pain through an approach that. The term comes from the term odontogenesis, which refers to the process that teeth are formed from embryonic cells. Chronic facial pain is a more descriptive term than. An understanding of the dentists limitations is important in order to ensure the safety and wellbeing of patients presenting with odontogenic infections.
This is a pdf file of an unedited manuscript that has. Patients can present with pain of odontogenic or non odontogenic origin, arising from the facial area, temporomandibular joints, ear, eyes, pharynx and larynx. An overview of odontogenic infections was presented including an overview of management and guidelines for referral. Orange beautiful 10 operatory office ready for merger. Ive seen tons of teeth that test nonvital but are normal to percussion. Tooth andor its supporting structures are often source of. Atypical odontalgia is predominantly diagnosed in females with 74 to 100% of cases reported 16. Odontogenic tumours daniel j brierley keith d hunter abstract odontogenic tumours are rare lesions and many nonspecialist histopathologists will not have seen many during their working lifetime. Dissemination of the infection was observed for the buccal, pterygomandibular, infratemporal and parapharyngeal spaces. Building effective strategies for the management of. Headache disorders may pose another complicated diagnosis. An overview of odontogenic infections when to refer.
Management of odontogenic and nonodontogenic oral pain. Pain in the orofacial region is the most common reason for patients to visit a dental clinic. Frequency of nonodontogenic pain after endodontic therapy. Journal of the california dental association issn 10432256 is. The average age for the patients with atypical odontalgia is in the midforties but has ranged from 20 to 82 1, 2, 4. However, clinician often encounters situation when odontogenic causes of pain are excluded and non odontogenic causes should be. The tooth may be sensitive to pressure, heat, cold, or sweets. Odontogenic pain is one of the most common forms of orofacial pains. Regions often presenting as orofacial pain complaints include the sinuses, salivary gland, ears, eyes, throat, mandibular, and maxillary bone pathology. Similarly, dental pain may be referred to non dental structures. Pain is not a simple sensation but rather a complex neurobehavioral event involving at least two components. Odontogenic pain complaintsofanguish,posturaldisplays,groaning,wincing,andgrimacing are all equated with pain, along with limitation of normal activity function, excessive rest, social withdrawal, and demand for medication. Pulpal pain, periodontal pain, gingival pain and bone pain are the 4 different types.
Pdf on mar 1, 2019, sameer shaikh and others published. The term odontogenic refers to things that originate from the tissues of the teeth. An understanding of nonodontogenic sources of pain that may mimic dental pain is, therefore, very important in avoiding a misdiagnosis. However, clinician often encounters situation when odontogenic causes of pain are excluded and non odontogenic causes should be considered. Often they may be complaining of pain from their teeth. Combining ibuprofen with apap provides dentists with an additional therapeutic. Patients presenting to a dental office with what they feel to be odontogenic pain must be screened to eliminate any potentially nonodontogenic source to their symptoms. Nonodontogenic toothache revisited semantic scholar.
Nonodontogenic cyst definition of nonodontogenic cyst by. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Odontogenic infections should be taken seriously when they occur. The decision to place the patient on antibiotics depends on the location and severity of the infection and the patients medical conditions. Knowledge of the various presentations of non odontogenic pains will ultimately prevent the misdiagnosis and the institution of incorrect and sometimes irreversible treatment to the patients. However, the site the patient feels pain may not be the actual source of pain. An abnormal membranous sac in the body containing a gaseous, liquid, or semisolid substance.
Petr schutz and hussein hassan hamed ibrahim june 26th 20. Lecture notes for the the 143 annual session of the south carolina dental association. Although pain of dental origin is the most common orofacial pain, other non odontogenic pains can af fect. No drug therapies are discussed or recommended, as drug availability and preferences vary throughout the world. Once odontogenic cause of pain has been excluded, other potential causes of orofacial pain should be taken into consideration, in order to establish a valid diagnosis. In the diagnosis of odontogenic cysts xrays play a major part. Review article cavernous sinus thrombosis of odontogenic. The assumption that a patient enjoys good dental health may not always be true. Orofacial pain odontogenic pain pain coming from the. The timely diagnosis and management of dental pain is an essential component of dental care, and this article reminds readers of the common presenting symptoms of simple dental pain, diagnoses and pragmatic management. Orofacial pain can be divided into odontogenic and nonodontogenic pain. Most patients reporting dental pain have symptoms that are odontogenic. Managing the periodontal inflammation is of primary importance in cases of combined occlusal. When a person sees a dentist or a doctor complaining about odontogenic pain, the most difficult part of the diagnosis is to assess the origin of the pain.
Pain of odontogenic and nonodontogenic origin pocket. Nonodontogenic facial pain can be caused by inflammation due to tumour, infection, or trauma. Most are harmless, but they should be removed when possible because they occasionally may change into malignant growths, become infected, or obstruct a gland. Pain originating from pulp dentine complex andor periodontal structures presents with variable clinical characteristics and can be accurately diagnosed and treated. Chronic facial pain is a more descriptive term than atypical facial pain and should be adopted for continuous. These characteristics and the perceived origin of the pain may be pathognomonic for specific sites. Atypical odontalgia misdiagnosed as odontogenic pain. Nonodontogenic oral and maxillofacial infections intechopen. It is addressed to national dental associations, dental academic groups and dentists, to improve proper management of this condition. Facial pain of odontogenic origin must not be overlooked as a possible source of chronic or complex orofacial pain. When teeth go from ip to necrosis, theyre pain free and non tender to percussion. Food impaction and pericoronitis soft tissue problems that may cause dull, throbbing, persistent pain include local inflammation acute gingivitis associated with food impaction or.
The dilemma the clinician faces is finding the correct origin of this pain whereby an effective treatment will provide relief. Odontogenic pain, a common malady globally and the most prevalent type of orofacial pain, originates from dental structures, pulpal or periodontal. Explain pain looks similar to the first edition but includes many new references, language changes and a font change. Sep 07, 2015 most patients reporting dental pain have symptoms that are odontogenic. Differential diagnosis for odontogenic pain is outlined in table 1. Pain of odontogenic origin is common, and distressing. Pain of odontogenic and nonodontogenic origin springerlink. Nonodontogenic toothache definition of nonodontogenic. Combining the present studys finding with our previous study that estimated the.
Non response does not always signify pulpal necrosis. Non odontogenic pain pdf four 44 per cent of 100 non dental orofacial pain patients had previously. This is because, often, the non odontogenic pains are mistaken with odontogenic pains. Pdf management of odontogenic and nonodontogenic oral pain.
Toothache definition a toothache is any pain or soreness within or around a tooth, indicating inflammation and possible infection. The orofacial region is the most frequent site for patients seeking medical attention for pain 1, 2 with 12. In cases of severe pain, identifying the problem tooth is often difficult. Toothache may be caused by dental odontogenic conditions such as those involving the dentinpulp complex or periodontium, or by non dental non odontogenic conditions such as maxillary sinusitis or angina pectoris. Diagnosis, causes, prevention and treatment paul a. Orofacial pain can be defined as any pain that occurs in the face and mouth, including the nose, ear, eye and throat. Paintypes terminology and clinical use term definition clinical use refractory pain pain that is resistant to ordinary treatment older adults with refractory pain may need a referral to an outpatient pain clinic for a comprehensive, interdisciplinary evaluation and development of a treatment plan. Odontogenic tumours daniel j brierley keith d hunter abstract odontogenic tumours are rare lesions and many non specialist histopathologists will not have seen many during their working lifetime. When teeth go from ip to necrosis, theyre pain free and nontender to percussion. I would suspect that theres some histologic apical periodontitis i dont have any proof, just opinion but i regularly seen necrosis with clinical evidence of apical periodontitis. Description a toothache may feel like a sharp pain or a dull ache. Odontogenic cyst and non odontogenic cyst epithelium. Pain must be considered in terms of quality, duration, temporal pattern, exacerbation, and relief. Tooth andor its supporting structures are often source of pain.
Similarly, dental pain may be referred to nondental structures. Overall, the second edition of explain pain can be delivered with much more. Odontogenic pain refers to pain initiating from the teeth or their supporting structuresthe oral mucous membrane, gingiva, maxilla, mandible, and periodontal ligament. Odontogenic pain management fdi world dental federation. Pdf differential diagnosis of nonodontogenic sinusitis. Mar 01, 2011 odontogenic pain refers to pain initiating from the teeth or their supporting structuresthe oral mucous membrane, gingiva, maxilla, mandible, and periodontal ligament. Neuropathic pain pain iniciated or caused by a primary lesion, dysfunction, or transitory perturbation in the peripheral or central nervous system neuropathic pain pain arising as a direct consequence of a lesion or disease affecting the somatosensory system iasp definition 2008 nonnociceptive, pathological pain. The metaanalytical summary estimate of nonodontogenic pain frequency was 3. There are two main types of pain, known as nociceptive pain and neuropathic pain. Psychogenic pain is another term that is sometimes used to. Temporary pain relief after therapy with carbamazepine for 3 months.
Heterotopic pain, non odontogenic toothache, orofacial pain, referred pain. Although patients may perceive that pain originates in a specific tooth, the pain may actually be referred from non dental structures. This fdi policy statement covers general aspects for consideration during odontogenic pain diagnosis and treatment selection. Oral pain of nonodontogenic origin can originate from the intraoral structures, such as buccal mucosa, gingival tissues, and alveolar bone. Pain arising from the teeth and supporting structures must always be. This is because, often, the nonodontogenic pains are mistaken with odontogenic pains.
A condition that may mimic symp toms of odontogenic pain is atypical odontalgia. Nov 04, 2014 non odontogenic tumors of oral cavityi 1. Epidemiology most common odontogenic cyst is periapical. This paper discusses nonodontogenic sources of dental pain and the. Although non odontogenic tumors of the jawbones typically involve the same basic tumorigenic processes as bone tumors in other parts of the skeleton, the former may. Patients can present with pain of odontogenic or nonodontogenic origin, arising from the facial area, temporomandibular joints, ear, eyes, pharynx and larynx. The term non odontogenic indicates that the tumor is not composed of cellular constituents whose primary purpose is to form teeth or toothrelated structures odontogenesis. Topographical classification is often applied to this complex region.
Cysts are radiolucent lesions, and the prevalent clinical features are swelling, lack of pain unless the cyst becomes secondarily infected or is related to a nonvital tooth, and missing teeth, especially third molars. Toothache may be caused by dental odontogenic conditions such as those involving the dentinpulp complex or periodontium, or by nondental nonodontogenic conditions such as maxillary sinusitis or angina pectoris. Although patients may perceive that pain originates in a specific tooth, the pain may actually be referred from nondental structures. This is all covered in nondental sources of pain expect pathologic structures. It affects millions of people every day around the world, and can be caused by a variety of disorders and diseases. Oral cavity cysts oral cavity cysts exist in jaw bones and soft tissue, gingiva odontogenic. Acute trigeminal pain is a common presentation in the dental surgery, with a reported 22% of.
When each study was eliminated in turn from the analysis and the meta. Treatment of nonodontogenic orofacial pain using botulinum toxin. Although pain of dental origin is the most common orofacial pain, other non odontogenic pains can affect the orofacial region and occasionally mimic dental pain. When patients present with diffuse pain andor pain radiating to other areas, nonodontogenic sources should be given additional consideration. Pain is perfect misery, the worst of evils and excessive, overturns all patience john milton, paradise lost 2. A summary estimate of nonodontogenic tooth pain frequency was derived using. Although toothache is by far the most common pain entity in the facial region, not all pains that present as toothache are of odontogenic origin. The three categories of pain are different entities, and it is meaningless to say acute pain changes over to chronic pain after x number of weeks. Explain pain 8311 ebook free download book library.
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