Odontogenic Pain

I decided to use oraqix because the patient had a few pockets depths between 6-7 mm, and was very sensitive during the power instrumentation. It helped me to effectively remove the plaque and the calculus from the pockets with the hand instruments, but I found that it was not as effective when I used the Cavitron. After the removal of plaque and calculus I reviewed OHI with my patient Evelyn and reinforced the proper use of dental floss and have the patient practice in her mouth. During the afternoon section, I worked on the mandibular arch and as before I started with the power instrumentation. However, I was not able to use it in all the mandibular teeth because some of them had recession, and the patient was extra-sensitive. The good thing was the mandibular arch had only one area with 6-7 mm of pocket depth. I also used Oraqix in this area, but did not help with the recession because the pain was related to the pulp and not to the gingiva, in where Oraqix works. After finishing with debridement, my patient expressed having pain on the distal surface of tooth # 17. We decided to take a PA of the area because that part of the tooth was not visible in the HBW I

Thang has not yet had any major work done inside his mouth and all three of his third molars are partially erupted with the #17 and #32 impacted and horizontal. He has sealants placed on teeth #3, 4, 5, 12, 13, 14, 20, 21, and 29 for preventative measures with composite fillings on the occlusal surfaces of #19 and of #30. These restorations were all performed in on visit two years ago. He has not had orthodontic work or reported any major dental problems or complaints. His periodontal status is stayed the roughly the same since his initial visit at AAP I, with a solitary 4 mm pocket on his mandibular second molars. There was bleeding on probing, but not enough to increase his classification. His gingival was generalized pink and stippled with

Today in the clinic I worked on my patient Evelyn Serrano. I started her a month ago, but could not see her again until now because she is a stay home mom and is hard for her to find who babysit her kids. For today, her boyfriend did not go to work to stay home with the kid. Also, she lives in Danbury and do not drive, so she come to her appointment with me. The dental office where she had her last dental radiographs taken two years ago, was not able to send us her radiographs, and we decided on taking vertical bite wings (VBW) because she while doing her periochart she had some pockets depth between 6-8 mm. However, taking the VBW resulted very challenging experience because my patient Evelyn had difficulty biting down on the sensor. Her teeth never reached the bite block and she was trying holding it in place with her lips. In addition, she had a bad gagging reflex. At the end, I was able to take 4 horizontal bite wings and 4 periapical for the Mx/Mn anterior. The radiographs allowed me to corroborate my probing findings on her extensive bone loss. My patient had active sings of periodontal disease since she had generalized bleeding with minimum manipulation of the gingivae tissue and some of the pocket depths readings were higher today than on her last visit (which is an indicator the gingivae tissue is more inflamed than the last visit). Her diagnosed was a generalized chronic moderate periodontitis with localized chronic advanced periodontitis; and due to the presence of generalized calculus and inflammation, we decided that she will benefit if we first did a power instrumentation cleaning in her teeth to help reduce the inflammation. With the cleaning and the OHI

To diagnose and rule out other causes of the pain, your dentist will perform a thorough oral examination. For immediate and long-term relief from pain caused by TMD, your dentist may recommend behavior modification, eating soft foods for a few days to reduce stress on the jaw joints, gentle stretching exercises, anti-inflammatory medications, muscle relaxants, biofeedback, stress management, and other conservative therapies. Surgery is usually performed when all other treatments have

In the days before an episode begins, some patients experience a tingling or numbing sensation or a somewhat constant and aching pain. There is usually a worsening of pain over time, with fewer and shorter pain-free periods before the attacks occur again. Trigeminal neuralgia generally does not occur when the patient is asleep, and this differentiates from tooth pain or migraines, which often wakes them up at night. Pain is located in areas in the body that are supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead. Pain can either focus in one spot or spread in a wider pattern. An acute onset of sharp, stabbing pain usually affects one side of the face. The right side of the face five times more often affected than the left side of the face. Pain generally begins at the angle of the jaw and radiates along the junction lines between each of three branches of cranial nerve V. (CN

conditions that cause pain and dysfunction in the jaw and in the muscles that control jaw

This is where the most pressure is applied and where someone might feel the majority of tenderness, which means some pain is a good possibility. Discomfort in the gums or tongue area, including the cheeks and the floor/roof of the mouth, is common because the edges of the aligner are in contact with this soft tissue. About half of all of the patients who use aligners experience painful feelings that have their roots with the aligners. While using aligners is not apt to produce any severe pain, like metal braces may, the constant rubbing could be uncomfortable. Taking the aligner out of the mouth or putting it back causes the irritation which is the cause of the pain. However, the good news is that this issue takes place in the earliest stages of the process, which means that as the gums and teeth get used to this happening, the level of pain slowly fades

The patient claimed he had previously experienced this pain on a number of occasion, but usually it resolved itself

The prudent dentist must be aware of the mechanisms and clinical symptoms of referred pain, peripheral sensitization, central sensitization, and convergence. This knowledge will aide the clinician to be able to properly diagnose non-odontogenic oro-facial pain in order to treat the patient properly and to avoid doing irreversible harm to the patient, such as extractions or endodontic treatment on healthy

Another differential diagnosis for a patient reporting a toothache could be from Herpes zoster in the trigeminal nerve (Tidwell, Hutson, Burkhart, Gutmann, & Ellis, 1999). This diagnosis is particularly hard to come by because the beginning stages of the infection result in only odontalgia (pain in the tooth). Herpes zoster virus is responsible for the infectious disease known as shingles. H. zoster affects the sensory ganglion and its cutaneous nerve. 13% of patients afflicted with H. zoster, experience the infection at the site of the trigeminal nerve. There are three diagnostic stages of this infection: (1) prodromal stage, (2) active/acute stage, and (3) chronic stage. The first stage consists of a burning, tingling, or prickly

Charcot-Maria-Tooth affect both motor and sensory nerves. Motor nerves affect the way muscles contract and control muscle activity such as walking, breathing, and speaking. A common feature of CMT includes weakness of lower leg muscles and the foot. Deformities of the foot can be

Also, Dr. Thomas Peltzer can examine your teeth for signs of unusual wear, check the muscles around your jaw, and ask specific questions about your behavior and medical history to determine if bruxism is a problem for you. Some other signs to watch for include rhythmic contractions of the jaw muscles, morning headaches or jaw pain, teeth that feel loose, and unexplained facial soreness or pain.

Plan: Analgesics – continue with Nonsteroidal anti-inflammatory drugs (NSAIDs) to take along with muscle relaxants e.g. Benzodiazepines (Aguirre, Nevidjon, & Clemens, 2008). Tricyclics, opioids, and steroids may also come into play. Apply moist heat and massage of jaw muscles. X-ray may show at rest and hinge movement of the TMJ. CT scan demonstrates greater detail of facial bones and MRI is a good choice when looking for displacement or pathological source. A nerve block is helpful whether pain comes from the TMJ or not. If all other non-surgical treatment fails, arthroscopy, condylotomy, disc repositioning, and discectomy are possible procedures proven to reduce pain 90% of patients who have gone through any of the said surgeries (Robinson & Holm, 2010). When skeletal problems are not obvious and masked by orthodontics, the patient’s teeth and jaws will continue to be unstable and L.A. will continue to suffer. Her bite, because of the position of the teeth and the shape of the skull or jaws will require orthognathic surgery to correct this level of deformity found in both dental and skeletal problems (Robinson & Holm, 2010). Her orthodontist and surgeon will be working hand in hand during the course of the

Pain is an unpleasant sensory and emotional experience associated with either actual or potential tissue damage or described in terms of such damage. Pain during periodontal therapy is one of the factor that could forbid the patient from seeking further periodontal treatment. Hence pain management is necessary for the periodontist in enhancing the success of the periodontal therapy. Controlling pain is an important outcome measure for successful periodontal therapy and patient recall. The most common and easy method for pain control during nonsurgical periodontal therapy is use of topical anaesthetics, out of which EMLA is one of them, which is a mixture of equal quantities of lidocaine and prilocaine.

During the extraoral and intraoral exam all findings were within normal limits, except for crepitus on the left side of the mandible. Her oral hygiene was good, but had generalized light plaque on the gingival margins, and light to moderate calculus on the mandibular incisors and maxillary and mandibular molars. She had a class V composite restoration on tooth # 19 with irregular borders on cervical side; this tooth also had furcation involvement class I. For her treatment plan, I did a full mouth debridement with cavitron and hand instruments. During hand instrumentation, the restoration on tooth #19 came off and I was able to clean the furcation area better. I reviewed OHI and reinforced the use of the proximal toothbrush and the modified bass technique. The patient had an upper removable partial. I asked the patient if it was fine to clean the partial, and she said yes. I cleaned the partial, recommended to always remove it at night time, and leave it inside a cup with water and tablet of polident. When the dentist came to do an exam, he recommended to do class V restorations on teeth # 5 and 12 due to abrasion to prevent the fracture of the teeth. In addition, he advise to write a note about the need of adjusting the clasp on the partial removal so it does not put pressure on the