All dental patients who present to the dental office with a chief complaint of “pain” may not have an odontogenic etiology for their pain. A differential diagnosis of nonodontogenic pain includes myofascial pain, pain of neurovascular origin, toothache of cardiac origin, episodic neuropathic toothache, atypical odontalgia, of a sinus toothache, and toothache of psychogenic origin1. A review of the characteristics of pain from an odontogenic source would be useful in order to recognize any aberrations. Characteristics of pain from an odontogenic source include a dull, achy, throbbing with occasionally sharp pain. Other characteristics of pulpal pain include an identifiable condition that would explain the symptoms and local anesthesia to the affected tooth eliminates the pain. Signs of periodontal pain are an identifiable periodontal condition that explains the symptoms of a dull, aching, or throbbing pain. Also, under a load of occlusal pressure during chewing, the tooth feels sore and discomfort is only felt when biting pressure is released. Local anesthesia to the affected periodontal …show more content…
tissue also eliminates the pain. In cases where the pain is a nonodontogenic source, signs and symptoms can vary for the specific etiology but they share a common characteristic of a non-identifiable dental cause for the pain or discomfort, the quality of pain is burning and non-pulsatile with a constant unremitting toothache1.
When pain is referred, local provocation of the site of pain fails to increase the pain1. In addition, local anesthesia placed at the site of pain fails to reduce the pain1. Patients with nonodontogenic pain also have a persistent recurrent toothache that lasts several months or years1. They can have spontaneous multiple toothaches and local anesthesia to the suspected tooth does not eliminate the pain1. This is the key difference between pain from an odontogenic and nonodontogenic source. In addition, pain from a nonodontogenic source fails to respond to dental
therapy1. Soft tissue can be a source of non-odontogenic toothache. Any ulceration in the oral cavity, mucositis, fungal or viral infections, or nutritional deficiencies can cause pain in the mouth. Diagnosis of soft tissue pathologies can be done with clinical examination, biopsy, and a review of the patient’s medical history. The following chart is a list of the differential diagnosis of nonodontogenic pain with their primary signs and symptoms that will help with obtaining an accurate diagnosis1.
It has been shown that intrathecal administriton of GABA receptor antagonists cause hyperalgesia and allodynia. Constitutive, the increase in the endogenous GABA activity in the spinal cord alleviate pain resulting from noxious and innoxious mechanical and thermal stimuli. Different GABA receptors have different roles in alleviating thermal and mechanical pain in different animal pain models. There is no study to date that has examined the involvement of GABA A and GABA B in sensory dimension of neuropathic pain resulting from compression of spinal cord. The current study tests the hypothesis that GABA A or GABA B receptors contributes to the allodynia and hyperalgesia observed after spinal cord injury. The results showed that the effect of GABA A and GABA B receptors on mechanical hyperalgesia is similar but these receptors have different effects on thermal hyperalgesia. While using baclofen as GABA B receptor agonist does not affect the thermal pain, thermal hyperalgesia resulting from spinal cord injury was greatly alleviated by different doses of GABA A agonist, muscimol. Both Baclofen and muscimol are able to reduce the mechanical and cold allodynia has been seen after spinal cord injury but the effect of baclofen is dose dependent with no effect in higher doses used in this study. While almost all doses of muscimol were used in this study reduce the amount of cold and mechanical allodynia. The other result obtained in this study is the short term effect of GABA agonist. The anitinociceptive effect of Baclofen and muscimol appear to be maxium at 15 min after injection and gradually diminished by time and their analgesic effect disappeared 3 hours after injection.
Phantom pain refers to the phenomenal experience of pain in a body part that has been amputated or deafferented (Flor, Nikolajsen & Jensen, 2006). The characteristics of phantom pain have been described to occur in quick and sudden attacks of pain shooting up and down the amputated limb as well as cases of constant, excruciating pain whilst intensely perceiving the amputated limb to be cramped or postured abnormally (Katz, 1992). Approximately eighty percent of amputees report suffering from or at least experiencing some level of phantom pain post amputation; therefore it is a prominent issue (Flor, Nikolajsen & Jensen, 2006). Phantom pain is neuropathic pain that has no individual trigger but instead a plethora of psychobiological aspects of neuroplasticity that contribute to the cause of phantom pain (Grusser, Diers & Flor, 2003). The following will: outline the role of the peripheral and central factors associated with phantom pain and discuss the cortical reorganisation of the somatosensory cortex in relation to phantom pain.
On his initial examination dated 23/06/13 the patient was seen for a routine full mouth scale and polish with reinforced oral hygiene instruction including flossing technique. He presented with excellent oral hygiene at this appointment which was a reflection of his commitment to good oral hygiene; tooth-brushing twice daily and dental flossing once daily. This was further supported by the patients plaque scores at 5% and bleeding scores at 4% with only minimal supra gingival calculus on lower anterior teeth. There was no erythema or oedema present on the gingival tissues.
Are you worried about feeling pain during a procedure? Are you scared of visiting the dentist and want to know how we can help? Our office offers three levels of dental sedation in order to help make your visit to Northwest Dental Healthcare as pleasant as possible. Learn more about our dental sedation options below.
Patients feel fear not so much from the actual pain but from the lack of control that they feel lying in a dental chair. That creates a lot of anxiousness in some patients, as they don’t feel helpless. Most dentists continue treating all patients in a similarly assuming that they all have similar pain level and will handle the procedure in the same way. Dentists should be mindful of their patient’s level of tolerance and make them aware of the entire procedure ahead of time so that they are able to handle the unexpected situations. They should take time to ensure that the patient feels comfortable at every step. Use of medications and wide array of techniques can help patients eliminate pain and anxiety and making dental visits a pleasant experi...
Pain is a universal element of the human experience. Everyone, at some point in their lives, experiences pain in one form or another. Pain has numerous causes, effects, and is itself a highly complex biological phenomenon. It also carries with it important emotional and social concerns. Pain cannot be entirely understood within the context of any one field of scientific inquiry. Indeed, it must be examined across a range of disciplines, and furthermore considered in relation to important non-scientific influences, such as emotional responses and social determinants. I conducted my explorations regarding pain with the following question in mind: to what degree is pain subjective? I found several avenues of inquiry to be useful in my explorations: they are (1) the expanding specialty in the medical profession of pain management; (2) pain in individuals with spinal cord injuries (SCIs) and (3) pain experiences of children. Examining these issues led to the conclusion that pain is in fact a highly subjective phenomenon.
In 1931, the French medical missionary Dr. Albert Schweitzer wrote, "Pain is a more terrible lord of mankind than even death itself." Today, pain has become the universal disorder, a serious and costly public health issue, and a challenge for family, friends, and health care providers who must give support to the individual suffering from the physical as well as the emotional consequences of pain (1).
Findings. Pain has many different meanings to many people. What is important to know as a nurse or health care provider is that pain is what the patient says it is. It is not the nurse or provider’s place to determine what the patient’s pain is but rather take an in-depth history and assessment. Using this assessment and history can therefore help treat your patient’s pain accordingly. Also pain theories have been proposed and used the implications of nursing practice in regard to pain.
Somatic pain is that in which nociceptors in the cutaneous or deep tissues are activated by noxious stimuli. This is usually characterized by dull, aching pain which is well localized. This type of pain may be commonly experienced by individuals with metastatic bone pain or those who h...
...c regimen, prolonged hospitalization, cost, workload on medical team, mortality rate. Moreover, unproductive assessment tool existence leads us to look for other evaluation criteria for pain. This study will aid in adding original information about the presented pain assessment tools and will demonstrate their effectiveness and ability to assess the level of pain in non-communicative patients comparing to The Critical-Care Pain Observation Tool (CPOT)
...tein, G. and Stubhaug, A. (2008). Assessment of pain. British Journal of Anaesthesia. 101 (1), pp 17-24.
Freud had a preoccupation with death and suffering. He lived with great personal pain and during a time in history of war and death. From the burning of his books to the murder of his sister and dispersal of his family from their homes, Freud experienced the effects of human depravity by the efforts of Nazi ideology. His preoccupation with death and suffering was justifiable be, but he needed a rationale for why this problem of pain existed, and how men should to respond to it. Through personal struggle with pain, Freud examined his own psyche. He had a dichotomous desire for his own death. One the one hand he wished for immortality, but on the other hand he wished for an end to suffering through death. He chose to reject beliefs of heaven, hell, paradise and immortality on the basis that these ideas were only childhood fantasies. Freud found it preferable to esteem the work of thought as an end. Seeking comfort through “child-hood fantasy” was not an option, according to him. He said that he could not “face the idea of life without work. What would one do when ideas fail...,” and that it would be “impossible not to shudder at the thought.” His rejection of a real God caused his understanding of how and why the problem of pain existed to be limited to the realm of human invention. Freud theorized that guilt was at the heart of antisemitism. He wrote, “Moses and Monotheism” for this very purpose. According to his theory, Christianity was invented in order to relieve the unbearable guilt that the world experienced. Judaism, however, rejected this solution for the relief of guilt and consequently the world “repays Judaism with eternal hatred.” Despite his determined conclusions derived from thought, Freud did state t...
Pain is worldwide. In every county and every city, pain is being experienced. Whether it is the pain of a stubbed toe or the pain of a massive heart attack, someone is in pain and that pain has a purpose. However, from the first experience of pain we begin to suspect that pain is no friend of ours. And as we continue to endure and be subjected to pain, we begin to loathe it. As the dislike towards pain grows, we Americans give up on bearing and conquering pain. Our medicine cabinets have become filled with pain pills and popping a pill at every miniscule ache has become routine. Yes, some pains of excruciating and chronic levels should be diminished, but pain should never be eradicated. We may wish to be invincible to pain, but pain has a purpose and it is a necessity to be felt. As humans with no natural armor, we fear pain and try to escape it; however, the rare disease of Congenital Insensitivity to pain reinforces and confirms that pain is the vital teacher essential to our survival, and above all we should all be grateful for pain.
Pain, a word that is always associated with getting hurt. The real question now is how it hurt. In life people experience many types of pain. There are two different kinds of pain; physical and mental. The physical part of pain is like falling from something, cutting your arm, or stubbing your toe. The mental part of pain is like hurting someone’s feeling from saying something harsh or doing something to them emotionally, which hurts inside. The causes and effects of physical and mental pain are very different but can be both equally devastating and even more dramatic with emotionally disturbed people.
What does pain mean to you? Pain is a tense feeling that tells you something may be wrong. There’s physical pain- acute and or chronic, emotional pain, and also a phrase known as “pain in the ass”- which is where something or someone is being annoying and or troublesome.