Understanding Pain Quality in PDAP Diagnosis

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PAIN QUALITY PDAP can present in a broad range of fashion. Diagnosis should not rely on pain characteristics only, as it may mislead the clinician towards other diagnoses such as tooth pain, myofascial pain or even trigeminal neuralgia (11). We summarized features of PDAP pain quality from studies of level 3 and 4 evidence (11) (35) (36). Among the most common descriptors for the baseline pain we find terms as aching, dull, pressing, heavy and cramping. Some patients report an itchy and tingly sensation other than a real pain. Pain exacerbations can be described even more variably and the most reported one is pain felt as intense heat. Clinicians must be aware of possible misleading descriptors for pain exacerbations such as throbbing and stabbing, that can lead towards a vascular …show more content…

Patients quality of life score was lower than in matched healthy controls in most of the domains, particularly in pain-related aspects and social functioning (35). The persistent nature of the pain has a tiring effect and involves every aspect of patient’s daily life (4). In the aforementioned study by List et al., patients also filled out the JFLS questionnaire (Jaw-Functioning-Limitation-Scale). Jaw related limitations are higher in PDAP patients than in controls. Though, according to a case-control study by Baad-Hansen et al., jaw limitations, as measured by the JFLS, are less severe in PDAP patients than TMD patients (43). Vena et al., administered the OHRQoL questionnaire (oral health-related quality of life) to 63 patients having persistent post-endodontic tooth pain. The authors concluded that patients reporting pain on percussion of the affected tooth have the lowest quality of life, as every time their tooth functions, they have pain exacerbation and a constant remainder of their chronic pain

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