Differential Diagnosis of Orofacial Pain

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Presentation transcript:

Differential Diagnosis of Orofacial Pain By Dr.bahram Azizi

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Vascular Origin Orofacial Pain Migraine Headache Cluster Headache Peroxymal hemicrania Vascular Headache

History Examination of Orofacial Pain

History Ex. of Orofacial Pain 1. Chief complaints A. Location of pain B. Onset of pain Association with other factors Progression C. Characteristics of pain Quality of pain Behaviour of pain Temporal Frequency Duration Intensity Concomitant symptoms Flow of pain

History Ex. of Orofacial Pain 1. Chief complaints (cont.) D. Aggravating and alleviating factors Physical modalities Function and parafunction Sleep disturbances Medications Emotional stress E. Past consultation and/or treatment F. Relationship to other complaints 2. Past medical history 3. Review of systems 4. Psychological assessment

Clinical Examination of Orofacial Pain

Clinical Examination 1. General examination 2. Muscle examination A. Vital signs Blood pressure Pulse rate Respiratory rate Temperature B. Cranial nerve evaluation C. Eye evaluation D. Ear evaluation E. Cervical evaluation F. Balance and co-ordination 2. Muscle examination A. Pulpation Pain and tenderness Trigger points and pain referal

Clinical Examination 3. Masticatory evaluation A. Range of mandibular movement Measurement Pain B. Temoromandibular joint evaluation Dysfunction C. Oral structures Mucogingival tissues Teeth Periodontium Occlusion 4. Other diagnostic tests A. Imaging B. Laboratory tests C. Psychologic provocation tests

Pain from Intraoral Origin

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa

Non Vascular Origin Orofacial Pain

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trieminal Neuralgia Atypicgal Neuralgia

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Vascular Origin Orofacial Pain

Vascular Origin Orofacial Pain Migraine Headache Cluster Headache Peroxymal hemicrania Vascular Headache

Vascular Origin Orofacial Pain Migraine Headache Cluster Headache Peroxymal hemicrania Vascular Headache

Vascular Origin Orofacial Pain Migraine Headache Cluster Headache Peroxymal hemicrania Vascular Headache

Vascular Origin Orofacial Pain Migraine Headache Cluster Headache Peroxymal hemicrania Vascular Headache

Vascular Origin Orofacial Pain Migraine Headache Cluster Headache Peroxymal hemicrania Vascular Headache

Pain for Intraoral Origin Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis

Non Vascular Origin Orofacial Pain Pain from Teeth (pulp) Pain from TM muscle Pain from TMJ Sinusitis Salivary gland Trigeminal Neuralgia Atypical Neuralgia

Vascular Origin Orofacial Pain Migraine Headache Cluster Headache Peroxymal hemicrania Vascular Headache

Thank You