1. Differential Diagnosis of Orofacial PainBy
Dr.bahram Azizi

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

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

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

5. History Examination of Orofacial Pain

6. 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

7. 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

8. Clinical Examination of Orofacial Pain

9. 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

10. 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

11. Pain from Intraoral Origin

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

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

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

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

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

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

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

19. Non Vascular Origin Orofacial Pain

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

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

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

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

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

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

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

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

28. Vascular Origin Orofacial Pain

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

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

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

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

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

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

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

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

37. Thank You