User:Sabhita Shabbir/sandbox

ORO FACIAL PAIN

Oro facial pain is defined as any pain which is felt in the mouth, jaws and the face. It is a common and frequent occurrence experienced by most patients. It may be acute or chronic. CAUSES OF OROFACIAL PAIN: 1)DENTAL PAIN:Pulpitis, cracked tooth, periradicular pathology, pericoronitis, dry socket.2)TEMPOROMANDIBULAR PAIN DISORDERS, 3)NEUROPATHIC PAIN DISORDERS: Trigerminal neuralgia, glosso pharyngeal neuralgia, post herpetic neuralgia.4).PATHOLOGY ASSOCIATED LOCAL STRUCTURES:Salivary glands, paranasal sinuses, eyes, cervical spine ,isorders, nasopharynx.5)VASCULAR DISORDERS: Headache, migraine, cluster headache, tension-type headache, giant cell arteritis.6) PSYCHOGENI FACIAL PAIN:Atypical facial pain.7)INTRACRANIAL LESIONS:Neoplasms ,Multiple sclerosis8).REFERRED PAIN FROM A REMOTE SIDE:Angina pectoris.

 DIAGNOSIS For differential diagnosis of oro facial pain some key points about pain is important.1)LOCATION: Pain may be localized or diffuse. e.g. atypical facial pain is diffuse and radiate.2)CHARACTER: Pain may be : sharp, dull, aching ,throbbing, shooting 3)SEVERITY: Rate the pain severity on the scale of 0 to 10. Scale of zero no pain and 10most severe pain.4)DURATION: Average duration of each episode may  help  diagnosis.e.g. pain from exposed dentine is fairly transient and pain from pulpitis lasts for  longer period. 5) FREQUENCY AND PERIODOCITY:Determine whether the pain occurs at     specific times.6) PRECIPATING AND AGGREVATING FACTORS:If any factor influence the pain. e.g. touching a trigger zone may precipitate   trigerminal neuralgia stress may worsen atypical facial pain.

	Diagnosis of orofacial pain is very difficult due to multifactorial nature of problem.The most important means of diagnosis of orofacial pain is proper history.Next step should be elimination of pains of local origin such as abnormal pulps, periapical and peridontal lesions.Clinical and radiographical examination is important.Vitality testing of teeth and diagnostic local anesthetic injections may be useful aid.