Facial Pain
Primary causes of pain
- Dentine sensitivity
- pulpitis
- periapical periodontitis
- abscess
- neuralgias
Neuralgias
- Trigeminal neuralgia
sharp stabbing episodic electric shock like pain; lasts a few sec
trigger zone - stimulated by washin face/shaving etc.
Treated with carbamazepine 100mg 2x per day. Local anesthetic, injected to trigger zone can relief pain temporarily
- Glossopharyngeal neuralgia
Posterolateral tongue + ear of affected side; stimuli -> eating, drinking, speaking
- Preherpetic neuralgia
Aching, burning pain, limited to distribution of trigeminal nerve
Treated with high dose acyclovir
- Postherpetic neuralgia
Unpleasant burning pain.
Blockade of stellate ganglion with bupivicaine (local anesthetic) (short term relief)
Pain of vascular origin
- migraine
Intense persisting aching pain, unilateral; stimuli -> food, alcohol, stress, hormones, give painkillers
- cluster headache
Intense aching pain that disturbs sleep, nasal congestion.
Stimuli : alcohol, vasodilators, high altitude.
Treat with ergotamine or sumatriptan.
- Giant cell arteritis
Throbbing headache, unilateral, fever, malaise, weight loss, treated with high dose prednisolone.
Atypical orofacial pain
Gripping, vice like aching pain, feeling of pressure
Burning mouth syndrome
- type 1 (not present on waking)
- type 2 (present on waking)
- type 3 - intermittent - Possible deficiency of vitamin B1 and B6
