Differential diagnosis of orofacial pain
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Differential Diagnosis of Orofacial Pain. By S. Wanachantararak. 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)

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Differential diagnosis of orofacial pain l.jpg

Differential Diagnosisof Orofacial Pain

By

S. Wanachantararak


Pain for intraoral origin l.jpg
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 l.jpg
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 l.jpg
Vascular Origin Orofacial Pain

  • Migraine Headache

  • Cluster Headache

  • Peroxymal hemicrania

  • Vascular Headache


History examination of orofacial pain l.jpg

History Examination ofOrofacial Pain


History ex of orofacial pain l.jpg
History Ex. of Orofacial Pain

C. Characteristics of pain

  • Quality of pain

  • Behaviour of pain

    • Temporal

    • Frequency

    • Duration

  • Intensity

  • Concomitant symptoms

  • Flow of pain

1. Chief complaints

A. Location of pain

B. Onset of pain

  • Association with other factors

  • Progression


History ex of orofacial pain7 l.jpg
History Ex. of Orofacial Pain

  • E. Past consultation and/or treatment

  • F. Relationship to other complaints

  • 2. Past medical history

  • 3. Review of systems

  • 4. Psychological assessment

  • 1. Chief complaints (cont.)

    D. Aggravating and alleviating factors

    • Physical modalities

    • Function and parafunction

    • Sleep disturbances

    • Medications

    • Emotional stress


    Clinical examination of orofacial pain l.jpg

    Clinical Examination of Orofacial Pain


    Clinical examination l.jpg
    Clinical Examination

    E. Cervical evaluation

    F. Balance and co-ordination

    2. Muscle examination

    A. Pulpation

    • Pain and tenderness

    • Trigger points and pain referal

    1. General examination

    A. Vital signs

    • Blood pressure

    • Pulse rate

    • Respiratory rate

    • Temperature

      B. Cranial nerve evaluation

      C. Eye evaluation

      D. Ear evaluation


    Clinical examination10 l.jpg
    Clinical Examination

    C. Oral structures

    • Mucogingival tissues

    • Teeth

    • Periodontium

    • Occlusion

      4. Other diagnostic tests

      A. Imaging

      B. Laboratory tests

      C. Psychologic provocation tests

    3. Masticatory evaluation

    A. Range of mandibular movement

    • Measurement

    • Pain

      B. Temoromandibular joint evaluation

    • Pain

    • Dysfunction



    Pain for intraoral origin12 l.jpg
    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 origin13 l.jpg
    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 origin16 l.jpg
    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 origin19 l.jpg
    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 origin22 l.jpg
    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 origin25 l.jpg
    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 origin28 l.jpg
    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 pain31 l.jpg

    Non Vascular OriginOrofacial Pain


    Non vascular origin orofacial pain32 l.jpg
    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 pain33 l.jpg
    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 pain36 l.jpg
    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain fromTM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia




    Non vascular origin orofacial pain39 l.jpg
    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain fromTMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia




    Non vascular origin orofacial pain42 l.jpg
    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 pain45 l.jpg
    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 pain48 l.jpg
    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 pain51 l.jpg
    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 pain54 l.jpg

    Vascular OriginOrofacial Pain


    Vascular origin orofacial pain55 l.jpg
    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache


    Vascular origin orofacial pain56 l.jpg
    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache




    Vascular origin orofacial pain59 l.jpg
    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache




    Vascular origin orofacial pain62 l.jpg
    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache




    Vascular origin orofacial pain65 l.jpg
    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache




    Pain for intraoral origin68 l.jpg
    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis


    Non vascular origin orofacial pain69 l.jpg
    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 pain70 l.jpg
    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache



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