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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)
Differential Diagnosis of Orofacial Pain

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Differential diagnosis of orofacial pain l.jpgSlide 1

Differential Diagnosisof Orofacial Pain

By

S. Wanachantararak

Pain for intraoral origin l.jpgSlide 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

Non vascular origin orofacial pain l.jpgSlide 3

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.jpgSlide 4

Vascular Origin Orofacial Pain

  • Migraine Headache

  • Cluster Headache

  • Peroxymal hemicrania

  • Vascular Headache

History examination of orofacial pain l.jpgSlide 5

History Examination ofOrofacial Pain

History ex of orofacial pain l.jpgSlide 6

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.jpgSlide 7

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.jpgSlide 8

    Clinical Examination of Orofacial Pain

    Clinical examination l.jpgSlide 9

    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.jpgSlide 10

    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 from intraoral origin l.jpgSlide 11

    Pain from Intraoral Origin

    Pain for intraoral origin12 l.jpgSlide 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

    Pain for intraoral origin13 l.jpgSlide 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

    Pain for intraoral origin14 l.jpgSlide 14

    Pain for Intraoral Origin

    Pain for intraoral origin15 l.jpgSlide 15

    Pain for Intraoral Origin

    Pain for intraoral origin16 l.jpgSlide 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

    Pain for intraoral origin17 l.jpgSlide 17

    Pain for Intraoral Origin

    Pain for intraoral origin18 l.jpgSlide 18

    Pain for Intraoral Origin

    Pain for intraoral origin19 l.jpgSlide 19

    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 origin20 l.jpgSlide 20

    Pain for Intraoral Origin

    Pain for intraoral origin21 l.jpgSlide 21

    Pain for Intraoral Origin

    Pain for intraoral origin22 l.jpgSlide 22

    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 origin23 l.jpgSlide 23

    Pain for Intraoral Origin

    Pain for intraoral origin24 l.jpgSlide 24

    Pain for Intraoral Origin

    Pain for intraoral origin25 l.jpgSlide 25

    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 origin26 l.jpgSlide 26

    Pain for Intraoral Origin

    Pain for intraoral origin27 l.jpgSlide 27

    Pain for Intraoral Origin

    Pain for intraoral origin28 l.jpgSlide 28

    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 origin29 l.jpgSlide 29

    Pain for Intraoral Origin

    Pain for intraoral origin30 l.jpgSlide 30

    Pain for Intraoral Origin

    Non vascular origin orofacial pain31 l.jpgSlide 31

    Non Vascular OriginOrofacial Pain

    Non vascular origin orofacial pain32 l.jpgSlide 32

    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.jpgSlide 33

    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 pain34 l.jpgSlide 34

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain35 l.jpgSlide 35

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain36 l.jpgSlide 36

    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 pain37 l.jpgSlide 37

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain38 l.jpgSlide 38

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain39 l.jpgSlide 39

    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 pain40 l.jpgSlide 40

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain41 l.jpgSlide 41

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain42 l.jpgSlide 42

    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 pain43 l.jpgSlide 43

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain44 l.jpgSlide 44

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain45 l.jpgSlide 45

    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 pain46 l.jpgSlide 46

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain47 l.jpgSlide 47

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain48 l.jpgSlide 48

    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 pain49 l.jpgSlide 49

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain50 l.jpgSlide 50

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain51 l.jpgSlide 51

    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 pain52 l.jpgSlide 52

    Non Vascular Origin Orofacial Pain

    Non vascular origin orofacial pain53 l.jpgSlide 53

    Non Vascular Origin Orofacial Pain

    Vascular origin orofacial pain54 l.jpgSlide 54

    Vascular OriginOrofacial Pain

    Vascular origin orofacial pain55 l.jpgSlide 55

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Vascular origin orofacial pain56 l.jpgSlide 56

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Vascular origin orofacial pain57 l.jpgSlide 57

    Vascular Origin Orofacial Pain

    Vascular origin orofacial pain58 l.jpgSlide 58

    Vascular Origin Orofacial Pain

    Vascular origin orofacial pain59 l.jpgSlide 59

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Vascular origin orofacial pain60 l.jpgSlide 60

    Vascular Origin Orofacial Pain

    Vascular origin orofacial pain61 l.jpgSlide 61

    Vascular Origin Orofacial Pain

    Vascular origin orofacial pain62 l.jpgSlide 62

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Vascular origin orofacial pain63 l.jpgSlide 63

    Vascular Origin Orofacial Pain

    Vascular origin orofacial pain64 l.jpgSlide 64

    Vascular Origin Orofacial Pain

    Vascular origin orofacial pain65 l.jpgSlide 65

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Vascular origin orofacial pain66 l.jpgSlide 66

    Vascular Origin Orofacial Pain

    Vascular origin orofacial pain67 l.jpgSlide 67

    Vascular Origin Orofacial Pain

    Pain for intraoral origin68 l.jpgSlide 68

    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.jpgSlide 69

    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.jpgSlide 70

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Thank you l.jpgSlide 71

    Thank You


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