Dental pain:-unpleasant sensation felt by
the pt. in relation to odontological cause.
Assessment of pt. suffering from orofacial pain:-electing as much information as possible
I. The nature of the pain
II. When the pain first start
III. Duration of pain.
IV. The site affected.
V. Initiating factors.
I. Precipitating factors.
II. Exacerbating factors.
III. Reliving factors..
IV. Associated signs &symptoms.
Dentine sensitivity: S&S:
The pain is best described as a sensation of sudden
shock and is sharp in nature. It is never spontaneous
Precipitating by a noxious stimulus, either hot or
cold, sweet or sour, or touch.
Localized &last for short time.
Diagnosed by inspection or by x-ray…..etc.
Management:-removal of caries & isolation of
Pericoronitis: an inflammation of the
operculum around the crown of partially
erupted a tooth (usually the third molar).
radiating pain in back of the mouth and
the inability to comfortably open or close the jaw. Not
only is it painful to close against the inflamed
operculum behind the erupting mandibular molar.
sever pain & inflammation .
Management:I. Preservative: irrigation ,anti-inflammatory
Dry socket:-failure of formation or maintenance of
blood clot in extraction socket leaving bare bone.
S&S: sever pain.
Irrigation under L.A.
II. Alveogel or an abundant material is placed in the
2. thermal shock
sharp pain with stimuli (esp cold)
subside within seconds after its removal
1-pain for short duration
2-visual checking for caries or fracture
II-Irreversible pulpitis: Cause:
2. Thermal shock
3. Chemical irritation
1. Pain with food impaction &cold & sweet food and
may be spontaneous intermitted or continuous.
The pain persist after removal of the stimuli and increase
when the patient lies down or bend over and relived with
The pain may referred to adjacent teeth or to ear or tmj
1. Visual deep cavity or secondary caries.
2. probing will cause pain.
4. Vitality test hyperplasia respond of the pulp (esp. cold)
which persist after its removal.
5. In late stage cold relief the pain.
Rct or extraction
Abscess:Point of comparison
Sensitivity to percussion Yes
May or may not
Angular bone Changes in apical area
Localized to Gingival tissue
Sharp, stabbing episodes, last for sac to 2min.
Initiating when trigger zone is touched.
>50 year &more in female.
Absence of associated signs &symptoms.
Management:I. Medical: carbamazepine
- Gama knife stereotactic surgery.
• L.A. injection :provide temporary relief &also confirming
Continuous Aching or burning pain mimic chronic
Limited to the distribution of the divisionof the
trigeminal nerve in which the lesion of H.Z.
May be localized by the pt. to a particular tooth or
Special investigation: Vitality test & x-ray to exclude dental pathology..
Also history of H.Z.
• Medical management:-
• Treatment of H.Z.by appropriate antiviral.
The pt. localized the pain to a tooth or group of teeth
are clinically and radiographically normal.
The pt. may have already undergone dental
treatment in an attempt to alleviate their
symptoms, including the extraction of one or more
tooth, with only temporary relief of symptoms.
The dentist must resist extracting healthy tooth in