100% Correct
Characteristics of neuralgic toothache (7) - Answer Pain is severe, unilateral, lancinating,
shock-like (paroxysmal pain) felt in a tooth
Pain episodes are brief, lasting only 5-10 seconds
There is no pain reported between episdoes
Pain is provoked by relatively innocuous peripheral stimulation of a trigger zone. The
trigger zone is commonly an extra-oral site such as the lip or chin but may be the tooth
If the tooth is the trigger zone, repeated stimulation will not produce the paroxysmal
pain (need time for quenching period)
Very localized anesthesia of the tooth (inter-ligamentous injection) will not reduce the
pain unless it is also the trigger zone
Local anesthetic at the trigger zone (or a nerve block) will eliminate the episodes of
paroxysmal pain and toothache during the period of anesthesia
Treatment considerations for neuralgic toothache? (3) - Answer Referral to neurologist
Tegretol, trileptal, neuroontin.etc- surgical considerations
Consider providing a local anesthetic block of the affective nerve
Characteraistics of neuritic toothache? (5) - Answer Peristent, nonpulsatile, often
burning pain felt in a tooth
Presence of other neurologic symptoms (paresthesia, dysesthesia, anesthesia)
other teeth may feel dead or strange
Associated gingival tissue may be affected
Onset of toothache followed an infection or trauma (sinusitis, surgery etc.)
, Treatment considerations for neuritic toothache when inflammation is suspected -
Answer Directed to the inflammatory condition (antibiotics, steroids)
Treatment considerations for neuritic toothache when trauma is suspected? - Answer
Managemnt is the same as with a continuous neuropathic pain disorder
Continous dentoalveolar pain is also called? (4) - Answer Persistent dentoalveolar pain
Atypical odontalgia
Phantom tooth pain
Atypical fascial pain (if felt in a tooth)
Characteristics of dentoalveolar toothache (7) - Answer Continuous toothache that may
vary in intensity but is always present
Most common in max molars an dpremolars
Pain location may change over time but usually remains in the same nerve distribution
Most common in middle aged females iwth a history of trauma to the painful region
THe pain is not changed by local provocation
The effect of local anesthesia is unpredictable
Toothache is nonresponsibe to dental therapies
Treatmetn considerations for continouous dentoalveolar toothache? (7) - Answer
Desipramine
Amitriptyline
Gabapentin
Pregabaline
Cymbalta
OXcarbazepine