Podcast
Questions and Answers
What is the definition of pain according to the International Association for the Study of Pain (2020)?
What is the definition of pain according to the International Association for the Study of Pain (2020)?
According to the text, how is the source of pain found?
According to the text, how is the source of pain found?
Historically, what type of pain scales have been used in clinical settings?
Historically, what type of pain scales have been used in clinical settings?
What does a score of '10' on the pain scale represent?
What does a score of '10' on the pain scale represent?
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Which term describes a patient who often asks for specific drugs, has very good pharmacology knowledge, and may have a burnt down tooth?
Which term describes a patient who often asks for specific drugs, has very good pharmacology knowledge, and may have a burnt down tooth?
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What is the chief complaint often reported by a 'Munchausen syndrome' patient or 'Munchausen by-proxy' patient?
What is the chief complaint often reported by a 'Munchausen syndrome' patient or 'Munchausen by-proxy' patient?
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What is important to document prior to any invasive procedure for non-pulpal diseases?
What is important to document prior to any invasive procedure for non-pulpal diseases?
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What did Yogi Berra suggest in the quote 'We made too many wrong mistakes'?
What did Yogi Berra suggest in the quote 'We made too many wrong mistakes'?
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What condition can manifest as orofacial pain instead of chest pain during myocardial infarction?
What condition can manifest as orofacial pain instead of chest pain during myocardial infarction?
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What is a possible cause of jaw pain that does not necessarily indicate vital pulp involvement?
What is a possible cause of jaw pain that does not necessarily indicate vital pulp involvement?
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Which condition can cause diffuse pain in the maxillary teeth, worsened by sudden movements?
Which condition can cause diffuse pain in the maxillary teeth, worsened by sudden movements?
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What condition is characterized by pain that comes in bursts and usually affects females more than males post menopause?
What condition is characterized by pain that comes in bursts and usually affects females more than males post menopause?
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What can cause acute pain in a specific neural segment due to risk factors such as emotional stress or immunocompromising diseases?
What can cause acute pain in a specific neural segment due to risk factors such as emotional stress or immunocompromising diseases?
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What may cause pain similar to cluster headache or odontalgia in the maxillary premolar area?
What may cause pain similar to cluster headache or odontalgia in the maxillary premolar area?
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What condition can be caused by deafferentation pain secondary to trauma or central sensitization?
What condition can be caused by deafferentation pain secondary to trauma or central sensitization?
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What can cause non-vital pulp and periapical lesions without obvious causes?
What can cause non-vital pulp and periapical lesions without obvious causes?
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What condition is often associated with eating and causes moderate to severe pain in the jaw?
What condition is often associated with eating and causes moderate to severe pain in the jaw?
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What might be a sign of a missed diagnosis and increased risk of death during myocardial infarction?
What might be a sign of a missed diagnosis and increased risk of death during myocardial infarction?
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What can be triggered by dental pain or discomfort?
What can be triggered by dental pain or discomfort?
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What may cause acute pain associated with specific risk factors like emotional stress or immunocompromising diseases?
What may cause acute pain associated with specific risk factors like emotional stress or immunocompromising diseases?
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In a study of patients referred for endodontic treatment, what percentage had solely endodontic problems?
In a study of patients referred for endodontic treatment, what percentage had solely endodontic problems?
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What did Gracely et al. (1979) identify in relation to pain intensity?
What did Gracely et al. (1979) identify in relation to pain intensity?
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What can cause referred pain from teeth?
What can cause referred pain from teeth?
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What is necessary prior to any invasive procedure to determine the source of pain?
What is necessary prior to any invasive procedure to determine the source of pain?
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What cardiac condition can cause pain in the lower jaw?
What cardiac condition can cause pain in the lower jaw?
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What is the average diagnostic delay for persistent idiopathic facial pain and dentoalveolar pain?
What is the average diagnostic delay for persistent idiopathic facial pain and dentoalveolar pain?
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What is commonly missed during endodontic treatment in lower first premolars?
What is commonly missed during endodontic treatment in lower first premolars?
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What can patients with necrotic pulp experience?
What can patients with necrotic pulp experience?
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What percentage of patients with angina pectoris experience only jaw/teeth symptoms?
What percentage of patients with angina pectoris experience only jaw/teeth symptoms?
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Study Notes
- Historically, simple pain scales have been used in clinical settings for measuring pain, but they may not capture both sensory and emotional aspects.
- One such scale is the Visual Analogue Scale (VAS), where pain is rated by marking on a line with a predetermined length.
- The human pulp, which contains sensory neurofibers, can be affected by disease leading to pain. A study showed poor correlation between perceived pain and nerve activity in inflamed human pulp.
- Gracely et al. (1979) identified various descriptors for pain intensity in a rating scale.
- In a study of patients referred for endodontic treatment, 88% had solely endodontic problems, while 9% had other oral pain issues in addition.
- A prospective study of complex non-dental orofacial pain cases found that 44 of 100 patients had undergone previous dental procedures.
- The diagnostic delay for persistent idiopathic facial pain and dentoalveolar pain was on average 19.3 months, with longer delays for intraoral pain.
- Referred pain from teeth can manifest as pain in areas other than the affected tooth, with lower teeth more likely to refer to upper teeth and vise versa.
- Prior to any invasive procedure, a thorough examination is necessary to determine the source of pain, including examination of the chief complaint, changes in the pain, current status, and vitality testing.
- Commonly missed canals during endodontic treatment include the second M-F canal in upper molars, second canal in lower anteriors, second canal in lower first premolars, and second canal in the distal root of lower molars.
- Patients with necrotic pulp may experience dull pain and difficulty locating the source due to neuroplastic changes in the CNS.
- Angina pectoris, a cardiac condition, can cause pain in the lower jaw, with up to 18% of patients experiencing only jaw/teeth symptoms and 32% reporting both craniofacial and other regional pain.
- The most common craniofacial pain locations during angina pectoris are the throat, left mandible, right mandible, left temporomandibular joint/ear region, and teeth.
- Female subjects were more likely to experience craniofacial pain as the dominating symptom in the absence of chest pain.
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Description
Test your knowledge of the association between angina pectoris and craniofacial pain as discussed in the JADA 2007 article. Explore the significance of craniofacial pain in patients with verified cardiac ischemic episodes and its potential implications for early diagnosis and treatment.