21 Questions
How does the patient typically describe bony origin pain?
Dull
What type of pain is associated with vascular response to tissue inflammation?
Throbbing
How is irreversible pulpitis or trigeminal neuralgia pain typically described?
Sharp
Which term describes pain associated with pulpal and apical pathoses?
Pulsing
How is the intensity of pain typically quantified?
On a scale of 0 to 10
What factor determines if dental pain is stimulated or spontaneous?
Affecting factors
What can exacerbate dental pain?
Lying down or bending over
What kind of diseases mimic endodontic pain?
Orofacial and nonodontogenic diseases
What is a characteristic of nonodontogenic involvement?
Pain that travels and crosses the midline of the face
Why may it be difficult for a patient to localize pain if the inflammation has not reached the periodontal ligament (PDL)?
The PDL contains sensory fibers that transmit only pain, not location
When is it easier for a patient to identify the source of the pain?
When the inflammatory process extends beyond the apex
What type of sensory fibers does the PDL contain?
Sensory fibers for proprioception
Why can orofacial diseases mimic endodontic pain?
Due to misperception of sensory information by the trigeminal nerve
What type of pain may be associated with nonodontogenic involvement?
Pain that surfaces with increasing mental stress
What is the only systemic contraindication to endodontic therapy?
Uncontrolled diabetes
What are the 5 basic directions of questioning used to understand the chief complaint?
Localization, commencement, intensity, provocation/attenuation, duration
What is the purpose of intraoral diagnostic tests in endodontic exams?
To help define the pain by evoking reproducible symptoms and provide an assessment of normal responses for comparison
Why should several adjacent, opposing, and contra-lateral teeth be tested before the tooth in question during an endodontic exam?
To establish the patient's normal range of response for comparison with abnormal responses
What is the purpose of asking the patient to point to the tooth that hurts or swells during triage of a patient with pain?
To verify the location of symptoms as perceived by the patient
Why is orofacial pain considered as a clinical manifestation of various diseases involving the head and neck region?
Because it can indicate different diseases involving the head and neck region
What type of medical history enables a clinician to determine the need for a medical consultation or premedication of a patient?
"o The patient’s medical history
Test your knowledge about the systemic contraindications to endodontic therapy and the factors determining the need for medical consultation or premedication of the patient based on their dental history and symptoms.
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