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Differential diagnostics of pain in the Head and Neck region .

Differential diagnostics of pain in the Head and Neck region . Detecting , monitoring pain. Which number sign of your pain ? Which number represent the pain strongest and lightness cases ? Which number represent the pain now ? Which number represent the tolerable level of pain ?

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Differential diagnostics of pain in the Head and Neck region .

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  1. Differentialdiagnostics of paininthe Head and Neckregion.

  2. Detecting, monitoring pain • Whichnumbersign of yourpain? • Whichnumberrepresentthepainstrongest and lightnesscases?Whichnumberrepresentthepainnow? • Whichnumberrepresentthetolerablelevel of pain? • 0 = No pain1-3 = Mildpain: Only a littlemodifytheeveryday life4-6 = Middlepain: Everyday life much more difficult7-10 = Severepain: The pain is thestrongesteffectinyour life

  3. Importantquestions • Localization • Whenstarted? • Howchangedit? • Is thereanychange of intensityina time of day? • Continiousorfluctuatingthepain? • Whatkind of yourpain? Sharp orblunt, deeporsuperficial, convulsive, burning? • Whenstrongerthepain? Moving, sitting, inbed, bendforward, sport? • Whichfactorscaneliminatethepain : hot, cold, drogs, massage?

  4. Examination • Extraoral and intraoralinspectio. Signs of theinflammation. Tumor calor, rubor, functiolaesa. • Palpation of thelaesion, lymphaticnodes, TMJ, periapicalareas • Biting, cold, hot, percussion, bendforward

  5. Caries Pain - foodpenetration - estheticdisorder - badsmell and taste - gingivitis Big lesion - X-ray, fiberoptic - change of tha approximalcontour

  6. Pulpalpain Reversiblealterationinthepulp: 1. Beforepulpitis (hyperaemicpain) - sharppainforstimuli. It stop immediatelywhenthestimulusstop. - hot cold and osmoticsensitivity no spontaneous and nightpain 2. Reversibleacutepulpitis(partial, serous) - spontaneous and stimulatedpainwithsharpcaracter, wich no eliminateimmediatelyafterstimuli stop radiatingpain, hardtolocalisation - no sensitivitytopercussion - more sensitivetocold - no painatnight

  7. Pulpalpain Irreversiblealterations 1. Irreverzibleacutepulpitis - specificpainforpulpitis, mainlyatnight, radiatingpain - painforpercussion, and biting - more sensitivefor hot (purulent) 2. chronicpulpitis - mild, longtimepainwithbillowycharecter (hot!) - pulpitischr. ulcerosa, polyposa 3. Gangraena of thepulp (simplexorcomplicata) - No spontaneouspain, butsensitivityfor hot and percussion

  8. Pulpalpain Aftergangrena: 1. Periodontitisacuta (parodontitisapicalisacuta) - spontaneouspain and sensitivityfor biting, welllocalisation (itseemslongerthantheothertooth) - discoloration, sensitivityfor hot, butnotalive - wecanseesymtoms of generalinflammation 2. Periodontitischronica (parodontitisapicalischronica) - discolorated, non vital, no symptoms, butX-ray! - fistula and focalinfectioncanappear 3. Periostitis és submucosusabscessus - seriousgeneral and local inflammation, withsymptoms - paincaneliminatebyformingabscessus

  9. Jég -20oC Spray -40oC Szénsavhó -70oC

  10. TMI

  11. The burningmouthsyndrome • Long history (months, years) of burningsense and painmainlyonthetongue (justlikescaldwithsomething –withoutpyhisicalinjuries). • The patientsaremainlywomenaftermenopause. • No visiblealterationexept of less saliva, thinmucosa. • Reasonsareunclear. (immune-hormone-nervesystem) • Therapy B vitamins, reassurance.

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