Other causes of Pain (feel free to add)

Pain
1) Dentin pain - brief, sharp twinge
2) Pulpal pain - deep, demanding, radiating pain precipitated by thermal shock to an inflamed pulp. pain may be spontaneous
3) Periodontal pain - The aggravating throbbing of a sore tooth.

Crack Tooth Syndrome

s/s: pain on biting, TTP, Wedge test +ve(not always), sensitive to cold air/water/sweets, , may be pulpitic

tx: molar band may be used to confirm diagnosis followed by crown or rct + crown


Sinusitis
s/s: TTP(upper molars), history of runny nose, morning sinusitis, pain when walking down stairs
x-ray - cloudy sinus on affected side, apex of molar root near or into sinus space

tx: exlude all other causes of pain, referral to ent or
acute: prescribe antibiotics (augmentin useful), antihistamines/decongestants, review, kiv rct/exo
chronic: nasal irrigation

Trigeminal Neuralgia
s/s: intense pain(burning or shock-like) on touch(skin) or movement, one sided. lasts anywhere from a few seconds to as long as 2 minutes per episode

tx:
1)Medication - Anticonvulsant medicines (carbamazepine), Tricyclic antidepressants (amitriptyline)
2)neurosurgical procedures.
-A rhizotomy is a procedure in which select nerve fibers are destroyed to block pain. A rhizotomy for TN causes some degree of permanent sensory loss and facial numbness.

• Balloon compression
  
• Glycerol injection
  
• Radiofrequency thermal lesioning
  
• Stereotactic radiosurgery
  

3)complementary techniques, usually in combination with drug treatment. These therapies offer varying degrees of success. Options include acupuncture, biofeedback, vitamin therapy, nutritional therapy, and electrical stimulation of the nerves.