oral pain
Introduction
Introduction The anterior wall of the mouth is the lip, which is ruptured to the outside through the mouth, and continues through the pharyngeal door and the oropharynx. The two sides are buccal, and the upper and lower walls are composed of the iliac crest and the sublingual area. Oral organs include soft tissues such as the lips, cheeks, tongue, sputum, sputum, and mouth, and hard tissues such as the upper and lower jaws, teeth, and temporomandibular joints. Oral pain is the pain that occurs in the above oral organs. It is the most common symptom in the clinical department of stomatology, and it is often the main reason for patients to seek medical care.
Cause
Cause
Pain is caused by a stimulus that damages the body's tissues. The irritant that causes pain is called a painful substance. The pain-causing substance is released during tissue damage, such as acetolcholine, serotonin, histamine. Bradykinin and its like peptides, potassium ions, hydrogen ions and acidic metabolites released during tissue damage. When these substances directly excite the pain receptors of the nerve endings, the impulses along the trigeminal thalamus bundle, up to the level of the pons and the side of the spinal thalamus, enter the cerebral cortex and then return to the first sensory area and cause pain. The patient's response to pain is determined by two factors, one is the patient's pain threshold; the other is the patient's sensitivity to pain. Both are different in every patient.
Examine
an examination
Related inspection
Determination of the vitality of dental pulp in ear, nose and throat swabs
(1) medical history
According to the main complaint, detailed medical history and symptom characteristics.
1. Understand the pain in the affected area such as trigeminal neuralgia. Pericoronitis occurs mostly in the area of the mandibular wisdom teeth. In acute pulpitis, patients often cannot locate themselves.
2. Distinguishing the nature of pain, sharp spontaneous pain is most common in acute pulpitis, very acute periarthritis, but also in acute periodontal abscess, pericoronitis, trigeminal neuralgia, acute maxillary sinusitis. Spontaneous dull pain is common in chronic sputum papillitis. Exciting pain is more common in wedge-shaped defects, dentin hypersensitivity and 110Ill0" caries. It only occurs when physical or chemical stimulation occurs in sensitive areas or lesions. The pain disappears after the stimulation is removed. Occlusal pain often occurs in dental trauma. Acute apical periodontitis, acute periodontal abscess, etc.
3. Understanding the course of pain Trigeminal neuralgia is a transient electric shock, and there is no discomfort during the intermittent period of pain. Acute pulpitis manifests as spontaneous pain, nocturnal pain, and paroxysmal reflex pain. The pain of chronic submandibular gland inflammation and ductal stones in the submandibular gland is associated with eating.
(2) Physical examination
1. Local examination to check the oral and maxillofacial lesions related to pain, such as tooth tissue defects, ulcers, trauma, swelling and so on.
2. Whole body examinations, especially whole body skin examinations, are of significance for psoriasis and riboflavin-deficient oral pain. In addition, the tendency of skin bleeding has an auxiliary value for the diagnosis of thrombocytopenic purpura and leukemia. The rash of cases such as scarlet fever or measles is more diagnostic.
(3) Laboratory inspection
1. For patients with oral and maxillofacial inflammation, blood tests, especially white blood cell counts and classification tests, have diagnostic value for the diagnosis of inflammation.
2. Hematological examinations and some specific tests such as serum and Kang's reaction in patients with oral diseases caused by systemic diseases are helpful for the diagnosis of diseases such as blood diseases and syphilis.
Diagnosis
Differential diagnosis
It should be differentiated from the following symptoms:
1. In the industrial production, oral magical touches often use heavy metals, high molecular compounds and toxic gases. After exposure to these toxic substances, the poisons will enter the human body through the gastrointestinal tract, respiratory tract, skin and mucous membranes, directly or indirectly. In the brain, the function is disordered and mental symptoms occur. The oral hallucinations are typical symptoms of mental disorders caused by tetraethyl lead acute poisoning poisoning. The patient feels that "there is something like hair and straw that comes out of the middle of the teeth." "There is a piece of meat in the mouth", as well as threatening and impulsive auditory hallucinations. In severe cases, seizures and coma can occur.
2. Oral blood bubble oral ulcer, also known as "mouth sore", is a blood bubble that occurs on the oral mucosa, the size can be from rice to soybean size, round or oval, ulcer surface is concave cavity, peripheral congestion It can cause pain due to irritating food, and usually heal itself in one to two weeks. The prevalence rate in the population is generally considered to be more than 10%, which can occur in men, women and children, and is most common among young people. Recurrent oral ulcer is a localized ulcerative ulcer of the oral mucosa characterized by periodic recurrence. It can heal itself and can occur in any part of the oral mucosa. In the mucous membranes of the lips, cheeks, soft palate or gums, single or multiple round or oval ulcers of different sizes occur, the surface is covered with gray or yellow pseudomembrane, the central depression, the boundary is clear, and the surrounding mucosa is red and micro Swelling, local burning pain is the main feature.
3. The oral mucosa is diffusely congested. Generally, the oral mucosa is reddish. When congestion occurs in the oral mucosa, the color becomes darker and the oral mucosa is diffusely congested.
