Diagnosis of Dental caries
Dental caries Diagnosis: Book Excerpts
Diagnostic Tests for Dental caries: Online Medical Books
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Toothache:
Differential Diagnosis
(In a Page: Signs and Symptoms)
-
Pulp pain (pulpalgia) secondary to dental caries
-
Traumatic tooth injury (e.g., tooth fracture, restoration fracture, avulsion)
-
Traumatic occlusion
–Secondary to a new restoration or bruxing
–Galvanic “shock” due to contact by two dissimilar metals (e.g., gold crown with amalgam filling)
-
Periradicular or periapical pain due to infection of the tooth root or abscess formation
-
Referred pain from a tooth in the opposing arch
-
Sinusitis
–Maxillary sinusitis is the most common extraoral source of tooth pain
–All or most teeth in the upper arch may become sensitive secondary to sinusitis
Headache
Temporomandibular joint pain (TMJ)
Trigeminal neuralgia
Barodontalgia from high altitudes
“Dental migraine”
–Associated with patients with depression
Salivary gland disorders (e.g., Sjögren's syndrome, systemic lupus erythematosus)
Otitis media and/or mastoiditis
Angina pectoris
Dry socket (osteitis)
Workup and Diagnosis
- History and ear, nose, throat, neck, and cardiac exam and intraoral exam should include mobility tests, percussion, electric pulp test, and thermal tests (ice)
–Tooth mobility is tested by using the back ends of two mouth mirrors on both sides of the tooth
–Reversible pulpitis pain is sharp, intermittent pain of short duration that is provoked by hot, cold, sweets, or biting; the pain does not linger more than a few seconds when the stimulus is removed
–Irreversible pulpitis pain lasts more than 30 seconds upon withdrawal of the stimulus and may occur spontaneously, such as when sleeping
–If an abscess is present, the tooth may be slightly elevated in its socket and mobile
–Periapical abscesses may have systemic findings such as lymphadenopathy or fever
–Toothache or TMJ pain in the morning may occur due to bruxing at night
-
Transillumination may show fracture lines in teeth
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Pulp necrosis will not have any response to stimulation or via the electrical pulp tester
-
Dental radiographs
-
Consider sinus X-rays or CT scan if sinusitis likely
-
Consider referral to dentist (e.g., tooth decay, abscess) or otolaryngologist (e.g., mastoiditis)
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
TOOTHACHE:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
This is simple. Refer the patient to a dentist. If infection is suspected, an antibiotic may be started if there is a delay in getting an appointment. If the dentist cannot find the cause, referral to a neurologist is appropriate.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
TOOTHACHE:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
This is simple. Refer the patient to a dentist. If infection is
suspected, an antibiotic may be started if there is a delay in getting an
appointment. If the dentist cannot find the cause, referral to a neurologist
is appropriate.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
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