Neuro & TMD

Neuropathy Trigeminal Nerve

OROFACIAL PAIN SPECIALIST

Types trigeminal neurology 1) Inflammation 5th nerve of head
2) 5th nerve damage

Types 5th nerve pathologies 1) Tension Headache
2) Neuralgia, Neuritis, Neuroma
3) Burning mouth

Headaches (old terms)
1) Tension HA
2) Mixed HA
3) Migraine HA
4) Neurovascular HA

Types Headaches: 1) Tension Headache: 48% females, 38% males
2) Migraine Headache: 18% females, 8% males

Tension Headache: episodic, frequent, daily
Unilateral temple or bilateral temples
More frequent women, 30 to 50’s
Mild: Dull, ache; Moderate: throbbing
High levels anxiety
Worse upon awakening or as day progress on workdays

Mixed Headache: 1) components tension and migraine
2) Severe whole head or bilateral temples
3) Frequent, episodic, or daily
4) May have mild photo-phono post HA
5) Rarely has aura
6) Typicall has cervical dysfunction

MIGRAINE 1) Severe whole head headache 2) May have visual changes prior HA 3) Post HA symptoms: nausea, light & sound sensitivity 4) Responses triptans, CGRP, Topomax, Betablockers

New Science on Migraines: 1) Accumulation multiple source inflammation.
2) Major sources inflammation are chewing and cervical systems 3) Inflammation: Chemical sensitivities, allergies, oral, ear, sinus, teeth, nerve, blood vessels 4) Orofacial pain reduces inflammation chewing system 5) PT reduces inflammation muscles & joints 6) Biofeedback reduces inflammation from stress & anxiety 7) Major sinus, tonsillar, or respiratory inflammation ENT joins team 8) Over load inflammation neurologist joins team

Orofacial pain specialist may assist neurologist treating migraine by

  1. Reduction cervical inflammation
  2. Reduction in parafunctional inflammation
  3. Reduction in muscle/joint inflammation
  4. Reduction in tension in muscles from anxiety-stress
  5. Improved sleep thus improved healing
  6. Recommend blood test for chemical sensitivities

Trigeminal Nerve Damage

Nerve Pathologies Treated by Orofacial Pain Specialists
1) Trigeminal neuralgia
2) Neuroma
3) Neuritis
4) Burning Mouth Syndrome (BMS)
5) Neurovascular
6) Intracranial compression
7) Nerve Entrapment
8) Extracranial compression by growth

Trigeminal Neuralgia

Orofacial Pain Specialist is diagnostic clearinghouse for Atypical Toothaches? 1) Triggers for TN are typically near to teeth-gums-lips 2) Majority of TN patients have both TN & TMD 3) TN can look like a severe toothache 4) Severe tooth pain provokes caring dentist into emergency root canals 5) Severe tooth pain causes patients to beg for root canals or extractions 6) Frustrations are high when root canal or extractions do not relieve pain 7) More frustration when referral OFP is required after pain remains 8) OFP is only speciality with training in all 7 of atypical toothaches 9) Great sense of relief for patient when the proper diagnosis is made and source pain Is treated

BURNING MOUTH

Orofacial Pain Specialist is only specialty that successfully treats BMS 1)Two different sets of nerves (pain, anxiety) are overloaded with impulses 2) Pain system is bombarded with several moderate to severe pain impulses 3) Anxiety system is overloaded with nerve impulses 4) Anxiety system overload is result of all levels of anxiety 5) Professionals tx BMS make mistake of treating symptoms not cause 6) BMS because requires team management & patient passion 7) Insurance is bias against all chronic pains

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