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Pulpal pain versus Periodontal pain.
Let's talk about Odontogenic pain.
These are algorithms, I'm always a little loath to discuss with dentists,
because we have this skill set.
We know pulpal pain and it's presentation,
and pain in the periodontal.
This is something that we have really done well from an acute pain perspective,
and I'd like you to think of it from my perspective.
We've done more than just modify the pain algorithm,
we've done something very very very special, and that is,
we have managed those,
and kept those acute injuries from trending chronic.
Many people believe the other entry into chronic pain,
is through poorly managed acute, and so,
this is something I think that dental community does
Pulpal pain is very specific,
is often described as a visceral pain,
it's all or none.
It's sort of a lack of proprioception.
It's difficult to localized pain that is purely pulpal.
These nerves show a high degree of convergence.
When we test these neurons,
in the nucleus caudalis,
we know that Dr. Sessle would show that they converge from multiple tooth pulps.
Periodontal pain, is more of a musculoskeletal type pain.
It is a graded response.
They're mechanoreceptors present in the PDL,
and it is easier to localize that location of pain in the context of periodontal pain.
Two of the most common acute pain conditions that occur in our collective practices.
For non-odontogenic pain, which is a very different style of pain,
does not involve the dentition.
There was no connection between the dentition.
What is important here is distinguishing that early on,
and one of the best ways to determine whether the tooth is involved or not involved,
is to go ahead and use diagnostic anesthesia on the presumptive tooth,
you thought it was an odontalgia,
to anesthetize that site.
If that site does not reduce the pain,
then it most likely is not the source of the pain.
So there is no need to engage in further treatment in that area.
Non-odontogenic pain sources are different.