MUCOGINGIVAL PAINS

DR.T.B.PHANINDHAR RAJ,
MSCD-ENDODONTICS,
2nd YEAR
 INTRODUCTION

• In the orofacial region, primary somatic pain of the superficial

type emanates from the skin of the Lips, Face, outer nares and
outer external auditory canal and from the mucogingival tissues
of the oral cavity.
• Pains from these structures display clinical features that
distinguish them from primary deep somatic pains and from
secondary heterotopic manifestations of somatic and
neuropathic pain disorder
BEHAVIOR OF CUTANEOUS AND
MUCOGINGIVAL PAINS
• The pain has a bright, stimulating quality
• Localization of pain is excellent and anatomically
accurate.
• Site of pain identifies the correct location of it source.
• Response to provocation at the site pain is faithful in
incidence, intensity and the location.
• The application of a topical anesthetic at the site of pain
temporarily arrests the pain
 TYPES OF PAIN
• 1) Cutaneous pains
• 2) Mucogingival pain

Cutaneous pains—
• Itching, pricking, raw, stinging or burning sensation—depending on
the intensity of the complaint
• Pain is initial felt as a fast ,sharp ,pricking pain
( blocking of A delta nociceptive neurons)
• Pain is slightly delayed ,less sharp,less precisely localized, burning
pain (c-fibers)
Treatment
• Application of topical anesthetics
 MUCOGINGIVAL PAINS
• Mucogingival pains are distinct raw, stinging or burning
sensation
• They have bright, stimulating quality, easily localized and
identify the adequate cause
• These pains respond faithfully to provocation at the site of
pain, do not present central excitatory effects .
• The oral tissues are fragile and easily injured by rubbing
against the teeth, tongue,cheecks and each other during
normal use.
• Saliva acts normally as the oral lubricant, is especially
responsive to the effects of emotional stress, physical
disorders, diseases and many medications...
• Pains arising from the lining tissues of the oral cavity can be
precisely located by the patient .such pain may be
generalized throughout the mouth when the cause widely
affects the mucogingival tissue ,or it may be isolated if the
hyperalgesic area is small.
• The pain arise from primary hyperalgesic due to local
cause. Such as irritating effect of foods,liquids,mouth
washes,dentifries and medications.
• The primary hyperalgesia of the oral lining tissues may
show no objective signs, no clinical signs and muco
gingival tissues may appear entirely normal.
• When the salivary deficit is great, normal functioning may
become traumatic to the oral tissues.
• Ordinarily ,central excitatory effects are not seen as a
result of mucogingival pain ,even when the pain are severe
and continuous and the development of secondary painful
muscle co-contraction do not occur.
• The pain of mucogingival origin is an expression of primary
hyperalgesia of the tissues that hurt, application
anesthetics to those tissues arrests the pain due to the
medication on the receptors and pain fibers in the
mucogingival tissues.
• Mucogingival pains may result from trauma, allergic
responses, local infections or systemic conditions or they
may present as burning mouth syndrome…
TRAUMA
 THERAPEUTIC OPTIONS
 Analgesics for palliative relief and counseling.
 Cause-related therapy
1. Identification and treatment of etiology factors and
contributing condition present..
2. Elimination of all oral irritants
3. Restriction of oral function within reasonable limits
4. Antibiotics and antimicrobials,topical and systemic
5. Antiviral agents esp for initial episodes
6. Xerostomia—elimination or reduction of saliva-depressing
drugs, chewing paraffin or gums to stimulate salivary flow,use
of saliva substitutes and or electric stimulation of saliva
 Pharmacologic therapy
1. Topical anesthetics(liquid,ointment,lozenge)
2. Analgesics balms
3. Anti-inflammatory agents
 Medical consultation