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Toothache with a multifactorial etiology: a case report.

A case report of orofacial pain originating from both dental and nondental conditions is presented. The spontaneous throbbing pain initiated from the left maxillary second premolar and spread throughout the entire upper part of the face to the frontoparietal area. Root canal treatment of the maxillary second premolar did not resolve the chief complaint. Magnetic resonance imaging examination revealed hypertrophy of the left inferior turbinate and soft tissue haziness in the left maxillary sinus floor. After antrostomy, submucosal turbinectomy, and endodontic treatment, the patient was free from pain. The final diagnosis of this case, in addition to pulpitis, was maxillary sinusitis with chronic rhinitis. The multiple factors associated with the etiology made the diagnosis difficult. The mechanism of referred pain from the maxillary sinus and paranasal mucosa to the maxillary teeth and face is discussed.

Chronic Disease↗

Dental nerve blocks. Toothache remedies for the acute-care setting.

Ideally, tooth pain is managed by a competent dentist, who can provide definitive care. However, timely access to such care may not be available late at night, on weekends, or in rural practice settings. This article introduces primary care physicians to dental nerve blocks that can be learned without extensive training and use in the acute-care setting to provide temporary relief of oral, dental, and facial pain.

Humans↗

Toothaches and death.

Deaths from dental abscesses today are so rare, that it is difficult to fathom that only 200 years ago, this was a leading cause of death. When the London (England) Bills of Mortality began listing the causes of death in the early 1600's, "teeth" were continually listed as the fifth or sixth leading cause of death. (This does not include the category of "Teething" which was probably erroneously blamed for many children's deaths. As we examine several historic factors of this period, it is apparent that the number of deaths attributed to "teeth" in the seventeenth and eighteenth centuries was probably fairly accurate, and it was not antibiotics, nor the discovery of asepsis, that brought about the dramatic reduction in these dental mortalities, but two much earlier dental innovations.

Anesthesia, Dental↗