• Journal of Oral Medicine and Pain
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• v.41 no.2
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• pp.80-84
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• 2016

Non-odontogenic toothaches are frequently present and can be challenge to the dental clinician. A 41-year-old male patient with sharp and spontaneous pain on the right maxillary posterior dentition, which developed as like localized toothache 3 months ago, was finally treated with endoscope assisted sinus surgery on right maxillary sinus. Although the initial clinical characteristics are similar to odontogenic toothache in this patient, previous several treatment with the affected teeth did not alleviate the pain. Sinusitis around the facial structure is one of the common causes to make referred pain to maximally teeth and the sinus toothache resembles the pulpal or the periodontal toothache. The clinician should be well aware of various causes of the non-odontogenic toothache and be able to differentiate them.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.1
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• pp.58-64
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• 2012

Purpose: Dental emergencies vary from toothaches to oral and maxillofacial traumas. Because the number of dental emergency cases has increased recently, we analyzed characteristics of patients seen during the last 2 years, in an effort to find a trend. Methods: This study was carried out with emergency room patients visiting the Department of Oral and Maxillofacial Surgery from 2009 to 2010. Results: The total number of patients studied was 1,162; the ratio of males to females was 1.73:1. The most frequent age group was 0 to 9 years, followed by 20 to 29 years. Trauma (58.7%) was the most frequent cause followed by acute toothache, oral hemorrhage, infection, and temporomandibular (TMJ) disorder. In the trauma group, injuries of soft tissue and alveolus were prevalent. The most common causes of soft tissue injury were falls, safety violations and assault. The highest incidence of emergencies was seen in patients 0 to 9 years old (41.8%). The most common causes of jaw fracture were falls, assaults, and traffic accidents in that order. In the acute toothache group, most patients had pulpitis (41.2%). In the infection group, most had buccal space abscesses (40.0%). In the hemorrhage group, post-operative bleeding cases (80.5%) were the majority, and hemostasis was obtained mostly by pressure dressings. For the TMJ disorder group, masticatory muscle disorder (65.4%) was more common than TMJ dislocation. Conclusion: In this study, trauma was the most frequent reason for patients who visited the emergency room. However, acute toothache, hemorrhage, infection and TMJ disorders were also seen frequently. Dental emergency patients could be better treated by understanding patterns of dental emergencies and performing proper diagnoses.

• Journal of Korean Dental Science
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• v.7 no.2
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• pp.99-105
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• 2014

Herpes zoster (HZ) is an acute, unilateral inflammatory viral infection characterized by a rash with painful blisters in a localized area of the body. HZ is often associated with intense pain in the acute phase and presents postherpetic neuralgia in the chronic phase. During the prodromal stage of the HZ from the trigeminal nerve, however, the only presenting symptom may be odontalgia, which could be particularly difficult to diagnose. This distinctive syndrome occurs predominantly in the immunocompromised or elderly individuals. In this article, we report a case of HZ developed in the trigeminal nerve of a 60-year-old immunocompromised female patient, whose symptoms including atypical, non-odontogenic odontalgia had improved after series of antiviral treatments.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.799-802
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• 2007

Purpose: The masserteric space is an important tissue compartment of the face, but a disease in it is difficult to diagnose and treat. The submasseteric abscess is located between the masseter muscle and mandibular ramus with different appearances such as sepsis, infection, or tumor. Especially the common misdiagnosis of submasseteric abscess is acute or chronic parotitis. The purpose of this report is to pay special attention to the possible diagnosis of submasseteric abscess for the symptoms of unilateral cheek swelling and tenderness that accompany marked trismus. Methods: A 11-year-old boy came to our hospital because of facial swelling, tenderness, and trismus in a history of left cheek swelling and toothache. We diagnosed his case as submasseteric abscess by CT scan and surgical intervention was performed. Under general anesthesia, the abscess was opened by the intraoral incision and considerably massive pus was drained. Results: Swelling, tenderness, and trismus became to subside during postoperative 10 days and general condition and vital signs became stable. After 6 months, CT scan showed that both masseteric muscles were symmetric and there was no periosteal reaction of the mandible. Conclusion: In conclusion, submasseteric abscess is a rare infection with the symptoms of cheek tenderness and marked trismus. A detailed medical history and clinical examination of a patient as well as computed tomography(CT) are important tools in the accurate diagnosis and efficient treatment of the submasseteric abscess. Adequate drainage, removal of cause, and antibiotic infusion are the management of choice.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.1
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• pp.20-22
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• 2004

Acute mercury inhalation poisoning is a rare cause of acute peripheral neuropathy. A 44-year-old female inhaled the fume from heating mercury to treat her palmar dermatitis. For 4 days, this procedure was done for 2-3 minutes after each meal. She subsequently complained flu like symptoms, such as headache, toothache, myalgia and arthralgia. She was admitted for 9 days and then symptoms disappeared. About 3 weeks after exposure, both knee pain developed and then she could not walk. To treat mercury intoxication, she was referred to our hospital. At that time, initial laboratory data were within normal limits, but blood and urinary mercury level were 5.6 11$\mu$g/dl, 132.8 $\mu$g/L. After treatment with D-penicillamine for 7 days, blood and urinary mercury level were 3.9 1$\mu$g/dl, 177.3 $\mu$g/L. During the following 1 month, both leg symptoms remained. Nerve conduction studies were performed, both leg sensory nerve amplitude decreased. These findings were suggestive of peripheral polyneuropathy.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.253-263
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• 2017

Regardless of whether it is acute or chronic, the assessment of pain should be simple and practical. Since the intensity of pain is thought to be one of the primary factors that determine its effect on a human's overall function and sense, there are many scales to assess pain. The aim of the current article was to review pain intensity scales that are commonly used in dental and oral and maxillofacial surgery (OMFS). Previous studies demonstrated that multidimensional scales, such as the McGill Pain Questionnaire, Short form of the McGill Pain Questionnaire, and Wisconsin Brief Pain Questionnaire were suitable for assessing chronic pain, while unidimensional scales, like the Visual Analogue Scales (VAS), Verbal descriptor scale, Verbal rating scale, Numerical rating Scale, Faces Pain Scale, Wong-Baker Faces Pain Rating Scale (WBS), and Full Cup Test, were used to evaluate acute pain. The WBS is widely used to assess pain in children and elderly because other scales are often difficult to understand, which could consequently lead to an overestimation of the pain intensity. In dental or OMFS research, the use of the VAS is more common because it is more reliable, valid, sensitive, and appropriate. However, some researchers use NRS to evaluate OMFS pain in adults because this scale is easier to use than VAS and yields relatively similar pain scores. This review only assessed pain scales used for post-operative OMFS or dental pain.