CV
Oral Surgeon and Neurobiologist
Professor of Oral Medicine, Oral Surgery and Orofacial pain
Departement of Dental Medicine, Bretonneau Hospital, AP-HP, Paris, France
Departement of Dentistry, Faculty of Health, Université Paris Cité, Paris, France
Laboratory of Orofacial Neurobiology (EA 7543), Université Paris Cité, Paris, France
Differential Diagnosis and Management of non Odontogenic Tooth Pain: a Primer for the General Dentist
Odontogenic tooth pain is a frequent -often daily- occurrence in general dental practice. Conversely, albeit less frequently encountered, non odontogenic tooth pain can be quite puzzling for the general dentist. The differential diagnosis of the numerous diseases that can present as non odontogenic tooth pain is often quite challenging for the non specialist, ultimately leading to significant diagnostic and therapeutic delay but also significant iatrogenesis (i.e. unnecessary dental treatment).
Considering the high etiological diversity of such non odontogenic odontalgias and the intrinsic severity of some of them (e.g. cardiac- or cancer-related tooth pain) an early positive diagnosis is of paramount importance to mitigate the untoward consequences of resulting diagnostic delay and iatrogenesis.
This lecture thus aims to present an overview of the main etiologies of non odontogenic tooth pain and their management in general dental practice, illustrated by clinical cases from a specialized tertiary orofacial pain clinic.
Learning objectives
- Understand and explain the concept of referred tooth pain
- Suspect a non odontogenic tooth pain
- Conduct a proper differential diagnosis of the main causes of non odontogenic tooth pain
- Refer the patient to the relevant specialist for appropriate management in a timely manner
Forewarned is Forearmed: Implicating the Dentist in Recognizing Early Oral Manifestations of Acute Leukemias
Leukemias are malignant hemopathies characterized by the abnormal differentiation and proliferation of hematopoietic stem cells, of either myeloid or lymphoid origin. Such blastic proliferation within the bone marrow will ultimately lead to severe pancytopenia (bone marrow failure), fatal without proper early management.
Acute leukemias, notably those involving myeloid cells, often present with oral manifestations, such as gingival bleeding, oral ulcers and gingival overgrowth, related to the bone marrow failure (anemia, leucopenia, thrombocytopenia) and blastic infiltration of oral tissues. Considering the dire prognosis of undiagnosed acute leukemias, early recognition of such oral manifestations is of paramount importance for the proper timely management of these malignant hemopathies. In that respect, general dentists must be knowledgeable about the possible oral manifestations of acute leukemias and their prompt management.
This lecture thus aims to provide the general dentist with a primer on the oral manifestations of acute leukemias, and how to manage them in general dental practice, illustrated by clinical cases from a specialized oral medicine clinic.
Learning objectives
- Recognize the oral manifestations of acute myeloid leukemias
- Conduct a proper diagnostic workup of a suspected undiagnosed acute myeloid leukemia
- Refer the patient to the relevant specialist for appropriate management in a timely manner