What is orofacial pain?

Orofacial pain What is orofacial pain? Orofacial pain is a general medical term that is often used to describe pain that may be occurring in any part of the face including the jaws, scalp, mouth, and face. The pain may be caused by diseases or disorders of structures that make up the face and oral cavity. In some cases, the pain may be referred to the face area from the scalp or the ear. Today it is being recognized that in many cases, the most common source of orofacial pain is from the mouth. The second most common cause is related to the temporomandibular joint dysfunction (TMD). All the other causes of orofacial pain are rare. Orofacial pain disorders are quite challenging for the physician because pain can arise from many sources. Diagnosis and management of orofacial pain is now increasingly being managed by dentists, ear nose and throat specialists and sometimes even neurologists. What are causes of orofacial pain? There have been attempts to classify causes of orofacial pain but there is no one system that is universally accepted. The simplest way to classify causes of orofacial pain is as shown: Oral Cavity causes - Cracked tooth - Dental cavities - Dental abscess - Teeth hypersensitivity - Gingivitis - Burning mouth syndrome - Ulcers of the mouth - Cancer of the mouth Neuropathic pain Trigeminal neuralgia Glossopharyngeal neuralgia Mental nerve neuralgia Headache Cluster headache Migraine Temporomandibular joint dysfunction (TMD) Emotional causes Anxiety Depression Psychosomatic How common is orofacial pain? Orofacial pain is a very common problem in society. In the US alone, it is believed that nearly 1/5th of the adult population has had some type facial pain in the past 6 months. In the majority of cases, this pain is due to a dental problem like a toothache. Next most common cause of orofacial pain is temporomandibular pain, which is often chronic in nature. Orofacial pain can affect both genders and can occur at any age. How do patients with orofacial pain present? The majority of patients complain of pain near or inside the oral cavity. In some cases the pain is continuous and in others it may occur with facial movements like chewing, swallowing, biting or speaking. The pain is often a dull ache and may even occur at night. Orofacial pain is often unresponsive to the usual over the counter pain medications. How is orofacial pain diagnosed? The diagnosis of orofacial pain is not easy because there are many structures around the face and mouth that can cause pain. The majority of people go through many healthcare providers before a correct diagnosis is made. Eventually most people are referred to a dental surgeon or an ear nose throat specialist. Besides a through physical exam, one also needs to undergo series of X-rays, CT scans and even MRI. One may need to see a number of specialists to determine the cause of pain. How is orofacial pain managed? The treatment of orofacial pain depends on the cause. If there is problem with teeth or gums, this can be managed by the dentist. If the problem is TMD then the treatment will be geared towards restoring function of the jaw and limiting pain. What are Home care remedies for TMD? 1. Patient education –the more a patient knows about the disorder the better is the outcome. Once patients learn that the condition is not life threatening, anxiety and pain are relieved. 2. Resting the muscles used for chewing and eating is also necessary; thus one may have to eat a soft diet, and apply moist heat or ice therapy. 3. If there is nighty grinding of the teeth this should be addressed by the dentist and wearing a night guard can help. Physical therapy Physical therapy is very helpful in restoring function of the TMJ. By strengthening muscles of chewing, this can help decrease inflammation and improve range of motions. It is best to enroll in a physical therapy program for a few weeks Medications Various medications are used to treat orofacial pain depending on the cause. The most common medications include use of: - Pain medications - Injection of local anesthetics - Corticosteroids - Muscle relaxants - Botox injections - Use of antidepressants Other Therapies Some people with TMJ syndrome may also benefit from oral appliances and acupuncture. Surgical care is undertaken when medical therapy fails or is ineffective. Surgery is usually the last choice of treatment and should never be undertaken if one has not attempted physical therapy or pharmacological management first. Types of surgery to treat TMJ syndrome include injection of corticosteroids, aspiration or cleaning the joint. Prognosis In most cases of TMD, the prognosis is good. Recurrence of pain is rare after treatment. In all cases, the initial treatment is conservative. Home care remedies usually are tried out first, followed by medical care and then surgery, as the last option.

Vacation in Rawai, Phuket.

Way before Pattaya and Koh Samuii became famous, one of the best places to visit in Thailand was Phuket. Located on the southern tip of Thailand. Phuket was once home to celebs from all over the world because of is pristine blue waters, soft sandy beaches, tropical weather and warm waters of the Andaman sea- it is the closest thing to paradise- serene, beautiful and stunning sunsets. Phuket is the largest island in Thailand and is connected to the southern tip of Phang Nga Province by a narrow road bridge. However, another small island that is not far from the southern tip of phuket is Rawai. This hidden gem is only known to a few people chiefly because of its location. Unlike phuket, few people come here to Rawai but it has stunning scenery that rivals almost any place in Asia. Tourists come here to experience Thai culture, relax, enjoy the tropical weather and watch the costal palm trees gently swaying in the wind- it is place of serenity and solitude. Coming to Rawai is like going to one of the small islands in the Caribbean where there are no crowds and you have the island to yourself. To get to Rawai, one has to take a ferry or a boat from phuket. This sea front town is divided into two segments; the northern part with its partially developed beaches and the southern part, which is more urbanized and has a fishing port. Getting there To get to Rawai, one first needs to get to Phuket. Small boats and ferries make the 30 min trip and charge about $2. Most tourists first fly into Bangkok and take the 60 mi trip to phuket by the local airlines. One can take a train or the bus to phuket but it is a long trip. Getting around Rawai may be a small island but the terrain is uneven and everything is spread out. So one should try and rent a motorbike which costs about $5-$8 a day. The good thing about Rawai is that there is little motor traffic and hence you will be safe. What to do Rawai is a place where most people come to relax and get away from the crowds. Some people just take it easy, get a tan and enjoy the evening and morning walks along the beach. The one place you should visit is the Phuket Sea Shell museum. The museum is strictly focussed on the exotic shells from the Andaman Sea. There are many exotic varies of shells here and some are very elegant. Entrance to the museum is $8 for adults. Unlike other places in Thailand, Rawai’s beach areas are heavily congested with boats and other small sailboats. Thus, this is not the place where you can swim but you can have the entire sandy beach and get a gorgeous tan. The northern part of rawii beach does allow for swimming in some areas but the south does not. Most people rent a boat and visit the nearby islands to catch the stunning scenery, go snorkeling and scuba diving. If you have time then perhaps a visit to the nearby islands of Ko Kaeo or Kon Bon which are worth a visit; about 30 minutes away the under water scenery is breathtaking and the beaches are immaculate. Go to Sea Gypsy village where there are many restaurants, nightclubs and bars. The nightlife is sedate compared to Bangkok but the view of the scenery is good enough for national geographic. Finally no one should leave this island without having spent an evening on Promthep Cape View Point, which is world famous for its splendid sunsets. Food Like most places in Thailand, you will not go hungry on Rawai. There are many food vendors, cafeterias and beach side restaurants. Food is relatively cheap and delicious. You can have a decent meal for less than $5 almost anywhere on the island. Some people go fishing/diving and bring their catch to the street vendors who cook up a great meal in the evening. Accommodation There are hostels for the budget traveler that cost anywhere from $12-$15 a room. In addition, there are some excellent villas and seaside hotels which cost about $50-$60 a night. You are unlikely to experience such views of the water in many other places on this planet. Today, one of the best ways to get cheap and great accommodation is via airbnb. Most airbnb rentals are cheaper than any hotel and are located along the beach. Cost varies from $30-$40. Final Word Over the past few years, phuket has earned a bad reputation because of crime, extreme congestion with tourists and being expensive. Thus, if you are looking for somewhere more quiet, peaceful, relatively cheap and just as beautiful, try Rawai island. This small island is fast becoming a popular destination for many people because of the scenery and its beauty. Best time to visit is from Feb to June, when the weather is not too hot or humid

How did I get pubic lice? I am a clean 22 year old female.

Cleanliness has nothing to do with sexually acquired disorders. You may be clean and perfect, but your partner may be a bum. If you got pubic lice, then you most likely got it during a sexual encounter from someone who already had these creatures. What this means is that both of you need treatment otherwise you are going to be passing on these nasty creatures to your other potential sexual partners. Just a word of warning- in some states not telling a partner that you have a sexually transmitted disease and having sex can lead to a lot of legal hassles.

I have tiny black insects in my pubic hair and I am very itchy. Any idea what this is? I am a 22 year old male

Looks like you got crabs or pubic lice. These tiny creatures are intense black and can cause a fair amount of skin irritation. There are a number of ways to get rid of them. You will need to get an over the counter medication called Quellada, also sold as Derbac-M and Prioderm. This lotion will kill the lice with a single application. The medication must be thoroughly rubbed into the pubic area and left for a minimum of 6-12 hours- the longer the better. Apply it at night and rinse it off in the morning. Most people need another application in 7-10 days to ensure that all the adults as well as the eggs have been killed. Since this is a sexually acquired infestation, your partner must also be treated

Does Viagra protect against sexually transmitted diseases?

Absolutely not. 

All men who buy Viagra should understand that the pill does not protect against any sexually transmitted diseases like HIV, gonorrhea or HIV. Thus, safe sex practice using latex condoms should be practiced.

How long does a genital herpes infection last?

Almost all genital blisters turn into open ulcers after a few days. The soreness does diminish a little but the general ill health continues for 5-14 days. 


After about 7-10 days, the ulcers dry up, become crusted and fall off. The entire episode can last 7-12 days. After the initial infection, the virus disappears and goes into a latent stage and may never again cause an infection (if you are lucky).


However, mind you the herpes virus never ever leaves the body and hides inside nerves. When the right opportunity presents, it again reactivates- albeit the pain is a little less this time.

I think I may have acquired genital herpes. Will the lesions become painful?

No one ever forgets an acute genital herpetic outbreak. 


The sores are tender to touch and even urination is painful. In those who are liberal in their sex life and acquire an anal infection, the feeling is like a hot-burning needle around the rectal area- in fact quite painful and pooping is almost impossible. 


Any thoughts of eroticism and sexual intercourse are always absent because of the pain.


For men, blisters occur at the tip of the penis and cause difficulty with urination and even wearing tight undergarments can be very uncomfortable. Of course, men have the same degree of pain as women.