The AAO Journal, 2016/03, 26(01):17-22, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.academyofosteopathy.org)

Keywords:

acute dental pain [1]
OMT [3924]
osteopathic manipulative treatment [3945]
temporomandibular joint dysfunction [7]
thoracic outlet syndrome [26]
case report [736]

Abstract:

Acute dental pain may result from a localized process, such as an abscess, or it may be the result of pain referral from the musculoskeletal structures of the orofacial, head, and neck regions. The following case report demonstrates the use of osteopathic manipulation treatment (OMT) in the management of acute undifferentiated dental pain in the absence of overt signs of infection. In this case, a 55-year-old female with a history of temporomandibular joint dysfunction and thoracic outlet syndrome presented to an outpatient neuromusculoskeletal medicine clinic with a 1-day history of dental pain. Physical examination revealed marked pressure sensitivity of the right upper first molar and right-side cervical lymphadenopathy, but no swelling in the surrounding soft tissues. Articular and myofascial somatic dysfunctions were found in the head, cervical, thoracic, and rib regions. OMT, including cranial, articular, myofascial release, and Still techniques, was used to treat the somatic dysfunctions found. These techniques, which also included an intraoral myofascial release of the sensitive tooth, afforded the patient immediate improvement in pain and pressure sensitivity and complete resolution of the symptoms within 24 hours. This case report discusses how preexisting biomechanical dysfunction may have predisposed the patient to her acute symptoms, and it explores potential mechanisms of the successful OMT, including optimization of vascular and lymphatic drainage, normalization of autonomic tone, and improvement of regional biomechanics.