Tag Archives | Pain

Dental Anxiety Associates with Pain During Dental Procedures

It is well known by dentists that some patients experience dental anxiety, with some patients have worse dental anxiety than others. In a review article titled “Dental Anxiety Is Considerably Associated With Pain Experience During Dental Procedures,” by Mike T. John, appearing in J Evid Base Dent Pract, 2013, issue 13, pp. 29-30, the issue of dental anxiety in dental patients is explored. The study reviews a study titled “Predictors of pain associated with routine procedures performed in general dental practice,” by Tickle M, Milsom K, Crawford FI, and Aggarwal VR, in Community Dent Oral Epidemiol, 2012 Aug;40(4):343-50. In the original study 508 patients who visit 38 different dentists in England participate. Dental anxiety was measured with the Corah Dental Anxiety Scale which resulted in a score between 4 and 20. This score was grouped into 4 different variables representing anxiety. The dental patients were asked to rate their intensity of pain on a scale of 0 to 10 during the procedure, after the procedure, and later after the procedure (not immediate). The researchers performed logistic regression and found that very anxious patients had a fivefold increased odds of experiencing pain during the dental procedure compared to patients who had […]

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How to Manage Pain Patients in Dental Practice

An interesting article appears in J Can Dent Assoc 2012;78:c83 titled “Neuropathic Orofacial Pain Patients in Need of Dental Care,” written by Gary D. Klasser and Henry A. Gremillion. It was posted online on August 17, 2012, over at http://www.jcda.ca/article/c83. The abstract of the article states “Dental pain is a common complaint among the general population. Most pain is a result of traumatic injury or bacterial infection in pulpal and periapical tissues, and dental practitioners are successful at diagnosing these conditions and providing prompt relief. However, in some cases, patients continue to complain of persistent pain, which may be categorized as neuropathic. These people may avoid or neglect routine dental treatment or interventions to prevent precipitation, perpetuation or exacerbation of their pain condition, and practitioners may have to modify their procedures when managing the dental needs of this unique population.” The article mentions that most dental pain is the result of traumatic injury or bacterial infection and classified as nociceptive or inflammatory. A description of the differences between nociceptive and inflammatory pain is provided. The article states that dental practitioners are very succesful at recognizing and treating these types of pain. The article then goes on to say “However, in […]

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Wisdom Teeth Caries Experience and Periodontal Pathology in Young Patients

An interesting article explored the prevalence of caries experience and periodontal pathology on asymptomatic wisdom teeth in young adults appears in a 2012 issue of the Journal of Oral and Maxillofacial Surgery by Rachel N. Garaas and et al. titled “Prevalence of third molars with caries or periodontal pathology in young adults” (J Oral Maxillofac Surg. vol. 70, pages 507-513, 2012). The article seeks to help inform young adults who are seeking advice about the extraction or retention of wisdom teeth about if these teeth can remain symptom free or not. The study includes 409 patients with an average age of 25. The authors define a periodontal probing depth of at least 4 mm as indicative of periodontal inflammatory disease. The authors found that a periodontal probing depth of at least 4 mm was detected more often on a mandibular wisdom tooth than a maxillary wisdom tooth (64% versus 20%). The authors found that fewer subjects were affected by wisdom teeth caries experience when compared to first and second molar caries experience (24% versus 73%). Caries experience was detected on a third molar exclusively in only 3 subjects (<1%). The authors further found that 229 of the patients had wisdom […]

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Updates on Anesthesia Provided by Oral and Maxillofacial Surgeons

Recently, it has come to my attention that the American Association of Oral and Maxillofacial Surgeons (AAOMS) has released a new white paper titled “Office-Based Anesthesia Provided by the Oral and Maxillofacial Surgeon,” in 2013, located over at http://www.aaoms.org/docs/papers/advocacy_office_based_anesthesia.pdf. This data contains some important data from the OMS National Insurance Company (OMSNIC) which to my knowledge had been previously closed. This data is Anesthesia Morbidity and Mortality Data from 2000 to 2010  for a total of 29,975,459 in-office anesthetics (conscious sedation, deep sedation and general anesthesia) provided by oral and maxillofacial surgeons in their offices. It was found from this data that the ratio of office fatalities/brain damage per anesthetics administered is 1 to 365,534.  I had long wondered what this data showed as I have previously looked at numerous studies attempting to determine how many deaths occur when anesthesia is used in dental offices, see http://www.teethremoval.com/mortality_rates_in_dentistry.html. Due to the fact that OMSNIC covers more than 80% of all oral and maxillofacial surgeons in the U.S., their data is very meaningful. My previous estimate was around 1 death in 450,000 cases when anesthesia is used in dental offices if I deweighted some older studies; however, using equal weight I had […]

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Can a Persistent Headache be Caused by Sinus Problems?

I came across an interesting article that appeared over a year ago in the Washington Post. The article is titled “A man’s persistent headache proves hard to diagnose and harder to treat,” by Sandra G. Boodman, and published on March 19, 2012. Article Link: http://articles.washingtonpost.com/2012-03-19/national/35448791_1_headache-sinus-pain-relievers The article discusses a 41 year old man who developed a constant headache in November of 2008. Over the course of many months the man consulted many neurologists, ear nose and throat doctors, ophthalmologist, and others but none could explain what was causing him the headache. The man is quoted as saying “I’d been chasing this for more than six months. No one could tell me what it was. I just remember thinking, ‘How am I going to be able to function if it never goes away?” Over the course of the treatment the man took antibiotics, corticosteroids, pain relievers, and had sinus surgery. It appears imaging studies were ordered and a CT scan showed a sinus infection which presumably led to the antibiotics and corticosteroids and later sinus surgery. The article describes how the man missed a significant amount of work and lost weight. He later saw another neurologist who gave him a diagnosis […]

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