Pain

How to Manage Pain Patients in Dental Practice

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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.” … Read more

Wisdom Teeth Caries Experience and Periodontal Pathology in Young Patients

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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 … Read more

Updates on Anesthesia Provided by Oral and Maxillofacial Surgeons

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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 … Read more

Can a Persistent Headache be Caused by Sinus Problems?

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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 … Read more

Electric Stimulation of Brain Releases Powerful Painkiller

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Researchers have been exploring delivering electricity through sensors on the skulls of chronic migraine patients and have found a decrease in the intensity of pain of their headaches. A recent study published in Frontiers in Psychiatry has shown that when electricity is sent to certain regions in the brain of a patient with chronic, severe facial pain it releases an opiate-like substance and powerful painkiller. In the study, researchers administered a radiotracer that reached important brain areas in a patient with trigeminal neuropathic pain. They then applied electrodes and electrically stimulated the skull right above the motor cortex  for 20 minutes during a PET scan which is known as transcranial direct current stimulation (tDCS). The radiotracer was designed to measure the local brain release of mu-opioid, a natural substance that alters pain perception. The researchers argue that this is the … Read more