• Korean Journal of Psychosomatic Medicine
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• v.30 no.1
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• pp.46-53
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• 2022

Objectives : This study aimed to assess the possible association of dental pain with suicidal ideation among adolescents by analysing data from the 2018 Korean Youth Risk Behavior Survey, a nationwide online survey. Methods : Of 62,823 adolescent middle and high school students in Korea, 60,040 participants were selected for analysis, after excluding cases with missing values. Participants were given a questionnaire about their self-evaluation of health including dental pain and suicidal ideation. Logistic regression analysis demonstrated the relationships between dental pain and suicidal ideation after controlling for potential confounding factors. Results : The proportion of Korean adolescents reporting suicidal ideation was 13.3%. The proportion of adolescents who experienced dental pain was 23.4%. Compared to adolescents who did not report dental pain, adolescents who reported experiencing dental pain were significantly more likely to experience suicidal ideation (OR=1.94, p<0.001). In two multivariate models, the relationships between dental pain and suicidal ideation (AOR=1.24, p<0.001) were statistically significant. Conclusions : Dental pain was associated with increased risk of suicidal ideation among Korean adolescents, even when controlling for sociodemographic factors and other health conditions. It is necessary to consider screening adolescent patients who present with dental pain for suicidal ideation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.5
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• pp.273-280
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• 2023

Background: Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers. Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. Methods: A total of 42 healthy children aged 7-10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants' demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min. The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann-Whitney U test. Results: The median pain score and range for the intervention and control groups were 4 (2 - 6) and 6 (4 - 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group. Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. Conclusion: Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.6
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• pp.337-346
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• 2023

Background: This study aimed to investigate the effect of local anesthesia (LA) on postoperative pain and hemostasis after dental rehabilitation under general anesthesia (DRGA) in pediatric patients. Methods: A total of 43 patients, aged 3-7 years and rated ASA I or II, who had a definitely negative rating on Frankel's behavior rating scale, were included in this two-arm, parallel-design, single-blinded, randomized, controlled study. The patients were allocated equally into two main groups receiving both restorative treatments and tooth extractions. Two pain scales and one bleeding scale were used. In Group A, the treatment was done with LA, and in Group B, the treatment was done without LA. Results: The statistical analysis revealed no significant differences in the pain scores between the groups. It also revealed significant differences in the bleeding scores between the groups but no significant differences in the duration of bleeding. Conclusion: Within the limitations of this study, the use of LA in pediatric dental patients undergoing DRGA had no effects on postoperative pain reduction or bleeding duration after teeth extraction. We also observed that the use of LA had an impact on the reduction in the bleeding scores in pediatric dental patients undergoing DRGA.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.3
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• pp.195-204
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• 2024

Background: Distraction is a technique used to divert a patient's attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children. Methods: Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong-Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal-Wallis and Wilcoxon signed-rank tests. Results: In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores. Conclusion: Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.

• The Korean Journal of Health Service Management
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• v.6 no.1
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• pp.141-151
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• 2012

In this study a survey was conducted of a total of 187 insurance sales workers from 10 branches of S Insurance Company located around Korea to gather information on causes of dental fear. Results revealed that the group who had experienced direct dental pain in the past showed higher fear levels than the group without such experience. With respect to indirect dental pain, the group with such experience showed higher fear levels in 'fear of dental appointments' and 'fear of antiseptic smells than the group without such experience. Concerning gender, higher fear levels were observed among females than among males. It was also found that the majority of the respondents seldom go for a regular dental check-up regardless of whether they had experienced direct or indirect pain during dental treatment. In addition, there was positive correlation among all the items in the Dental Fear Survey Scale at a significance level of 0.1%. Twenty of all the DFS items were found to be related to causes of dental fear, meaning that most of the elements involving the dentistry may contribute to the development of dental fear among dentally fearful people.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.31-34
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• 2015

Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.143-149
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• 2019

Background: Uncooperative behavior of children due to dental anxiety may interfere with the effective delivery of dental care and compromise the quality of treatment provided. Injection of local anesthesia is one of the most anxiety-inducing stimuli in pediatric dentistry. This study aimed to compare the efficacy of a child-friendly device, having a combined effect of vibration and distraction, with the conventional method of injection on pain, anxiety, and behavior of pediatric patients aged 6-11 years. Methods: This randomized, crossover, split-mouth study included 30 children requiring a bilateral inferior alveolar nerve block. The children were equally divided into two groups: group 1, aged 6-8 and group 2, aged 9-11 years. All children were injected with anesthesia using the conventional and device method in two separate sessions. They were assessed for anxiety by measuring the pulse rate before and during the administration of local anesthesia. Behavior was assessed using Faces, Legs, Activity, Cry, Consolability (FLACC) scale, and the child's experience while receiving anesthesia was assessed using the Wong Bakers Pain Rating Scale. Results: Results showed that the children who received local anesthesia using the device method had a lower mean pulse rate, FLACC scores, and pain rating scores than those who received local anesthesia using the conventional method. Conclusion: The device method was more effective than the conventional method in managing pain, anxiety, and behavior of patients aged 6-11 years. The device is a cost effective, simple, and child-friendly product for administrating local anesthesia in pediatric patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.197-204
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• 2022

Background: Injections are one of the most fear-provoking stimuli in dentistry. Painless administration of an injection is a vital step in alleviating anxiety, which in turn leads to good behavior in children. The aim is to evaluate and compare anxiety levels and pain perception using conventional, insulin, and deception syringes during the administration of local anesthesia in children. Methods: Forty-five children aged 6-12 were selected using a standard sample size formula and equally divided into three groups. Local anesthesia was administered using a conventional syringe to Group A participants and an insulin syringe for Group B participants. Group C participants were administered local anesthesia using a deception syringe by showing the patient disposable obturation tips, and eventually a conventional syringe was used for administration of local anesthesia after hiding them from the patient. Anxiety levels were assessed using Venham's Picture Scale and pulse rate at baseline and after administration of local anesthesia. The Wong-Baker Faces Pain Rating Scale was used to assess pain perception after the administration of local anesthesia. Results: Insulin and deception syringes showed better reduction in anxiety levels and pain perception than conventional syringes, demonstrating a high statistically significant difference. Conclusion: The use of insulin and deception syringes for administration of anesthesia was demonstrated to be effective in alleviating anxiety in children and is therefore recommended as an alternative to conventional syringes.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.89-94
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• 2016

Anxiety and phobia in dental procedures are common deterrents for patients visiting the dental care unit. For these individuals, procedural sedation may aid in completion of dental treatments. In most cases, the patients are conscious during sedation, thereby allowing spontaneous ventilation. Intravenous sedation (IVS) is widely used during dental treatment to relieve patient anxiety. IVS is the most effective route of administration to achieve this goal, but it requires advanced training, more than that provided during undergraduate education. During IVS, rapid onset, repetitive drug administration, easy titration, and rapid recovery from sedation can be achieved. However, conscious sedation during IVS can result in deep sedation that can cause respiratory and cardiovascular depression. Therefore, the characteristics of intravenous sedatives should be known. The purpose of this review is to discuss the characteristics and usage of intravenous sedatives currently used for dental procedures.

• Journal of Oral Medicine and Pain
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• v.49 no.1
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• pp.18-21
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• 2024

Orofacial pain has various causes, making it challenging to differentiate from dental-related diseases based solely on symptoms. Toothache, usually attributed to pathological changes in the pulp and periodontal tissue, is the most common cause of orofacial pain and relatively easy to diagnose. However, distinguishing orofacial pain and nonodontogenic toothache due to myofascial, neuropathic, neurovascular, paranasal sinus and cardiac originating, and psychogenic pain presents diagnostic challenges that may result in incorrect treatment. Therefore, dentists must recognize that orofacial pain can arise from not only dental issues but also other causes. This case report explores the necessary considerations in diagnosing orofacial pain and nonodontogenic toothache by examining the diagnoses of patients presenting at the dental hospital with orofacial pain and nonodontogenic toothache of cardiac origin.