• Title/Summary/Keyword: Dental pain

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Treatment of severe pain in a patient with complex regional pain syndrome undergoing dental treatment under general anesthesia: A case report

  • Rhee, Seung-Hyun;Park, Sang-Hun;Ha, Sung-Ho;Ryoo, Seung-Hwa;Karm, Myong-Hwan;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.5
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    • pp.295-300
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    • 2019
  • Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.

Diagnosis and treatment of abnormal dental pain

  • Fukuda, Ken-ichi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.1
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    • pp.1-8
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    • 2016
  • Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, these potential alternate causes should be considered. In this clinical review, we have presented a case of referred pain from the digastric muscle (Patient 1), of pulpectomized (Patient 2), and of pulpectomized pain (Patient 3) to illustrate referred, neuromodulatory, and neuropathic pain, respectively. The Patient 1 was advised muscle stretching and gentle massage of the trigger points, as well as pain relief using a nonsteroidal anti-inflammatory and the tricyclic antidepressant amitriptyline. The pain in Patient 2 was relieved completely by the tricyclic antidepressant amitriptyline. In Patient 3, the pain was controlled using either a continuous drip infusion of adenosine triphosphate or intravenous Mg2+ and lidocaine administered every 2 weeks. In each case of abnormal dental pain, the patient's diagnostic chart was used (Fig.2 and 3). Pain was satisfactorily relieved in all cases.

An Insight Into Neurophysiology of Pulpal Pain: Facts and Hypotheses

  • Jain, Niharika;Gupta, Abhishek;Meena, N.
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.347-355
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    • 2013
  • Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.

Personality Profile of TMD Patients from the Viewpoint of Pain (통증을 중심으로 본 악관절장애 환자의 인성적 경향에 대한 고찰)

  • Sang-Cheol Yoon;Jae-Kap Choi
    • Journal of Oral Medicine and Pain
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    • v.20 no.1
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    • pp.79-87
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    • 1995
  • Personality characteristics of third decade female TMD patients was studied by means of SCL-90-R test. 112 TMD patients and 96 dental controls were subjected at the department of Oral medicine, Kyungpook National University Hospital. All the patients were divided into 3 groups according to their pain profile namely, MPDS, ID with Pain and ID with out Pain, and dental controls were divided into 2 groups manely, Dental Controls with Pain and Dental Controls without Pain for comparison. The obtained results were as follows : 1. Mean T-scores of SCL-90-R primary scales and global indexes in the patient and control group were within normal range. 2. When compared between groups with pain, MPDS group were significantly higher in scales of SOM, 0-C, I-S, HOS and PHOB than ID with Pain group and in scales of SOM, I-S. DEP, HOS and PHOM than Dental Controls with Pain group. 3. When compared with ID and Control groups in same pain condition, there were no significant differences between ID without pain and Dental Controls without Pain group. 4. When compared between groups with pain and groups without pain, there were significant differences in scales of SOM and O-C between Dental Controls with Pain and Dental controls without Pain group.

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The efficacy of photobiomodulation on dental injection pain: a systematic review of randomized clinical trials

  • Maryam Altuhafy;Virda Baig;Luay Jabr;Junad Khan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.3
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    • pp.145-159
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    • 2024
  • Dental injections are routinely performed and can result in pain and anxiety in patients. This systematic review aimed to evaluate the efficacy of photobiomodulation therapy (PBMT) in dental injections for pain management in patients undergoing dental treatment. Indexed databases, including PubMed, EMBASE, Scopus, ISI Web of Knowledge, and Cochrane Library, were electronically searched without a time limit up to February 2024. A risk of bias evaluation was performed using the Cochrane tool. A preliminary investigation using electronic and manual methods yielded 4,920,881 manuscripts. Based on the eligibility requirements, 13 randomized control trials (RCTs) were included. Self-assessed pain was determined using the visual analog scale, Face, Legs, Activity, Cry, Controllability scale, or Wong-Baker face pain scale. Eight RCTs demonstrated a notable decrease in needle pain in patients undergoing dental needle injections using PBMT. Based on current evidence, PBMT may help reduce needle pain related to dental anesthesia. Further standardized studies are needed to assess the significance of PBMT for postoperative pain in patients undergoing dental injections.

Dental fear & anxiety and dental pain in children and adolescents; a systemic review

  • Shim, Youn-Soo;Kim, Ah-Hyeon;Jeon, Eun-Young;An, So-Youn
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.2
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    • pp.53-61
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    • 2015
  • Background: There are few previous studies investigating the relationship of dental fear and anxiety (DFA) with dental pain among children and adolescents. To address this issue, we examined the literature published between November 1873 and May 2015 to evaluate the prevalence of DFA and dental pain among children and adolescents, and their relationships with age and sex. Methods: We performed a broad search of the PubMed database using 3 combinations of the search terms dental fear, anxiety, and dental pain and prevalence. A large proportion of the identified articles could not be used for the review due to inadequate end points or measures, or because of poor study design. Thirty-two papers of acceptable quality were identified and reviewed. Results: We found that the prevalence of DFA was estimated to be 10%, with a decrease in prevalence with age. It was more frequently seen in girls, and was related to dental pain. Conclusions: We concluded that dental fear, anxiety, and pain are common, and several psychological factors are associated with their development. In order to better understand these relationships, further clinical evaluations and studies are required.

Maxillary Sinusitis Resembling Trigeminal Neuralgia

  • Ahn, Hyung-Joon;Hong, Yoo Ree;Kim, Sora;Kim, Bok Eum;Park, YounJung;Kwon, Jeong-Seung;Kim, Seong-Taek;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.47 no.3
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    • pp.144-147
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    • 2022
  • Chronic maxillary sinusitis is a common disease, with symptoms of dull, aching pain or pressure below the eyes and signs such as tenderness over the involved sinus, whereas trigeminal neuralgia is described as severe, paroxysmal, and lancinating brief pain limited in distributions of one or more divisions of trigeminal nerve. In cases where these two non-odontogenic toothache symptoms overlaps, the diagnostic process can be confusing. Here, we report a case of a 54-year-old male patient with chief complaints of intermittent, severe, and electric-like pain in the upper left premolar and first molar area, initially diagnosed with trigeminal neuralgia but finally with maxillary sinusitis after pain recurrence 2 years after that. Therefore, thorough history taking and precise imaging interpretation should be considered to make correct diagnose especially in case of a patient with newly developed or altered or atypical symptoms.

The influence of pain experience upon dental fear (통증경험이 치과공포에 미치는 영향)

  • Ju, On-Ju;Park, Chung-Soon
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.6
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    • pp.987-993
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    • 2013
  • Objectives : The aim of the study is to offer basic data that help to reduce dental fear by measuring adult dental fear level with DFS scale. Methods : The subjects were 300 persons including college students in W University and their parents in Jeollabuk-do Province. Data were collected by convenience sampling from May 1 to May 30, 2013. Results : 1. Dental clinic visit provoked pain in 99 people(47.4%). Oral examination and preventive treatment evoked pain in 13 people(6.2%). 2. Women tended to feel much pain than men. Both women and men felt the thrilling fear when a needle pricks the flesh. 3. Respondents having dental caries, gum bleeding, halitosis, shaking tooth, and painful tooth had a higher dental fear level. 4. The direct pain experience(p<0.001) had the greatest influence. The next influencing factor was the insufficient anesthesia(p<0.05). 5. The explanatory power that the pain experience has influence upon dental fear is $R^2$=0.151. Conclusions : The direct pain experience and the insufficient anesthesia experience have the great influence upon patients' dental fear level. Anesthetics and analgesics can be considered as one of the positive methods for pain control.