• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.317-320
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• 2016

A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur. Therefore, we used a fiberoptic bronchoscope to insert the NTT. After surgery, we performed a tongue-tie to protect against airway obstruction caused by the backward movement of the tongue during recovery. The patient recovered without any complications. We determined the status of the patient precisely and consequently performed thorough preparations for the surgery, allowing the patient to be anesthetized safely and recover after surgery. Careful assessment of the patient and airway prior to surgery is necessary.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.141-146
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• 2015

Background: An understanding of the features of postoperative pain is essential for optimal analgesic dosing strategies. Using a visual analogue scale (VAS) score and patient controlled analgesia (PCA) infusion pattern analysis, an anesthesiologist can estimate when and how severely patients suffer from pain. Several reports have been published about circadian changes in the pain threshold. Postoperative pain was analyzed retrospectively in 250 patients who underwent orthognathic surgery. Methods: A total of 250 patients were allocated into two groups according to the time of recovery from anesthesia. Patients in the early group (group E) recovered from anesthesia before 06:00 p.m. Patients in the late group (group L) recovered from anesthesia after 06:00 p.m. All patients received intravenous patient controlled analgesia (IV PCA) at the end of the operation. The VAS score of pain intensity was measured. Self-administration of bolus analgesic from the IV PCA device was also analyzed according to actual time and elapsed time. Results: VAS scores showed no difference between the two groups except 36 hours after recovery from anesthesia. On POD1, there were two peaks for self-administration of bolus analgesics in group L and one peak in the morning for group E. Two peaks each in the morning and in the afternoon were shown in both groups on POD2. Conclusions: Diurnal variance in pain should be considered for effective dosing strategies.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.277-288
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• 2019

Background: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. Methods: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. Results: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. Conclusions: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

• Journal of Oral Medicine and Pain
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• v.43 no.3
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• pp.84-86
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• 2018

Salivary and lacrimal gland dysfunction is relatively frequent after radioiodine therapy. In most cases this is a transient side effect, but in some patients it may persist for a long period or appear late. Radioiodine ($^{131}I$) therapy is often administered to patients following total thyroidectomy to treat well-differentiated follicular cell-derived thyroid cancer. In addition to the thyroid, $^{131}I$ accumulates in the salivary glands, giving rise to transient or permanent salivary gland damage. Salivary gland dysfunction following radioiodine therapy can be caused by radiation damage. But, it also may be associated with $Sj{\ddot{o}}gren$ syndrome (SS) developed after radioiodine therapy. It would be recommended that the evaluation for SS including anti-SSA/Ro and anti-SSB/La should be considered before and after radioiodine therapy.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.118-122
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• 2019

Paraneoplastic pemphigus (PNP) is a rare and often fatal autoimmune blistering disease accompanied by both benign and malignant neoplasms. Usually, oral, skin, and mucosal lesions are the earliest manifestations shown by PNP patients. Oral ulcers are initial lesions in various autoimmune diseases like pemphigus, bullous pemphigoid, erythema multiforme, graft-versus-host, lichen planus, it does not improved despite of high-dose steroid therapy. We report a-35-year-old female who presented oral ulceration, lip crust and skin lesions. By doing several examinations, such as enzyme-linked immunosorbent assay, incisional biopsy with indirect immunofluorescence, she was diagnosed PNP with non-Hodgkin's lymphoma on pancreas.

• Journal of Korean Academy of Dental Administration
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• v.9 no.1
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• pp.32-37
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• 2021

Many approaches to local anesthesia have been studied in dentistry. In this study, we introduce a new local anesthetic method, "Point-Inject Technique (PIT)", and compare it with traditional injection techniques. The PIT method utilizes both the vasoconstrictive and antinociceptive properties of local anesthetics as well as the application of controlled pressure during injection, reducing the time to complete anesthesia. Fifty patients were selected as the experimental group who were anesthetized using PIT, and the other 50 patients were selected as the control group using the direct injection method with a carpool syringe. The PIT group received 0.25 cartridges of 2% lidocaine with 1:100,000 epinephrine. The control group received 1.5~2 cartridges of 2% lidocaine with 1:100,000 epinephrine. Both groups were asked to mark the intensity of the pain caused by anesthesia using the Numeric Pain Rating Scale. The average time to recover from anesthesia was 40 minutes in the experimental group and 90 minutes in the control group. Additionally, 96% of the experimental group reported feeling no pain, while 78% of the control group reported having some form of pain during injection. The PIT method reduced both the reported pain scores of patients as well as time to recover from local anesthesia than the widely-used syringe injection method.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.2
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• pp.55-61
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• 2020

During dental treatment, a dentist usually applies the local anesthesia. Therefore, all dentists should have expertise in local anesthesia and anesthetics. Local anesthetics have a neurotoxic effect at clinically relevant concentrations. Many studies have investigated the mechanism of neurotoxicity of local anesthetics but the precise mechanism of local anesthetic-induced neurotoxicity is still unclear. In addition, it is difficult to demonstrate the direct neurotoxic effect of local anesthetics because perioperative nerve damage is influenced by various factors, such as the anesthetic, the patient, and surgical risk factors. This review summarizes knowledge about the pharmacology of local anesthetics, nerve anatomy, and the incidence, risk factors, and possible cellular mechanisms of local anesthetic-induced neurotoxicity.

• Journal of Korean society of Dental Hygiene
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• v.1 no.1
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• pp.63-76
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• 2001

This study was designed to evaluate the effects of music on dental pain and anxiety during ultrasonic scaling. One hundred and twenty five patients visited dental unit of Soonchunhyang University Chunan hospital for scaling were enrolled during August 1999 and February 2000. The patients were allocated randomly into two groups. music (n = 61) and control groups (n = 65). The music group patients listened to self-selected music using an earphone during scaling. Standardized questionnaire were used to assess the subjective denial pain and anxiety before and after scaling in both groups. In music group, more information on music effect was collected. To evaluate changes of physical signs by scaling, blood pressure and pulse were checked by a wrist check oscillometric. The results were as follows: 1. No significant difference in dental pain and anxiety between before and after scaling was observed in music group. However, the music group patients were satisfied with music because of reduction of pain(93.5%) and anxiety(93.4%), 96.7% of music subjects wanted to listen to music in next scaling. 2. While no significant difference in systolic blood pressure before scaling between music and control groups, systolic blood pressure of control group during scaling was significantly higher than that of music group(P<0.05). 3. In multiple logistic regression. the odds ratio(OR) of pain was decreased with age and female patients had higher OR (1.7, p>0.05). Patients with previous scaling experience complained of more dental pain during scaling than patients without experience. Music was not a significant predictor of denial pain during scaling, controlling for possible confounders. 4. While age. music. and scaling experience were not related to dental anxiety during scaling, sex and dental hygiene index were significant predictors of dental anxiety in multiple logistic regression. 5. Both during and after scaling. mean blood pressure of music patients were significantly lower than control patients after controlling for age, sex, and BMI. In conclusion, our data demonstrated that although listening to music did not disappear the dental pain and anxiety. but reduced the intensity of pain and anxiety during scaling. Furthermore, our data imply thai music has a effect of reduction of increasing blood pressure by scaling.

• Journal of Korean society of Dental Hygiene
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• v.14 no.6
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• pp.881-886
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• 2014

Objectives: The purpose of the study was to investigate the related factors to dental fear in some adults. Methods: A self-reported questionnaire was filled out by 320 adults in Seoul and Gyeonggi-do from April to June, 2013. Except 14 incomplete answers, data were analyzed by SPSS 18.0 program. The questionnaire consisted of general characteristics of the subjects(7 questions), dental fear related factor(18 questions), distrust for dentist(15 questions), and distrust for dental hygienist(11 questions). The instrument for dental treatment fear was Dental fear Survey(DFS) adapted from Kleinknecht and partly modified by Choi. Out of 20 questions, 18 questions were reconstructed and score by Likert 5 scale. Higher score means higher dental fear. Cronbach alpha was 0.959 in the study. The distrust for dentist and dental hygienist was adapted from Choi and reconstructed and score by Likert 5 scale. Higher score means higher distrust for dentist and dental hygienist. Cronbach alpha was 0.937 in distrust for dentist and 0.874 in distrust for dental hygienist in the study. Results: Those who experienced dental pain tended to have dental fear. The reasons for dental fear were as follows; bad breath(2.96 out of 5 points, hereafter represented as of 2.96/5), dental caries(2.88/5), missing teeth(2.87/5) and tooth pain(2.77/5). The distrust for the dentist was the main dental fear in the adults. Conclusions: The dental fear was closely related to gender, experience of dental pain, oral symptoms and distrust for the dentist. As the psychological pain in the patients was mainly influenced by the trustful atmosphere, it is necessary to make the patient easy before treatment.

• Journal of Oral Medicine and Pain
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• v.45 no.4
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• pp.110-114
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• 2020

Myofascial pain (MFP) is one of the most common causes of persistent orofacial pain. Patients with chronic myofascial orofacial pain may present with diffuse heterotopic pain, complicating the correct diagnosis. Treatment of chronic MFP should focus on the elimination of aetiologic factors. This article describes two cases of chronic MFP of the masticatory muscles, whose symptoms were exacerbated after masseteric nerve neurectomy. The patients had suffered from irrelevant treatment which did not resolve the symptom. Their symptom was managed by conventional treatment protocol. These cases emphasize the importance of correct diagnosis and evidence-based approach.