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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Orofacial pain, the main reason why many patients seek dental advice, usually has a local cause--primarily the sequelae of dental caries--but a wide range of diseases, particularly neurological, psychogenic and vascular disorders, can cause orofacial pain. This article will discuss disorders that can present with pain and the neurological, psychogenic and vascular causes of orofacial pain. The first article in this series made several general observations on diagnosis and treatment which should be borne in mind in relation to the material presented here.
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PMID:Orofacial disease: update for the clinical team: 9. Orofacial pain. 1121 69

Pain during invasive treatment of dental caries is a common phenomenon, if no local analgesia has been used before cavity preparation. Atraumatic restorative technique (ART) is a suggested procedure which is at least less traumatic for the patient. Although the ART approach has been received well by both children and adults who belong to population groups hardly ever exposed to regular oral health care, it has not yet been proven that this particular procedure really causes less pain, compared to more conventional techniques with rotating instruments. In the present study, pain was reported in connection with tooth restoration in 19.3 percent of the cases, when the ART technique was used, which is significantly less than with a conventional restorative technique (35.7 percent). Finally the results show a clear relationship in the pain reports between the first and the following treatments in both ART and the conventional technique groups.
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PMID:Pain related to different ways of minimal intervention in the treatment of small caries lesions. 1082 48

The objective of this study was to evaluate a new chemo-mechanical method (Carisolv) for the removal of primary root caries in vivo in terms of efficiency, treatment time and patient perception. Thirty-eight patients participated in an open, randomised and controlled study. Of the 60 root carious lesions included, 34 were randomised for chemo-mechanical treatment and 26 for drilling. A within-subject comparison was used whenever the patient had two cavities, which was the case for 22 subjects. All the Carisolv-treated cavities became caries free, as did all but one of those treated with drilling, as judged by an independent examiner. Only 4 of 34 patients asked for anaesthesia in the Carisolv group compared with 6 of 26 patients in the drilling group. Of those who did not use anaesthesia, 12 individuals in the drilling group experienced some pain compared with none in the chemo-mechanical group (p<0.001). The mean treatment time for the Carisolv method was 5.9+/-2.2 min, compared with 4.5+/-2.0 min for drilling; time for anaesthesia excluded (p<0.05). No negative reactions or adverse effects were recorded during the study. All 55 teeth examined in the 1-year follow-up were found to be sensitive using an electric pulp tester, and there was no difference regarding the condition of fillings between the lesions treated with Carisolv and drilling. It can be concluded that root caries can be effectively removed using the Carisolv method. The longer treatment time was compensated by less need for anaesthesia.
Caries Res
PMID:Evaluation of Carisolv for the chemo-mechanical removal of primary root caries in vivo. 1086 28

Previous studies have indicated that a chemomechanical caries removal system (CRS) has been effective in minimizing the use of conventional mechanical instruments and that it may reduce the need for local anesthesia. In the present study, a comparison of the pain experienced both during treatment with a chemomechanical technique and during conventional caries removal (control) was made for each of 47 patients who initially were not given a local anesthetic. One of two dentists was randomly selected to examine and treat patients with a matched pair of carious teeth, and each pair of teeth was treated in a randomized order with the CRS or control procedure. Responses to the McGill Pain Questionnaire (MPQ) revealed a significantly higher level of pain (p < 0.025) associated with the conventional treatment compared with the chemomechanical procedure. A significantly greater number of patients (p < 0.05) requested local anesthetic for the tooth subjected to the control procedure than for the tooth subjected to the CRS procedure. However, 72.3% of the patients did not request local anesthesia for either treatment, although pain was experienced by these patients in 46.8% of the control teeth and 27.7% of the teeth which received the CRS treatment. Of the 20 pain descriptor categories listed on the MPQ, the sensory categories accounted for the greatest mean number of pain descriptors selected for both the CRS (4.4) and control procedures (8.0), compared with the mean number of descriptors selected from the affective pain categories for the CRS (0.8) and control procedures (1.0). The results suggest that sensory pain factors are more important than affective pain factors in controlling the overall discomfort of patients and the need for local anesthetic during caries removal and subsequent restorative procedures.
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PMID:Comparison of pain associated with mechanical and chemomechanical removal of caries. 1087 6

Xerostomia results from salivary gland irradiation during treatment of head and neck malignancies. In addition to having difficulty with speech and swallowing, these patients experience loss of taste, dental caries, and chronic fungal infections. The paired submandibular glands provide 70 percent of the normal salivary flow and are difficult to shield during radiation therapy. Another sicca condition, xerophthalmia, may result from facial nerve injury or other medical disorders and results in pain, corneal ulceration, and possible vision loss. Treatment options for xerostomia are limited, and management of xerophthalmia usually focuses on the eyelids, rather than the fundamental problem of inadequate secretory protection. In this study, a rat model for submandibular gland microvascular transplantation was developed to assess the feasibility of salivary tissue transfer. Sixteen rats underwent submandibular gland transplantation from the neck to the groin. Fourteen of these rats underwent microvascular anastomosis of the vascular pedicle. Ten glands were assessed for viability at 4 days after transplantation, and four glands were examined after 7, 10, 14, or 21 days. By gross and histologic examination, 93 percent of transplanted glands showed expected long-term viability after at least 4 postoperative days. Microvascular techniques were shown to be applicable to the transplantation of submandibular gland salivary tissue. This has not previously been shown in a rat model. It is possible that submandibular glands could be transplanted to the eye for treatment of xerophthalmia and out of the neck during irradiation of the head and neck, with subsequent replantation after treatment as a means of preventing permanent xerostomia.
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PMID:Microvascular transplantation of the rat submandibular gland. 1108 64

Over recent years the dental profession has shifted towards practising preventive dentistry and adopting more conservative and tooth-preserving procedures. Such progression is considered to be a response to the decline in the level of dental caries and advances in materials science. This shift in caries management will no doubt continue over the coming decades, based on rational clinical and scientific principles. Chemomechanical caries removal involves the application of a solution that selectively softens the carious dentine, thus facilitating its removal. This limits the removal of sound tooth structure, the cutting of open dentinal tubules, pulpal irritation and pain compared with conventional mechanical methods.
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PMID:A chemomechanical method for caries removal. 1121 35

The neural status of carious teeth, particularly those associated with a painful pulpitis, is largely unknown. This study sought to determine differences in the innervation density of human primary and permanent teeth and whether caries or painful pulpitis was associated with anatomical changes in pulpal innervation. Coronal pulps were removed from 120 primary and permanent molars with a known pain history. Teeth were categorized as intact, moderately carious, or grossly carious. Using indirect immunofluorescence, we labeled sections for the general neuronal marker, protein gene product 9.5. Using image analysis, we found permanent teeth to be significantly more densely innervated than primary teeth. While there was no significant correlation with reported pain experience, neural density in both dentitions increased significantly with caries. Analysis of these data suggests that caries-induced changes in neural density may be functionally more important in the regulation of pulpal inflammation and healing than in the processing and perception of dental pain.
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PMID:Innervation of human tooth pulp in relation to caries and dentition type. 1126 34

The aim of this study was to assess the knowledge of dental patients about dental health and diseases. A questionnaire was developed with three sets of questions, 1-general knowledge of dental conditions, 2-use of alternate methods in prevention and treatment of dental diseases, 3-awareness about personal oral health. Six hundred questionnaires were distributed in 6 cities from 4 different regions (i.e. Makkah, Riyadh, Tabuk, Gizan). 367 respondents (61% response rate) constituted 233 (63.5%) male and 134 (36.5%) female with the age range 11-70 years (mean 30 +/- 11.9). The data were analyzed by SPSS version 9.0 and results presented in frequency distributions. 99% male and 96% female considered their teeth for chewing food, 97% male and 96% female knew that increased carbohydrate intake and poor oral hygiene are related to tooth decay, 89% male and 96% female used toothbrush and paste to prevent dental diseases and 75% male and 66% female were regular user of miswak (chewing sticks.) 67% male and 59% female visit dentist, only in pain. 46% used miswak after their meals, only 14% of the subjects used miswak on their lingual and palatal surfaces of teeth, while 38% of the subjects used clove as remedy for toothache, 25.6% used saline and 10% used lemon for bleaching their teeth. 15% considered honey important for their good oral health. Regarding personal oral health, 35% had pain in gums, 36.8% were with bad breath, 28% had tooth hypersensitivity, and almost 50% used toothbrush twice daily while 42% had bleeding gums. It is important to note that knowledge and awareness about dental health and disease conditions are better in male subjects, dietary habits and oral hygiene methods need to be addressed in future investigations. There is a need to provide more health education to female subjects to improve their oral health.
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PMID:Knowledge of dental health and diseases among dental patients, a multicentre study in Saudi Arabia. 1130 38

Plasma-treated lenowoven polyethylene ribbon was used for splinting between teeth around osteotomy lines in anterior segmental dentoalveolar osteotomy. This fixation was continued for 2 to 3 months, during which there was no damage or fall of the ribbon. In addition, the patients were able to eat their usual food, had much less pain in the teeth and oral mucosa, did not feel uncomfortable in the mouth, had no tooth damage or carious teeth, and had a good aesthetic appearance. In all eight jaws (five patients), accurate and strong bone fixation was achieved based on the planned occlusion. Patient complaints and pain were obviously less with this method than other methods. Polyethylene ribbon is quite useful for bone fixation in anterior segmental dentoalveolar osteotomy.
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PMID:Plasma-treated lenowoven polyethylene ribbon for bone fixation at dentoalveolar osteotomy. 1131 93

Complications of dental caries not treated and mal-treated are frequent in Africa (cellulitis, osteitis, etc...). Patients consult late due to effective automedication with anti-inflammatory agents but the continuing pathological process leading to fistulae, perforation and persistent pain are finally the reasons of consultation. We present a case of a young Ivorian student of 22 years we have received after one year of erratic treatment with a right jaw perforation.
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PMID:[Cheek perforation of dental origin and the effect of anti-inflammatory drug treatment during self-medication. Apropos of a case]. 1137 91


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