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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atypical odontalgia (AO) is a dental condition that is usually diagnosed by exclusion after failure of multiple dental treatments. A functional definition of AO includes (1) continuous pain in and about a tooth or teeth, (2) pain present for longer than 4 months, (3) inadequate local cause (no abnormality detected on dental radiographs), and (4) anesthetic blockade gives equivocal relief of toothache. The purpose of this study was to assess the potential role of electronic thermography in the diagnosis of AO. Results from measurements of facial thermal symmetry indicated that normal subjects = 83.5%, AO group = 65.8% (p less than 0.01). Electronic thermography interpreted by thermography experts has promise as a diagnostic test for AO among patients with toothache for which the dentist can find no convincing dental explanation.
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PMID:Electronic thermography in the diagnosis of atypical odontalgia: a pilot study. 279 44

This study explored the personal impact of dental problems in terms of pain, worry, and conversation avoidance, and factors associated with this impact. A self-reported dental health index, comprising three questions asked of participants in the Rand Health Insurance Experiment, was examined. Index reliability was 0.69. One-way analysis of variance and Pearson's product-moment correlations were used to explore the bivariate associations between the index and sociodemographic variables, provider-assessed clinical indicators, and the respondent's report of a toothache. Perceived dental health of the study sample (N = 1,658) was notably lower in the presence of a toothache, increasing numbers of decayed teeth, and worsening periodontal health. Weaker, but statistically significant, associations were observed for sociodemographic factors. Nonwhites and those persons with lower educational and income levels reported more impact. In regression analysis, standardized coefficients indicated that the respondent's report of a toothache and, secondarily, numbers of decayed teeth were the most important explanatory factors. These findings suggest that in the future improved self-reported measures, in addition to clinical indicators, may be an acceptable and cost-effective method of epidemiological data collection and dental health outcome assessment.
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PMID:Correlates of self-reported dental health status upon enrollment in the Rand Health Insurance Experiment. 280 77

The purpose of this study was to examine in man the analgesic effect of non-segmental electroacupuncture (EA) limited to a single point (Hoku hand point) and the influence of naloxone using an original modified electrical dental pain test. Results in the literature are still contradictory as to the degree and specificity of acupuncture analgesia and its opioid nature. Acupuncture techniques as well as experimental pain models are factors accounting for the discrepancies in the results. For this reason, we designed an experimental pain test characterized by a high degree of specificity, validity and reliability. We chose optimal conditions for eliciting specific acupuncture effect, i.e. non-segmental, low frequency and painful intensity range. A cross-over repeated measure experimental design was used. Five normal trained subjects participated in 65 sessions under four conditions (control, EA, EA+naloxone, EA+placebo). Changes in experimental dental pain thresholds served as indices of analgesia. The results indicated a 27% pain threshold increase after 30 minutes of EA stimulation (p less than .0001), with no differential effect between pain detection (mild pain sensation) and pain discomfort (strong pain sensation). This increase was partially blocked by the double blind injection of 0.8 mg naloxone IM (p less than .005). The experiment was designed in such a way as to prevent the occurrence of a stress analgesic effect. The endogenous opioid system was shown to be partially involved in acupuncture analgesia. Other mechanisms of action are discussed in view of the literature findings.
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PMID:Influence of naloxone on electro-acupuncture analgesia using an experimental dental pain test. Review of possible mechanisms of action. 288 37

Although dihydrocodeine (DF118) is widely prescribed by general dental practitioners, there is little evidence that it is successful in controlling post-operative dental pain. Ibuprofen is known to be effective in this situation. A single dose, double-blind study was carried out in 148 patients to compare 400 mg ibuprofen with 30 mg dihydrocodeine and placebo for treating moderate to severe pain following the removal of unilateral, impacted mandibular third molar teeth under local anaesthesia. An additional dose of either ibuprofen or dihydrocodeine was available after 2 hours. The post-operative ibuprofen reduced pain and produced more pain relief than dihydrocodeine or placebo. Furthermore, fewer patients receiving ibuprofen took additional analgesic at 2 hours. Patients who received ibuprofen as supplementary medication also experienced less pain and had greater pain relief than those receiving dihydrocodeine as supplementary medication, even when their post-operative treatment had been placebo. More patients reported the medication as having been effective if they took ibuprofen either post-operatively or as supplementary analgesia. Ibuprofen is an appropriate analgesic for treating post-operative dental pain.
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PMID:A comparison of ibuprofen and dihydrocodeine in relieving pain following wisdom teeth removal. 292 Jan 33

The effect of physical exercise on dental pain thresholds, the release of pituitary stress hormones and thermal sensitivity of skin was tested in healthy human subjects. Different levels of exercise (100-300 W) at different pedal frequencies were produced by a cycle ergometer. Thermal limen (the interval between warm and cool thresholds) determined from glabrous hand, hairy forearm and leg was used as a parameter of thermal sensitivity. In all subjects the heart rate and blood pressure were increased with increasing work load. Dental pain thresholds were elevated at high work loads with a concomitant activation of pituitary stress hormone (especially growth hormone) release. Thermal limens at all 3 sites were increased work load, too, independent of the pedal frequency. The increase of thermal limen was most marked in the leg and least in the glabrous hand. The results indicate that physical exercise produces a non-segmental, load-dependent decrease of pain and thermal sensitivity with a concomitant activation of pituitary stress mechanisms. The magnitude of modification varies with skin region. Activation of inhibitory mechanisms at spinal levels via muscle and proprioceptive afferents, in a way suggested by the gate control theory of pain mechanisms, seems to have only a minor, if any, contribution to the present findings, since a higher pedal frequency did not produce a more marked decrease of sensitivity.
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PMID:Modification of dental pain and cutaneous thermal sensitivity by physical exercise in man. 300 May 34

Nimesulide is a new non-steroidal anti-inflammatory analgesic agent given orally or rectally on a twice daily basis in a number of inflammatory and pain states. Although still at an early stage of clinical assessment, preliminary evidence suggests that nimesulide 200 to 400mg daily is significantly more effective than placebo in reducing the pain, fever and inflammatory symptoms of chronic rheumatoid arthritis or osteoarthritis, respiratory tract infections, otorhinolaryngological diseases, soft tissue and oral cavity inflammation, dysmenorrhoea, phlebitis/thrombosis, urogenital disease and postoperative pain states. In a number of comparative studies, nimesulide has also been shown to be more effective than piroxicam (in osteoarthritis), paracetamol (acetaminophen) [in respiratory tract inflammation], benzydamine or naproxen (in otorhinolaryngological disease), phenylprenazone (in laryngotracheitis/bronchitis, respiratory inflammation and otorhinolaryngological disease), Serratia peptidases (in postoperative or dental pain, trauma and phlebitis), ketoprofen (in postoperative dental pain) and mefenamic acid (in dysmenorrhoea). In addition, the efficacy of nimesulide has been observed to be comparable with that of aspirin, with or without vitamin C, and mefenamic acid (in respiratory tract infection), ibuprofen (in soft tissue disease), naproxen (in respiratory tract inflammation, dysmenorrhoea and postoperative pain states), suprofen and paracetamol (in postoperative pain states), benzydamine (in genitourinary tract inflammation) and dipyrone, paracetamol or diclofenac (in fever). The safety profile of nimesulide has yet to be fully established, although initial evidence suggests the usual adverse effects associated with non-steroidal anti-inflammatory drugs occur, possibly with a lower incidence of gastrointestinal problems than with other members in its therapeutic class. Nimesulide, therefore, appears to offer a useful alternative to other non-steroidal anti-inflammatory drugs in the treatment of patients with inflammatory conditions and/or pain and fever states. However, further definition of its efficacy and tolerability is clearly required, particularly in comparison with established or other new drugs in its therapeutic class.
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PMID:Nimesulide. A preliminary review of its pharmacological properties and therapeutic efficacy in inflammation and pain states. 306 59

Dental pains provoked by an altitude beyond 5.000 ft can occur with any kind of tooth, healthy or restored. It is considered as a consequence of a brutal pressure change. The incidence has not been decreasing in spite of flight conditions improvement. These kind of dental pain cause a problem for those who fly: civilian and military pilots as well as airlines passengers. The conditions in which this might happened are variable. There may be a definite correlation between the character of the symptoms of aerodontalgia and the underlying pulpal pathology. The proposed etiology concerning pathological teeth is an oedema and hyperthermia of the pulp which can lead to necrosis. In an indirect type dental pain is secondary to stimulation of the superior alveolar nerves by a maxillary barosinusitis, or anatomic malformation. The most frequent is a pain during ascent (decompression), and the most concerned teeth are upper molars. The preventive treatment is very important. Both complete clinical and radiological examinations must be achieved. Regular dental examination are-essential for the crew. Aerodontalgia can be largely prevented by high quality root and dental cares. The case of a 26 years old man who use to suffer for a long time of dental pain during flights is in accordance with the dominant clinical symptoms of this affection.
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PMID:[Aerodontalgia. Report of a case]. 316 62

Case histories of 15 patients with dental pain who were examined at the Royal Adelaide Hospital Pain Clinic were reviewed. These were the only patients with dental pain seen at the clinic over a 10-year period and represent less than 1% of the total patients fully examined at the clinic. Only one patient had an underlying organic problem; the remainder had a diagnosis of atypical facial pain. Common characteristics that pointed to the diagnosis of intractability were the duration of the pain, extensive and multiple ineffective treatments, a history of pain elsewhere in the body, and a history of psychologic disturbance. Ten of the 12 patients who were offered and accepted psychotherapeutic treatment had appreciable symptomatic relief. No dental or surgical treatments resulted in any pain relief.
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PMID:Dental patients in a general pain clinic. 316 79

The severity of postoperative dental pain can be variable depending on the type of procedure. Both centrally acting and peripherally acting analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and acetaminophen are used. NSAIDs are generally better suited to ambulatory outpatients. The most commonly used postoperative dental pain model includes patients who have undergone surgical removal of impacted third molar teeth. The analgesic efficacy of piroxicam in this pain model was studied both in the United States and in foreign centers. The foreign studies suggest that piroxicam at 20-mg doses produces analgesia in patients with postoperative dental pain. Seven single-dose, randomized, double-blind trials of 798 patients in the United States more clearly evaluated the efficacy of piroxicam. These studies used various doses of piroxicam (5, 10, 20, and 40 mg), aspirin 648 mg, and placebo. Safety results showed that a wide range of piroxicam doses were safe when administered in single doses. Although neither piroxicam 5 mg nor 10 mg produced clinically significant analgesia, 20-mg and 40-mg doses were significantly superior to placebo and both were comparable with aspirin 648 mg over the initial six hours. Piroxicam 20 mg and 40 mg, however, produced significantly longer durations of analgesia than aspirin 648 mg, and it appears that the analgesic effect of piroxicam may extend for up to 24 hours in a substantial proportion of patients.
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PMID:Analgesic efficacy of piroxicam in postoperative dental pain. 328 10

One hundred eight consecutive patients with proved coronary artery disease and reproducible exercise-induced myocardial ischemia were studied. During repeated exercise testing, 52 patients (Group I) had myocardial ischemia in the absence of pain (silent ischemia) whereas 56 patients (Group II) experienced anginal symptoms in the presence of electrocardiographic signs of ischemia. A pulpal test was carried out in all patients using an electrical dental stimulator commonly used in dentistry. Electrical current was delivered in increasing intensity from 10 to 500 mA, and the dental pain threshold and the reaction of the patients to maximal stimulation were determined. During the pulpal test, 71.2% of the patients in Group I did not experience pain, even at maximal stimulation (threshold 0), 11.5% were sensitive at threshold I (10 to 200 mA) and 17.3% felt pain at threshold II (210 to 500 mA). In Group II, 69.7% of the patients complained of dental pain at the low intensity test current (threshold I), 10.7% at threshold II and 19.6% at threshold 0. In Group I, 71.2% of patients did not have discomfort (reaction -), even at maximal stimulation, 21.1% had a mild reaction (reaction +) and 7.7% had an intense painful reaction (reaction ++). In Group II, 80.4% of patients were sensitive to the pulpar test (67.9% reported intense painful sensation at maximal stimulation, 12.5% had a mild reaction); 19.6% of patients had no reaction. The two groups of patients were similar with respect to age, sex and angiographic features.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dental pain threshold and angina pectoris in patients with coronary artery disease. 339 25


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