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

Patients suffering from acute dental pain were treated with ice massage of the web between the thumb and index finger of the hand on the same side as the painful region. Control groups received tactile massage alone or with explicit suggestion that the massage was intended to alleviate their pain. Changes in pain intensity produced by the procedures were measured with the McGill Pain Questionnaire. Ice massage decreased the intensity of the dental pain by 50% or more in the majority of patients. Furthermore, the pain reductions produced by ice massage were significantly larger than those produced by tactile massage alone or with explicit suggestion. The results indicate that ice massage has pain-reducing effects comparable to those of transcutaneous electrical stimulation and acupuncture. The fact that cold signals are transmitted to the spinal cord exclusively by A-delta fibres and not by C fibres provides a potential method for differentiating the various feedback systems that mediate analgesia produced by different forms of intense sensory input. Ice massage provides a simple method for the palliative control of pain in dental clinics.
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PMID:Relief of dental pain by ice massage of the hand. 736 12

Effects of electroacupuncture on the jaw opening reflex after tooth pulp stimulation were investigated in lightly anesthetized rats. Electroacupuncture stimulation (45 Hz, 5 msec) was delivered to 8 meridian points and 6 nonmeridian ones for 15 min so as to compare the degree of suppression elicited from each point. Significant suppressive effects on the reflex were observed in the cases of Yin-Hsiang, Ho-Ku and Shou-Sanli stimulation and these effects were antagonized by naloxone. However, stimulation of Hsia-Kuan, Chu-Chih, Neiting and Taichi, although these points were reported to suppress oro-facial or dental pain in man, scarcely produced suppressive effects. On the other hand, stimulation of some nonmeridian points produced moderate analgesic effects as gauged by the jaw opening reflex. The present study revealed that specificity of the meridian points is not absolute, but relative and that Yin-Hsiang, Ho-Ku and Shou-Sanli points were fairly effective in suppressing pulp-evoked jaw opening reflex in rat, which is presumably a noxious reflex. When the jaw opening reflex was evoked by non-pulpal stimulation, electroacupuncture was less effective on the reflex.
Pain 1980 Oct
PMID:Local electrical stimulation: effective needling points for suppressing jaw opening reflex in rat. 745 85

Ongoing pain, intermittent sharp pain, or intermittent dull aching pain around the teeth can evoke the suspicion of tooth pathology. However, when no dental cause can be found clinically or radiographically, the differential diagnosis involving neuropathic pain and pulpal pathology is still a challenge. Neuropathic facial pains are still too often misdiagnosed as tooth pain of dental origin, resulting in unnecessary dental extraction or endodontic therapy. The purpose of this study was to determine if electronic thermography was able to differentiate neuropathic facial pains presenting as toothache from pulpal pathology. Electronic thermography was used to compare asymptomatic subjects and subjects with neuropathic facial pains. Asymptomatic subjects and subjects with trigeminal neuralgia, pre-trigeminal neuralgia, and pulpal pain without periapical pathology showed no thermographic difference in the territory of the pain complaint when compared to the opposite nonpainful side. Patients with sympathetically maintained traumatic trigeminal neuralgia (atypical odontalgia) and half of the group with sympathetically independent traumatic trigeminal neuralgia presented with "hot" thermograms. The other half of the patients with sympathetically independent traumatic trigeminal neuralgia displayed "cold" thermograms in the area of their pain complaints. Electronic thermography was the least selective test for the group showing "cold" thermogram patterns (80% agreement with the thermographic characterization criteria). These data suggest that electronic thermography may be helpful in differentiating neuropathic pains from pulpal pathology.
J Orofac Pain 1995
PMID:Thermographic assessment of neuropathic facial pain. 748 83

Although interactions between opioids and adrenergic agonists in the treatment of pain have been demonstrated in humans, the contribution of specific adrenergic receptors in this interaction remains to be clarified. In a double-blind, placebo-controlled study in male patients with postoperative dental pain, we investigated the effect of preoperative administration of the alpha 2-adrenergic antagonist, yohimbine, on analgesia produced by postoperative intravenous morphine. Although yohimbine by itself did not affect the pain, the overall analgesic effect of morphine was significantly enhanced in the presence of yohimbine. This report is the first to demonstrate that an alpha 2-adrenergic antagonist enhances opiate analgesia in humans.
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PMID:Enhancement of morphine analgesia by the alpha 2-adrenergic antagonist yohimbine. 763 74

Propiram is an orally administered opioid analgesic with partial morphine-like agonist and weak antagonist properties. Analgesic efficacy of propiram, usually 50 or 100mg, appears comparable to that of standard dosages of other oral opioid drugs [i.e. pentazocine, pethidine (meperidine)] in patients with acute pain of moderate to severe intensity arising from various gynaecological and surgical procedures, and may be superior to codeine in gynaecological and postoperative dental pain. Some evidence of a more rapid onset of action for propiram than for these opioid agents, and a longer duration of action for propiram than for codeine, is encouraging but remains to be substantiated in more extensive clinical use. The tolerability profile of propiram resembles those of others in its class, with drowsiness, nausea and vomiting, and dizziness experienced most frequently in controlled trials. The apparently low propensity of propiram for development of physical dependence and psychotomimetic effects requires confirmation with wider clinical experience. Available data thus indicate that propiram is an effective, orally administered opioid analgesic suitable for providing relief of acute moderate to severe pain arising from various surgical or gynaecological procedures, and that the drug is likely to become a useful alternative in such conditions where opioid analgesia is appropriate.
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PMID:Propiram. A review of its pharmacodynamic and pharmacokinetic properties, and clinical use as an analgesic. 769 33

Hypersensitive dentine responds to normal changes in touch or temperature with abnormal pain sensations. This paper reviews studies that have shown dynamic changes in sensory nerve structure, cytochemistry and location after tooth injury, suggesting that those changes contribute to dentine hypersensitivity. Nerve fibres containing calcitonin gene-related peptide (CGRP) are the main type of sensory fibre to innervate dentine. Evidence that many of those dentinal nerve endings originate from small myelinated fibres is presented here. The location of CGRP nerve terminals correlates with the pulpal gradients of nerve growth factor that have been demonstrated in normal teeth by in situ hybridization histochemistry. When shallow cavities are drilled into the outer dentine of rat molars a five-to-eight-fold increase in pulpal nerve growth factor precedes the extensive structural changes in the sensory nerve reactions eventually subside if healing occurs, but both continue if inflammation continues. Evidence correlating pulpal inflammation with long-term changes in central trigeminal pain pathways is reviewed. There can be extensive neuroplasticity after tooth injury, both within dental pain fibres and in central pain pathways. The timing of those alterations of nerve structure, location, and cytochemistry is consistent with their involvement in mechanisms of dentine hypersensitivity.
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PMID:Dynamic plasticity of dental sensory nerve structure and cytochemistry. 770 61

Although a hypertension-related hypalgesia has been described, the relation between pain perception and the 24-hour blood pressure trend is still unknown. The ambulatory blood pressure monitoring parameters and dental pain sensitivity were correlated in 67 male subjects. The pulpar test (graded increase of test current of 0 to 0.03 mA) was performed on three healthy teeth, and mean dental pain threshold (occurrence of pulp sensation) and pain tolerance (time when the subjects asked for the test to be stopped) were evaluated. Three groups of subjects with normal (n = 34), intermediate (n = 13), and high (n = 20) blood pressure values were identified according to ambulatory monitoring results. Pain threshold differed among the three groups (P < .02), being higher in the group with highest blood pressure. The groups of hypertensive subjects showed higher pain tolerance than the normotensive group (P < .02). Pain threshold was correlated with 24-hour, diurnal, and nocturnal blood pressure values. Pain tolerance was also related to 24-hour blood pressure and to diurnal and nocturnal diastolic and mean arterial pressure values. Systolic and diastolic blood pressure loads were significantly associated with pain threshold, and diastolic load was also associated with tolerance. The blood pressure variability (SD) did not relate to pain perception. The 24-hour arterial pressure was more closely associated with pain perception than the blood pressure values obtained before the pulpar test. A close correlation between pain perception and 24-hour ambulatory blood pressure was demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Twenty-four-hour noninvasive blood pressure monitoring and pain perception. 776 77

The objectives of this analysis were to describe the dental service use pattern of the 35-44- and 65-74-yr-old age groups and to determine to what extent this pattern could be explained by selected sociodemographic and attitudinal variables. The study populations comprised 398 35-44-yr-old and 559 65-74-yr-old Hong Kong Chinese. Use of dental services was determined on the basis of the respondents' own perception of the regularity of their dental visits and by the time since the last dental visit. The younger groups was categorized into regular users, irregular users, and nonusers, and the older group was categorized into three groups according to last dental visit (within 2 yr, 2-5-yr, 5 yr or more). A modification of the Andersen and Newman model for individual determinants of health care use was used as the framework for a logistic regression analysis. Predisposing variables were sex, education, occupation, attitudes, knowledge, preventive orientation, and dental anxiety; enabling variables were Family Possession Index, income, family support and access to a dental programme; need variables were perceived conditions of teeth, dental problems, dental pain, need for treatment, normative need for treatment, and denture wearing. In general, use of dental services was low. For the 35-44-yr-olds, the best regression model (sensitivity: 62%, specificity: 95%, overall correct classification: 88%) indicated that there was an increased probability of having a regular dental care pattern if respondents were prevention oriented, had access to a dental benefit programme, had not experienced pain, had a higher income, perceived their teeth as fair or poor, and perceived a need of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Use of dental services by the middle-aged and the elderly in Hong Kong. 783 34

Pain following removal of impacted third molar teeth has proven to be a useful clinical model for evaluating oral analgesics. Moreover, as the underlying pathophysiology becomes elucidated the model serves as a tool for monitoring the relative contributions of different pain events, including peripheral and central sensitization. Non-steroidal anti-inflammatory drugs (NSAIDs) demonstrate high potency in this model, reflecting the large contribution that peripheral prostaglandins may make to the pathophysiology of postoperative pain. However, other analgesic agents, with weak activity against peripheral prostaglandin synthesis (e.g. paracetamol, opioid analgesics), may also provide pain relief in the dental pain model. The activity of these agents is dependent on the time and method of administration, and may be related to more centrally located analgesic activity, or to peripheral actions other than inhibition of prostaglandin synthesis. In single dose studies it is possible to enhance pain relief by combining analgesic agents of different activities, e.g. ibuprofen 400 mg and codeine 20 mg. Such enhanced activity is also demonstrated by higher doses of certain NSAIDs, e.g. ketoprofen 100 mg. This may reflect the existence of complimentary analgesic activities within a single therapeutic agent. As a clinical research tool the dental pain model has several attributes which suggest that it will continue to be of value in identifying potentially improved analgesic strategies for postoperative pain.
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PMID:Analgesic agents and strategies in the dental pain model. 784 60

Munchausen's syndrome is a rare psychiatric disorder in which patients repeatedly confabulate so as to cause unnecessary investigations and operative treatments to be carried out on them. Two cases are reported and the literature reviewed. The first patient complained of repeated dental pain and subsequently underwent repeated endodontic treatment; the second had salivary gland pain and glossopharyngeal neuralgia. Munchausen's syndrome can only be diagnosed by the exclusion of organic and other disease.
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PMID:Munchausen's syndrome: oral presentations. 784 59


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