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At least 307 records · Page 17Linked to original sources
PubMed2007

Craniofacial pain as the sole symptom of cardiac ischemia: a prospective multicenter study.

BACKGROUND: Craniofacial pain can be the only symptom of cardiac ischemia. Failure to recognize its cardiac source can put the patient's life at risk. The authors conducted a study to reveal the prevalence of, the distribution of and sex differences regarding craniofacial pain of cardiac origin. METHODS: The authors prospectively selected consecutive patients (N = 186) who had had a verified cardiac ischemic episode. They studied the location and distribution of craniofacial and intraoral pain in detail. RESULTS: Craniofacial pain was the only complaint during the ischemic episode in 11 patients (6 percent), three of them who had acute myocardial infarction (AMI). Another 60 patients (32 percent) reported craniofacial pain concomitant with pain in other regions. The most common craniofacial pain locations were the throat, left mandible, right mandible, left temporomandibular joint/ear region and teeth. Craniofacial pain was pre-ponderantly manifested in female subjects (P = .031) and was the dominating symptom in both sexes in the absence of chest pain. CONCLUSIONS: Craniofacial pain commonly is induced by cardiac ischemia. This must be considered in differential diagnosis of toothache and orofacial pain. CLINICAL IMPLICATIONS: Because patients who have AMI without chest pain run a higher risk of experiencing a missed diagnosis and death, the dentist's awareness of this symptomatology can be crucial for early diagnosis and timely treatment.

Adult↗
PubMed2005

The psychosocial effects of severe caries in 4-year-old children in Recife, Pernambuco, Brazil.

The aim of this study was to analyze the psychosocial effects of severe caries in 4-year-old children in Recife, Pernambuco, Brazil. The clinical examination was conducted by a single examiner in order to select children with severe caries and caries-free (kappa = 1). Of the 861 children examined, 77 (8.1%) had severe caries and 225 (23.6%) were caries-free. Data were collected by applying validated questionnaires answered by the parents or guardians. Most of the parents or guardians of children with severe caries reported that their children complained of toothache (72.7%), and a significant portion stated that their children had problems eating certain kinds of food (49.4%) and missed school (26.0%) because of their teeth. Most of the parents or guardians of children with severe caries (68.8%) stated that oral health affects their children's life, while the same was stated by 9.8% of the parents or guardians of the caries-free children. Severe caries was found to have a negative impact on children's oral health-related quality of life.

Brazil↗
PubMed2006

[Prevalence and factors associated with dental pain that prevents the performance of routine tasks by civil servants in Rio de Janeiro, Brazil].

The aims of this study were to estimate the prevalence of dental pain preventing the performance of routine tasks and to assess its association with socioeconomic factors, minor psychiatric disorders, number of missing teeth, and dental consultation patterns. A cross-sectional study was conducted using a self-completed questionnaire answered by 4,030 administrative employees at a university in Rio de Janeiro, Brazil (the Pró-Saúde Study). Data were analyzed using multiple logistic regression. Prevalence of toothache preventing the performance of routine tasks in the two weeks prior to the interview was 2.9% (95%CI: 2.5-3.6). Men (OR = 1.6; 95%CI: 1.1-2.4), individuals with minor psychiatric disorders (OR = 1.7; 95%CI: 1.2-2.6), individuals with extensive tooth loss (OR = 3.4; 95%CI: 1.5-7.8), and those failing to appear for regular dental checkups (OR = 2.5; 95%CI: 1.8-17.3) showed increased odds of experiencing dental pain. Dental pain was an important problem in this population. Unfavorable living conditions and lack of regular dental checkups increased the odds of dental pain.

Activities of Daily Living↗
PubMed1986

An unusual cause of bilateral mental neuropathy in an AIDS patient. Report of a case.

A case is reported of a patient with sudden onset, generalized toothache accompanied with a numb chin and lower lip. A thorough oral examination was negative. A complete medical evaluation revealed a positive HTLV-III antibody titer and acute lymphoblastic leukemia (Burkitt's-type). An unexplained trigeminal neuropathy should prompt the dentist to refer the patient for complete medical evaluation. A high index of suspicion of a malignant process should be maintained in all cases of unexplained numb lower lip and/or chin.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Oral disease, impairment, and illness: congruence between clinical and questionnaire findings.

In 1992 a questionnaire was sent to 50-year-olds in two Swedish counties. These self-report data were compared with clinical observations with regard to number of teeth, removable dentures, caries, and periodontitis. Complete information from both data sources was obtained for 1041 persons. The relevant questionnaire item explained 71% of the missing tooth variance. An agreement of 0.91 (Cohen's kappa) was obtained for removable dentures. A question about problems in opening the mouth differentiated clearly with regard to measured mouth opening ability. Toothache and tooth sensitivity were reported with 95% probability when having 22 decayed teeth and with 46% when there were no decayed teeth (58% correctly predicted). Two teeth with pockets > or = 6 mm gave 5% probability and 22 such teeth gave 39% probability of reporting migration of front teeth. The main conclusion from this study is that there is good correspondence between subjective self-reports and clinical findings, especially for those conditions that are relatively easy for the patient to observe, such as the number of teeth and the presence of dentures. Thus questionnaire data can be used for information and screening about some well-defined oral conditions.

Dental Caries↗
PubMed1997

Dental health and dental treatment needs among recruits of the Finnish Defence Forces, 1919-91.

The first two surveys of the dental health of young Finnish men were conducted in 1919 and 1965. The objective of four subsequent surveys (1976, 1981, 1986, and 1991) was to collect both interview and clinical examination data for the monitoring of changes in the oral health status of the recruits. A significant reduction in self-reported toothache, gingival bleeding, and number of decayed teeth was observed from 1976 to 1991. At examination, the numbers of decayed teeth, teeth indicated for extraction, teeth in need of fillings, and missing teeth decreased substantially, as did the teeth with visible plaque, subgingival calculus, and teeth with 4-mm or deeper periodontal pockets. This comprehensive series of successive cross-sectional oral health surveys clearly shows that since 1976 a significant decrease in oral disease and treatment needs has taken place among the Finnish population of young men.

Adult↗
PubMed2003

Anatomical relevance of some acupuncture points in the head and neck region that dictate medical or dental application depending on depth of needle insertion.

Many of the acupuncture points on the face, according to classic acupuncture textbooks, could be used to treat facial pain, paralysis, and toothache. But it is not specified which acupuncture point would be effective for which tooth. Many of these points, when used for the treatment of dental pain, often fail. From an anatomical point of view, we describe which acupuncture point to use for each specific area for effective treatment of dental pain. Also, we emphasize the importance of the depth of needle insertion, especially the necessity to touch the facial bone, for effective pain treatment. When performed properly, acupuncture can be very effective for relief of dental pain.

Acupuncture Analgesia↗
PubMed1998

Driving out the 'toothworm' in today's China.

For thousands of years people have tried to explain toothache as the result of a worm residing in a carious tooth. Fumigation of the carious tooth, with the smoke from burning henbane or leek seeds, was used to drive the "toothworm" out of the tooth. A quack in modern China adopted the same ruse and supposedly drove the worms out of student's tooth. This duplicitous procedure was captured on film by a dentist who witnessed it.

Dental Caries↗
PubMedDate not supplied

Knowledge of dental health and diseases among dental patients, a multicentre study in Saudi Arabia.

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.

Adolescent↗
PubMed2001

[Poverty and ignorance: the cause of late consultation in odontostomatology at the University Hospital Center in Yaounde].

Coming to consult a dentist implies a toothache. Bucco-dental diseases have an insidious evolution, starting from low sound that rapidly leads to complications that are primarily manifested as pain and gingivorhage in patients. Yet there are ways of detecting these in the early stages before the stage of pain. Treating enamel decay can also be considered late if we cannot pay the price. But leaving the teeth of children decay can affect their general health throughout life. What keeps patients far from bucco-dental consultation services? Among the raisons given by 14 patients chosen at random in the Stomatology unit at CHU-Yaounde, only poverty and lack of information have drawn our attention. And to conquer this education to prevention is the solution indicated.

Adult↗
PubMed2001

[Dental pain].

"The extreme variability of toothache is such that a good rule for any examiner is to consider all pains about the mouth and face to be of dental origin until provide otherwise" (Welden E. Bell). Dental caries is a disease of the calcified tissues of the teeth, characterised by demineralization of the inorganic portion and destruction of the organic substance of the tooth. The acids which affects the primary decalcifications is derived from the fermentation of starches and sugar logged in the retaining centers of the teeth. Dental caries can be classified in relation with the depth of the lesions: caries of the enamel, caries of the dentin, pulp diseases which are the result of dental caries in which bacterial invasion of the dentin and pulp tissue occurs, diseases of the periapical tissues which leads to periapical cyst, or to periapical abcess.

Acute Disease↗
PubMed2001

Long-lasting orofacial pain--a study of 109 consecutive patients referred to a pain group.

The aim was to register and evaluate the orofacial pain condition, with special focus on the equalities/inequalities between the sexes, in consecutive patients referred to the pain group at the Centre for Oral Health Sciences in Malmö, Sweden. The 109 patients, 85 (78%) women and 24 (22%) men, were referred to the pain group during the years 1988 to 1993 and were clinically examined using a standardised procedure. Pain duration of one year or more was experienced by 83% of the patients. The pain onset was related to dental care or toothache by 56% of the patients. Temporomandibular disorders were the most common diagnoses (52%) and were more common among women than among men (p < 0.05). Multiple pain locations were frequently reported, range 1-47 locations, and the women had significantly (p < 0.05) more pain locations than the men. Equalities between the sexes were more frequent than inequalities among patients referred for long-lasting orofacial pain. It can be discussed whether the sex difference in the prevalence of pain of musculoskeletal origin emerges from biological differences or can be explained by different psychosocial circumstances.

Adult↗
PubMed2003

Strategies for managing the endodontic pain patient.

The most common form of orofacial pain is odontalgia, or toothache. This painful condition afflicts about 12-14 percent of the population, or about 2.5 million Texans (1-4). This is an important clinical challenge since our patients have high expectations for receiving the latest advances in health care, and successful pain control in endodontics is no exception. Fortunately, research has provided new approaches for delivering more effective pain control treatments in an efficient and reproducible manner. This article provides an overview of several treatment strategies for managing acute odontogenic pain; due to space limitations, interested readers are encouraged to use the references for more extensive discussions on these topics.

Analgesics↗
PubMed2003

Incidence of adverse reactions from 23,000 exposures to simulated terrestrial altitudes up to 8900 m.

INTRODUCTION: Adverse reactions during hypobaric chamber operations result from changes in barometric pressure per se and to the related reductions in the partial pressure of inspired oxygen. Previous studies have indicated that an adverse reaction may occur in approximately 6% of exposures in chambers used for flight training. The purpose of this study was to determine the rate of adverse reactions in a chamber used exclusively for terrestrial altitude research studies. METHODS: Data for incidence of ear block, sinus block, toothache, and other adverse reactions were analyzed using a master history file that contained information such as annual and total number of studies and human exposures, and onset and outcome of adverse reactions. Incidence for a given time period was calculated as (# of reactions x 100)/(# of exposures). RESULTS: In 33 yr, there have been 23,656 human exposures and 296 adverse reactions. The overall incidence was 1.25 reactions per 100 exposures (0.72 for research volunteers and 0.53 for staff). The majority (75% of all reactions) were ear blocks (0.93 reactions per 100 exposures). Staff members were more likely than research volunteers to have more than one reaction. DISCUSSION: The incidence of 1.25 reactions per 100 exposures for our chamber is considerably lower than that reported in the literature. This is due primarily to our use of lower altitudes and slower rates of ascent and descent compared with other facilities whose emphasis is on aircraft flight training.

Altitude↗
PubMed1992

A classification of residential neighbourhoods (ACORN) in relation to dental health and dental health behaviours.

Five-year-old children in two district health authorities in the North Western Region of England were examined during 1989-90. Questionnaires were issued to parents to determine whether dental health and related behaviours were associated with socio-economic status. Parents of 1858 children in Salford (response rate = 78 per cent) and 1691 in Trafford (response rate = 81 per cent) returned the questionnaires. Their replies were analysed by dividing the children into a hierarchy according to a classification of residential neighbourhood (ACORN). Significantly fewer in the highest of three Divisions in both districts had suffered from toothache and had undergone a general anaesthetic to have teeth extracted. They were also more likely to have had their teeth brushed with toothpaste by their first birthday and to have visited the dentist by their second. Because ACORN had detected these differences in dental health related behaviour it was possible to identify localities towards which dental health promotion activities can be directed.

Carbonated Beverages↗
PubMed1992

A comparison between the dental health of 3-year-old children living in fluoridated Huddersfield and non-fluoridated Dewsbury in 1989.

A study was undertaken to compare the prevalence of dental caries and developmental defects of enamel between 3-year-old children who were lifelong residents of fluoridated areas of Huddersfield (1 ppm F) and non-fluoridated Dewsbury (less than 0.3 ppm F). An interview was also conducted with the parents of the children to provide information regarding previous dental experiences. The study populations were identified using the national child health system. The mean dmft was 0.30 in Huddersfield and 0.74 in Dewsbury. The percentage of children who had experienced dental caries and the percentage with carious teeth were significantly lower in the fluoridated area. The Dewsbury children had suffered more toothache. There was a significantly higher number of children in Huddersfield with diffuse enamel defects on their upper and lower first molars. This study has also demonstrated that the national child health system provides a method for obtaining a random sample of pre-school children from the general population, thus avoiding the problems associated with studies using selected populations. Fluoridation in Huddersfield ceased in October 1989 and it is hoped that this decision will be reversed as soon as possible.

Child, Preschool↗
PubMed1992

Role of intradental A- and C-type nerve fibres in dental pain mechanisms.

The arousal of the two components of pain (the first rapid or sharp pain and the second dull pain) are considered to be related to activation of A delta- and C-type nociceptive primary afferents, respectively. The same dichotomy of pain sensations may also exist in teeth, although due to the short distance between the site of stimulation and the brain the two sensations might not be as clearly separated as in stimulation of, for example, the extremities. The sensations evoked by stimulation of human teeth vary according to the type of the stimuli applied. Low-intensity electrical stimulation is able to induce non-painful (prepain) sensations. At high current intensities pain is evoked. Drilling, probing and air-drying of exposed dentin induce only pain. Most studies also indicate that thermal stimulation only induces painful sensations. The quality of dental pain can vary. Typically, dentinal stimulation of teeth with healthy pulps induces sharp pain. On the other hand intense heat stimulation can result in dull pain which radiates to a wider area of the face and jaws. This component of the stimulus-induced pain seems to share some characteristics of toothache associated with painful pulpitis. Single fibre recordings of intradental nerve activity in experimental animals have shown that in addition to A-fibres a considerable number of C-type primary afferents innervate the dental pulp. This is in accordance with the results of neuroanatomical studies, which indicate that 70-80% of pulpal axons in human, monkey, dog, and cat teeth are unmyelinated. Intradental A- and C-fibre groups seem to be functionally different and can be activated separately by certain external stimuli. Comparison of the response characteristics of the pulp nerve fibres and the sensations induced from human teeth indicate that: 1) A-fibres are responsible for the sensitivity of dentine and thus for the mediation of the sharp pain induced by dentinal stimulation, 2) Prepain sensations induced by electrical stimulation result from activation of the lowest threshold A-fibres some of which can be classified as A beta-fibres according to their conduction velocities. Comparison of the responses of the A beta- and A delta-fibres indicate that they belong to the same functional group, 3) Intradental C-fibres are activated only if the external stimuli reach the pulp proper. Their activation may contribute to the dull pain induced by intense thermal stimulation of the tooth and to that associated with pulpal inflammation.

Animals↗
PubMed2003

Prevalence estimates and associated factors for dental pain: a review.

PURPOSE: To assess the methodological quality of epidemiological studies on dental pain and review the published literature for its prevalence, and association with age, gender and socio-economic status. MATERIALS AND METHODS: Medline and reference lists of relevant articles were searched for observational studies published in English from 1966 to 2001 carried out on humans aged 19 years and over. Articles for reading of the full text were selected by two reviewers independently. Selected articles were assessed independently by the two reviewers according to a set of 8 standardized criteria. Inter-rater agreement was measured using the kappa statistic. Disagreements were discussed and a final score for each study agreed. Data on prevalence estimates and their distribution by age, gender and socio-economic factors were extracted. RESULTS: 422 studies were identified, and 23 selected for review. Inter-rater agreement was high for all 8 criteria used (kappa > 0.6). Methodological quality was poor with the number of criteria fulfilled by each study ranging from 1 to 6, median score 3. The prevalence estimates for 5 case definitions identified were: 'toothache' 7-32%, 'pain in teeth with hot, cold or sweet things' 25-38%, 'pain and discomfort needing medication or treatment' 7-9%, 'pain or discomfort in the mouth, teeth or gums' 19-66%, and 'oral and facial pain'40-44%. Younger subjects and those from lower socio-economic groups were more likely to report pain. Gender was not associated with dental pain. CONCLUSION: Epidemiological data on dental pain are sparse and of poor quality. There is a need for well-designed surveys using randomly selected community samples and standardized measurement criteria to fill this knowledge gap.

Adult↗