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PubMed1990

Pre-trigeminal neuralgia.

Eighteen patients who subsequently developed typical trigeminal neuralgia experienced a prodromal pain termed "pre-trigeminal neuralgia." These patients described their prodromal pain as a toothache or sinusitis-like pain lasting up to several hours, sometimes triggered by jaw movements or by drinking hot or cold liquids. Typical trigeminal neuralgia developed a few days to 12 years later, and in all cases affected the same division of the trigeminal nerve. Six additional patients experiencing what appeared to be pre-trigeminal neuralgia became pain-free when taking carbamazepine or baclofen. Recognition of pretrigeminal neuralgia makes it possible to relieve the pain with appropriate medications and avoid unnecessary irreversible dental procedures.

Adult↗
PubMed1999

Does temporomandibular disorder pain dysfunction syndrome affect dietary intake?

Temporomandibular disorder pain dysfunction syndrome (TDPDS) is the most common cause of facial pain after toothache. The symptoms are varied but are likely to affect the choice, intake and enjoyment of food. This has not been previously investigated. In this paper a preliminary study of 35 patients attending a department of oral and maxillofacial surgery at a general hospital is presented. Thirty-one subjects reported that eating was a problem; 15 prepared food differently and 24 considered that their choice of food was limited. Four of the five foods most often reported to be difficult to eat are valuable in the diet: meat (22), apples (20), bread (13), toast (7) and toffees (6). Twenty-three subjects reported eating a softer diet. Most (25) reported pain when eating. Such circumstances make it harder for TDPDS sufferers to meet current nutritional guidelines, especially, perhaps, for some to achieve an adequate intake of iron.

Adolescent↗
PubMed2002

Septic pulmonary embolism associated with periodontal disease: reports of two cases and review of the literature.

We report two cases of septic pulmonary embolism associated with periodontitis. Chest CT revealed multiple nodular shadows with features characteristic of septic pulmonary embolism in both patients. Both patients had toothache, fever, and chest pain, and showed findings of periodontitis at initial presentation. Antimicrobial agents combined with dental surgery were successful in treatment. While septic pulmonary embolism from the lesions of periodontitis appears to be rare, periodontitis remains important in the differential diagnosis of septic pulmonary embolism.

Aged↗
PubMed1981

Painful, ulcerated lesions of the palate and facial skin.

Herpes zoster is an acute viral infection that principally affects the skin. It occasionally may involve the oral region with patients sometimes initially complaining of toothache. Generalized skin involvement by the disease should alert the clinician to the possibility of an underlying malignancy. Dentists should also be aware that the disease is infectious and can be transmitted, especially to susceptible individuals.

Facial Dermatoses↗
PubMed1992

Trigeminal neuralgia: how to rule out the wrong treatment.

Toothache is difficult to diagnose and treat appropriately when traditional dental diagnostic test results are negative. This study looked at 61 patients who were treated for pretrigeminal or trigeminal neuralgia. Of these, 61 percent were incorrectly diagnosed and treated.

Dental Pulp Diseases↗
PubMed2001

Hypoglycemic syncope induced by a combination of cibenzoline and angiotensin converting enzyme inhibitor.

A 65-year-old Japanese woman with dilated cardiomyopathy, hypothyroidism and refractory sustained ventricular tachycardia experienced a near-death hypoglycemic syncope. The attack seemed to be induced by a high level of serum insulin, probably due to cibenzoline and by concomitant use of an angiotensin converting enzyme inhibitor (ACEI). Additionally, decreased food intake because of a severe toothache may have contributed to the deterioration of her condition. This case warns cardiologists that a combined cibenzoline and ACEI therapy can provoke serious adverse effects such as hypoglycemic syncope in the elderly. Therefore, the possibility of a hypoglycemic attack associated with these drugs should be explained to patients who are in poor condition.

Aged↗
PubMed1998

Adjunctive use of a subgingival controlled-release chlorhexidine chip reduces probing depth and improves attachment level compared with scaling and root planing alone.

The present studies evaluated the efficacy of a controlled-release biodegradable chlorhexidine (CHX) (2.5 mg) chip when used as an adjunct to scaling and root planing on reducing probing depth (PD) and improving clinical attachment level (CAL) in adult periodontitis. Two double-blind, randomized, placebo-controlled multi-center clinical trials (5 centers each) were conducted; pooled data are reported from all 10 centers (447 patients). At baseline, following 1 hour of scaling and root planing (SRP) in patients free of supragingival calculus, the chip was placed in target sites with PD 5 to 8 mm which bled on probing. Chip placement was repeated at 3 and/or 6 months if PD remained > or = 5 mm. Study sites in active chip subjects received either CHX chip plus SRP or SRP alone (to maintain study blind). Sites in placebo chip subjects received either placebo chip plus SRP or SRP alone. Examinations were performed at baseline; 7 days; 6 weeks; and 3, 6, and 9 months. At 9 months significant reductions from baseline favoring the chlorhexidine chip compared with both control treatments were observed with respect to PD (chlorhexidine chip plus SRP, 0.95 +/- 0.05 mm; SRP alone, 0.65 +/- 0.05 mm, P < 0.001; placebo chip plus SRP, 0.69 +/- 0.05 mm, P < 0.001) and CAL (chlorhexidine chip plus SRP, 0.75 +/- 0.06 mm; SRP alone, 0.58 +/- 0.06 mm, P < 0.05; placebo chip plus SRP, 0.55 +/- 0.06 mm, P < 0.05). The proportion of patients who evidenced a PD reduction from baseline of 2 mm or more at 9 months was significantly greater in the chlorhexidine chip group (19%) compared with SRP controls (8%) (P < 0.05). Adverse effects were minor and transient toothache, including pain, tenderness, aching, throbbing, soreness, discomfort, or sensitivity was the only adverse effect that was higher in the chlorhexidine group as compared to placebo (P = 0.042). These data demonstrate that the adjunctive use of the chlorhexidine chip results in a significant reduction of PD when compared with both SRP alone or the adjunctive use of a placebo chip. These multi-center randomized control trials suggest that the chlorhexidine chip is a safe and effective adjunctive chemotherapy for the treatment of adult periodontitis.

Adult↗
PubMed1991

Couvade syndrome: male counterpart to pregnancy.

Couvade is the common but poorly understood phenomenon whereby the expectant father experiences somatic symptoms during the pregnancy for which there is no recognized physiological basis. Symptoms commonly include indigestion, increased or decreased appetite, weight gain, diarrhea or constipation, headache, and toothache. Onset is usually during the third gestational month with a secondary rise in the late third trimester. Symptoms generally resolve with childbirth. Couvade has been seen as an expression of somatized anxiety, pseudo-sibling rivalry, identification with the fetus, ambivalence about fatherhood, a statement of paternity, or parturition envy. It is likely that the dynamics of couvade may vary between individuals and may be multidetermined.

Ceremonial Behavior↗
PubMed2001

Oral health attitudes/behavior and gingival self-care level of Korean dental hygiene students.

The purpose of this study was to examine oral health attitudes/behavior and gingival self-care levels of Korean dental hygiene students (n = 271). A questionnaire known as HU-DBI (Korean version) was administered to each class. Higher scores of the HU-DBI indicate better oral health attitudes/behavior. The student's gingival self-care level was scored as excellent (+2), good (+1), questionable (0), poor (-1), or very poor (-2) according to the criteria of the Oral Rating Index (ORI) for youth. The mean score of the HU-DBI was 6.40, and that of the ORI was +0.12. Most samples scored 0 or +1. The mean HU-DBI scores of year-2 and year-3 students (7.06, and 7.61 respectively) were significantly greater than that of year-1 students (5.23) (P<0.001). Twenty-three percent of the students reported a belief that they may eventually require false teeth. Half stated that they put off going to the dentist until they had toothache. Year-1 students were more likely to have this attitude compared to year-3 students. HU-DBI scores were significantly associated with ORI scores (r = 0.315; P<0.001). The differences in the HU-DBI and ORI scores across the level of education were highly significant.

Attitude to Health↗
PubMed2002

Oral self-care behavior among dental school students in Greece.

The purpose of this study was to determine the oral health attitudes/behavior of Greek dental students. The subjects (n = 539) were officially registered students at the University of Athens Dental School. Their oral health behavior was assessed with the use of a 12-graded-item questionnaire. A significant increase per year of study was observed in the number of students reporting careful brushing of the teeth [OR: 1.1 (1.0-1.3)] and being able to clean their teeth well without the use of toothpaste [OR: 2.5 (2.0-3.1)]. Each year of education significantly increased the probability of disagreement with statements such as: "I think my teeth are getting worse despite my daily brushing" [OR: 1.5 (1.2-1.9)], "It is impossible to prevent gum disease with tooth-brushing alone" [OR: 1.3 (1.1-1.5)], and "I put off going to the dentist until I have a toothache" [OR: 1.3 (1.2-1.6)]. Examination of the summary questionnaire score revealed that females presented significantly higher total scores. All scores increased significantly in the fourth and fifth years of dental studies. During the years of university study, the score variation and favorable attitudes/ behavior toward oral health appear to reflect the variation in the students' educational training experience.

Analysis of Variance↗
PubMed2005

Need and demand for sedation or general anesthesia in dentistry: a national survey of the Canadian population.

The aim of this study was to assess the need and demand for sedation or general anesthesia (GA) for dentistry in the Canadian adult population. A national telephone survey of 1101 Canadians found that 9.8% were somewhat afraid of dental treatment, with another 5.5% having a high level of fear. Fear or anxiety was the reason why 7.6% had ever missed, cancelled, or avoided a dental appointment. Of those with high fear, 49.2% had avoided a dental appointment at some point because of fear or anxiety as opposed to only 5.2% from the no or low fear group. Regarding demand, 12.4% were definitely interested in sedation or GA for their dentistry and 42.3% were interested depending on cost. Of those with high fear, 31.1% were definitely interested, with 54.1% interested depending on cost. In a hypothetical situation where endodontics was required because of a severe toothache, 12.7% reported high fear. This decreased to 5.4% if sedation or GA were available. For this procedure, 20.4% were definitely interested in sedation or GA, and another 46.1% were interested depending on cost. The prevalence of, and preference for, sedation or GA was assessed for specific dental procedures. The proportion of the population with a preference for sedation or GA was 7.2% for cleaning, 18% for fillings or crowns, 54.7% for endodontics, 68.2% for periodontal surgery, and 46.5% for extraction. For each procedure, the proportion expressing a preference for sedation or GA was significantly greater than the proportion having received treatment with sedation or GA (P < 0.001). In conclusion, this study demonstrates that there is significant need and demand for sedation and GA in the Canadian adult population.

Adolescent↗
PubMed1994

Implicit and explicit memory for compound words.

Subjects studied visually presented compound words (e.g., TOOTHPASTE, HEARTACHE) and then received a recognition, perceptual identification, or word-fragment completion test that contained old, recombined (e.g., TOOTHACHE), and partially and completely new words. False recognitions increased with the increasing number of previously studied components; however, priming in perceptual identification occurred only for old words. Priming in word-fragment completion occurred for old and recombined words. Reducing the time available to solve word fragments, from 20 sec to 5 sec, did not affect the pattern of results; it is therefore unlikely that priming for recombined words resulted from the use of a recollection-based strategy. Memory tasks that involve a conceptual component access memories that are constructed from parts; memory tasks that are primarily perceptual do not access such memories.

Humans↗
PubMed1992

[On the postoperative mucocele of the maxillary sinus and its simulating cases. A clinical treatise].

The postoperative mucocele of the maxillary sinus typically occurs after 11-15 years after the initial Caldwell-Luc operation with the complaints of swollen and painful cheek. Typical signs and symptoms will be divided into two groups, the one which is associated with expansive lesions and the other with pains along the various branches of the maxillary nerve. In the clinical set-ups, cases with the similar signs and symptoms, and yet lacking definite mucoceles, are often encountered. The present treatise will compare 86 definite cases and 27 simulating cases as to the history, signs and symptoms, various modalities of imaging (CT & MRI), and the possible causes leading to simulating cases. The age at onset, gender, affected side, and period after the initial sinus surgery all showed no differences between the two, i.e., definite and simulating cases. Among signs and symptoms, the definite case showed more of swelling-related matters whereas the simulating case more of pain-related except toothache. The past history of surgeries for the mucoceles on the similar sides to the present lesion is more often seen in the simulating case (64.3%) than in the definite case (18.3%). The findings by imagings in the simulating cases are as follows; obliterated sinus (25.0%), healthy, aerated postop. cavity (35.7%), postop. cavity with mucosal thickening (32.1%), and cyst-like aerated cavity (7.1%). The possible causes leading to the simulating cases are as follows; causes unknown (39.3%), recurrent infection in the postop. cavity (28.6%), dental origin (10.7%), atypical neuralgia (10.7%) and the case shortly after the proceeding sinus surgery (within 12 months, 10.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Oral habits among 7-10 year-old school children in Ibadan, Nigeria.

OBJECTIVE: To assess the prevalence of oral habits among 7-10 year-old children in Ibadan, Nigeria. DESIGN: An epidemiological survey of randomly selected school children. Criteria for social class was based on registrar general's social class. SETTING: Primary schools from different parts of Ibadan city, Nigeria. SUBJECTS: 493 school children aged 7-10 years consisting of 237(48.1%) boys and 256(51.9%) girls. MAIN OUTCOME MEASURES: Only children still actively involved in oral habits were coded positive. RESULTS: In all, 49(9.9%) of the children were involved in one type of oral habit or the other with digit sucking being most prevalent 40(8.1%). Lip sucking was observed in 6(1.2%) while 1(0.2%) had an unusual sucking habit--sucking of left forearm with resultant severe anterior open bite (10 mm). The relationship between the oral habits anterior open-bite and increased overjets were very significant statistically (p<0.01). No significant associations were noted between the habits and social class as well as Angle's classification of molar relations. None of the children examined had gone for routine dental check-ups before except for the 62(12.6%) who had previous dental consultations due to toothaches. CONCLUSION: Oral habits especially digit sucking needing management was revealed by this study and none of them had been to a dentist for help. This suggests that there is need to intensify oral health education in our environment, targeted at both parents and school children to enable them benefit from interceptive orthodontic care which has numerous advantages.

Age Distribution↗
PubMed2005

Malignant tumours presenting after dental extraction: a case series.

OBJECTIVE: To present the clinical spectrum of malignant neoplasms detected after extraction of teeth. DESIGN: Retrospective study. SETTING: Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Nigeria. MAIN OUTCOME MEASURES: Demographic and clinical data of patients diagnosed with malignant neoplasms related to a history of tooth extraction. RESULTS: Twelve patients with histopathologically confirmed tumours detected after extraction of teeth were studied. There were 11 males and one female giving a male to female ratio of 11:1. They ranged in age from 15-85 years with a mean age of 53 years. Pain and swelling were the most common presenting complaints. The mandible was more often involved seven (58.3%) cases while five (41.7%) cases occurred in the maxilla. Squamous cell carcinoma (in 9 cases) was the most common malignant neoplasm among these patients. CONCLUSION: Malignant tumours can mimic periapical infections necessitating a high index of suspicion when faced with toothache of uncertain cause.

Adolescent↗
PubMed1992

Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination.

OBJECTIVE: To identify the most useful clinical examination findings for the diagnosis of acute and subacute sinusitis. DESIGN: Prospective comparison of clinical findings with radiographs. SETTING: General medicine clinics at a university-affiliated Veterans Affairs Medical Center. PATIENTS: Two hundred forty-seven consecutive adult men with rhinorrhea (51%), facial pain (22%) , or self-suspected sinusitis (27%) (median age, 50 years; median duration of symptoms, 11.5 days). MEASUREMENTS: Patients were examined by a principal investigator (86%) or by a staff general internist, internal medicine resident (postgraduate year 2 or 3), or physician assistant, all blinded to radiographic results. All examiners recorded the presence or absence of 16 historical items, 5 physical examination items, and the clinical impression for sinusitis (high, intermediate, or low probability). The criterion standard was paranasal sinus radiographs (4 views), which were interpreted by radiologists blinded to clinical findings. RESULTS: Thirty-eight percent of patients meeting entrance criteria had sinusitis. Sensitivity, specificity, and likelihood ratios were measured for clinical items. Logistic regression analysis showed five independent predictors of sinusitis: maxillary toothache (odds ratio, 2.9), transillumination (odds ratio, 2.7), poor response to nasal decongestants or antihistamines (odds ratio, 2.4), colored nasal discharge reported by the patient (odds ratio, 2.2), or mucopurulence seen during examination (odds ratio, 2.9). THe overall clinical impression was more accurate than any single finding: high probability (likelihood ratio, 4.7, intermediate (likelihood ratio, 1.4), low probability (likelihood ratio, 0.4). CONCLUSIONS: General internists, focusing on five clinical findings and their overall clinical impression, can effectively stratify male patients with sinus symptoms as having a high, intermediate, or low probability of sinusitis.

Adult↗
PubMed1994

The use of aspirin in children under 12 years old attending a paediatric dentistry department in a dental hospital.

For several years it has been recommended that aspirin should be avoided in children under the age of 12 years because of the risk of Reye's Syndrome. In this study we investigated the reported use of analgesics among children who attended the Children's Department of the Dental Hospital in Newcastle upon Tyne. In addition the study also investigated the complaints that led to use of analgesics, the dose and frequency of administration of the analgesic, and past and current contact with medical services. Of 179 children investigated, 129 were under 12 years-old; of these 129 children under 12 years-of-age, 72 (56%) had taken an analgesic within the previous six months, 12 (17%) of whom took aspirin. Three of these children who had taken aspirin were reported to have had a serious illness in their lives, and would therefore have had significant contact with medical services. One-quarter of all children who had taken an analgesic did so for toothache. Inappropriate use of aspirin in children under 12 years-of-age indicates that health education about the possible risks of Reye's Syndrome needs to be improved.

Aspirin↗
PubMedDate not supplied

Management of mandibular fascial space infection of odontogenic origin.

Cellulitis is an acute, painful infection whose swelling is larger with diffuse borders. When palpated, early cellulitis can be very soft or doughfy; a severe cellulitis is almost always described as indurated or even as being "board-like". It can be innocuous in its early stages and extremely dangerous in its more advance, indurated, rapidly spreading stages. Randy, a 16 years old boy who thought that a regularly occurring toothache can advance into a life-threatening complication has a lot to be thankful for. The patient was referred to the Pediatric Dentistry Division by the E.R. doctors for further evaluation and management due to a swelling on the lower quadrant of his face. This was on the 8th day after he experienced the first pain on tooth no. 47.

Adolescent↗