Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Toothache”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed2004

Comparison of using calcium hydroxide or a dentine primer for reducing dentinal pain following crown preparation: a randomized clinical trial with an observation time up to 30 months.

The purpose of this study was to evaluate effect of a calcium hydroxide suspension [Ca(OH)2] or glutaraldehyde based dentine primer (GDP) to reduce tooth sensitivity after full crown preparation. Thirty-six patients were treated with Ca(OH)(2) on one tooth and with GDP on another. Patients completed a questionnaire regarding sensitivity during crown preparation, when the not-anaesthetized abutments were irritated [cotton pellet (20 degrees C)]. The teeth were tested before (T(0)) and after using the desensitizer (T(1)), again after 7 days (T(2)), 6 months (T(3)) and 30 months (T(4)). The results were registered on a visual analogue scale [0 (no pain)-100 (severe pain)]. The changes of tooth sensitivity between different testing times were analysed. The median and the (interquartile range) for the different time intervals for Ca(OH)(2) were DeltaT(0)-T(1): 5 (6-17), DeltaT(0)-T(2): 17 (14-32), and for GDP, DeltaT(0)-T(1): 9 (7-18) DeltaT(0)-T(2): 18 (16-33), the decreases in sensitivity were lower for DeltaT(0)-T(1) than for DeltaT(0)-T(2) for both desensitizers (P < 0.001). There was no statistical difference (P > 0.05) between the agents (DeltaT(0)-T(1), DeltaT(0)-T(2), DeltaT(3)-T(4)). Both substances might be useful in reducing tooth sensitivity after crown preparation, but no differences in the efficacy were found when comparing the materials.

Adult↗
PubMedDate not supplied

Atypical odontalgia: a review of the literature.

OBJECTIVE: To review previous reports of cases of atypical odontalgia to examine its epidemiological and clinical characteristics and to explore the etiology and pathophysiology of the disease. BACKGROUND: Atypical odontalgia is one of many painful conditions that affect the oral cavity and is often overlooked in the differential diagnosis. METHODS: A search of the literature was performed for all cases of atypical odontalgia reported from 1966 to the present. RESULTS: The typical clinical presentation of atypical odontalgia that has been reported involves pain in a tooth in the absence of any sign of pathology; the pain may spread to areas of the face, neck, and shoulder. The existing literature suggests that this condition occurs in 3% to 6% of the patients who undergo endodontic treatment, with high female preponderance and a concentration of cases in the fourth decade of life. Deafferentation seems to be the most likely mechanism to initiate the pain, but psychological factors, alteration of neural mechanisms, and even an idiopathic mechanism have been implicated. Not all reported cases were preceded by trauma to the teeth or gums. The treatment of choice is a tricyclic antidepressant, alone or in combination with a phenothiazine. The outcome is usually fair, with many patients obtaining complete relief from pain. Especially in the absence of overt pathology, particular attention should be paid to avoiding any unnecessary and potentially dangerous dental intervention on the teeth. CONCLUSION: Atypical odontalgia is surprisingly common, of uncertain origin, and potentially treatable.

Antidepressive Agents, Tricyclic↗
PubMed2002

Nociceptive behaviour induced by dental application of irritants to rat incisors: a new model for tooth inflammatory pain.

Animal models simulating acute human pulpitis are still lacking. The rat incisors present a particular situation where most of their innervation is considered to be unmyelinated and concentrated mainly in the tooth pulp. This study reports on a new model for dental pain induced by inflammatory agents applied to the tooth pulps of incisors. In different groups of rats, artificial crowns were fixed on the lower incisors, after cutting 1-2mm of their distal extremities. A volume of 7-10 microl of solutions of saline, capsaicin (1-10mg/ml) or formalin (2.5% or 5%) was injected in the crown cavity, and the nociceptive behaviour was quantitated following a devised scoring method of four scales. Intradental application of capsaicin produced nociceptive scores in the form of one plateau for 1-2h depending on the concentration used. Similar results were obtained with intradental application of formalin 2.5%. The one plateau of nociceptive scores obtained with formalin contrasts with the biphasic aspect of nociceptive behaviour described with the intradermal formalin test. This discrepancy could be attributed to a difference in the types of afferent fibres involved in each situation. Pretreatment with morphine (2 mg/kg) attenuated, in a naloxone-reversible manner, the nociceptive behaviour observed following intradental application of capsaicin. Pretreatment with meloxicam (a cyclo-oxygenase-2 inhibitor) exerted a less pronounced attenuation of the nociceptive scores when compared with morphine. These results provide evidence for the validity of the described model for the simulation of tooth pulp inflammatory pain in awake animals.

Analgesics, Opioid↗
PubMed2001

Radiographic follow-up of impacted third molars from age 20 to 32 years.

Nineteen patients (13 male, six female) with 34 impacted third molars, 21 in the mandible and 13 in the maxilla were radiographically followed from age 20 to 32. All were examined clinically and panoramic radiographs were taken at baseline and at the end of the study. Radiographic analysis included resorption of teeth, enlargement of the follicle, development of the root, change in inclination of the third molar, state of impaction, relative depth of the third molar in bone and relation to the ramus of the mandible and to the second molar tooth. In the mandible, the mean change in inclination was 19 degrees and the percentage of teeth with changed angulation was 76%. In the maxilla, only 23% of the teeth changed their inclination. The state of impaction (soft tissue, partially in bone, completely in bone) had changed for 44% of the teeth. According to the questionnaire, no pain or symptoms in the region of the third molars were reported by 74% of the students during the 12-year period. It is concluded that considerable radiographic changes, without notable symptoms, may occur involving inclination of the tooth and state of impaction in impacted third molars after the usual age of eruption.

Adult↗
PubMed2001

Analgesic effects of peripherally administered opioids in clinical models of acute and chronic inflammation.

A series of double-blind, placebo-controlled clinical trials demonstrated that low doses of morphine (0.4, 1.2, and 3.6 mg) administered into the intraligamentary space of a chronically inflamed hyperalgesic tooth produced a dose-related naloxone-reversible analgesia. This analgesic effect is mediated by a local mechanism in the inflamed tissue, because subcutaneous administration of a 1.2 mg dose of morphine failed to elicit an analgesic response. In contrast, submucosal administration of 1.2 mg morphine or 50 microg fentanyl to the site of extraction of an impacted third molar after the onset of acute pain failed to elicit an analgesic response despite demonstration of a sensitive bioassay. These data indicate that peripheral opioid analgesia can be evoked in a model of chronic, but not acute, inflammatory pain, suggesting a temporal dependent mechanism needed for the expression of peripheral opiate analgesia during inflammation in humans.

Acute Disease↗
PubMed2000

Effect of trephination on postoperative pain and swelling in symptomatic necrotic teeth.

OBJECTIVE: The purpose of this prospective, randomized, blinded study was to determine the effect of trephination on postoperative pain and swelling in symptomatic necrotic teeth. STUDY DESIGN: Fifty emergency patients participated, and each had a clinical diagnosis of a symptomatic necrotic tooth with associated periapical radiolucency. After endodontic treatment, patients randomly received either a trephination or mock trephination procedure. The trephination procedure used an intraosseous perforator to provide an initial opening in the cortical bone that was enlarged with files (No. 25 through No. 70) and an endodontic spoon. After surgery, each patient received ibuprofen; acetaminophen with codeine (30 mg); and a 7-day diary to record pain, percussion pain, swelling, and number and type of pain medication taken. RESULTS: The majority of patients with symptomatic necrotic teeth had significant postoperative pain and required analgesics to manage this pain. The use of a trephination procedure with an intraosseous perforator, files, and a spoon excavator did not significantly reduce pain, percussion pain, swelling, or the number of analgesic medications taken in symptomatic necrotic teeth with periapical radiolucencies (P >.05). CONCLUSION: We cannot recommend the routine use of a trephination procedure, as used in this study, for relief of pain in symptomatic necrotic teeth with radiolucencies.

Adult↗
PubMed2000

Effect of systemic penicillin on pain in untreated irreversible pulpitis.

OBJECTIVE: The purpose of this prospective, randomized, double-blind study was to determine the effect of penicillin on pain in untreated teeth diagnosed with irreversible pulpitis. STUDY DESIGN: Forty emergency patients participated, and each had a clinical diagnosis of an irreversible pulpitis. Patients randomly received a 7-day oral dose (28 capsules, 500 mg each, to be taken every 6 hours) of either penicillin or a placebo control in a double-blind manner. No endodontic treatment was performed. Each patient also received ibuprofen; acetaminophen with codeine (30 mg); and a 7-day diary to record pain, percussion pain, and number and type of pain medication taken. RESULTS: The administration of penicillin did not significantly (P >.05) reduce pain, percussion pain, or the number of analgesic medications taken by patients with untreated irreversible pulpitis. The majority of patients with untreated irreversible pulpitis had significant pain and required analgesics to manage this pain. CONCLUSION: Penicillin should not be prescribed for untreated irreversible pulpitis because penicillin is ineffective for pain relief.

Adult↗
PubMed2001

Intracanal use of a corticosteroid-antibiotic compound for the management of posttreatment endodontic pain.

OBJECTIVE: The purpose of this randomized, double-blind study was to determine the effect of a corticosteroid-antibiotic combination when used as an intracanal medicament for the treatment of posttreatment pain in endodontically involved teeth with vital pulp-test readings. STUDY DESIGN: Out of 988 patients, 480 experienced intratreatment pain. Endodontic treatment was completed in 3 visits. Patients who experienced pain after the first or second visit (postextirpation or postinstrumentation) were given an emergency visit during which no local anesthetic was used. The patients randomly received either intracanal corticosteroid-antibiotic compound or a placebo. Patients subjectively rated their pain on a scale of 1 to 4 as none, mild, moderate, and severe. The ratings were done at 1, 2, 4, 8, 12, and 24 hours postmedication. RESULTS: Intracanal use of the corticosteroid-antibiotic medication significantly reduced (P < .001) the mean pain score quite rapidly and was significantly superior to the placebo until the end of the study (P < .001). Furthermore, there were no reoccurrences of pain, and no side effects from use of the drug were noted. CONCLUSION: These results support the intracanal use of corticosteroid-antibiotic combination for controlling posttreatment endodontic pain.

Adolescent↗
PubMed2001

Vertical root fracture in endodontically treated teeth: a review of 25 cases.

OBJECTIVE: We sought to examine the clinical conditions under which 25 endodontically treated teeth underwent vertical root fracture (VRF) and to relate this condition to the time elapsed from endodontic treatment to fracture. STUDY DESIGN: This was a retrospective study in which we reviewed 25 case histories of patients with postendodontic VRF and studied the effect of various pretreatment and posttreatment factors as they related to VRF. RESULTS AND CONCLUSIONS: The mean time to VRF was 54 months; this was not significantly influenced by the presence or absence of prior restoration or by the presence or absence of a crown fitting. The use of a prefabricated, cylindrical, cemented intraradicular retainer increased the time between endodontics and VRF. Teeth restored with conventional amalgam took significantly longer to undergo VRF than those restored with composite or bonded amalgam. In contrast, amalgam-restored teeth suffered more coronal fractures before VRF than did teeth in the other 2 groups.

Cementation↗
PubMed2002

Fusobacterium nucleatum in endodontic flare-ups.

OBJECTIVE: The extent to which Fusobacterium nucleatum is recovered from root canals of teeth that present with an interappointment flare-up following endodontic instrumentation was investigated. STUDY DESIGN: Included in the study were 28 patients that sought emergency treatment after initiation of root canal therapy. Only non-painful teeth that had been treated because of a necrotic pulp and periapical inflammatory lesion were studied. Root canal samples for bacterial analysis were taken, transported to a bacteriological laboratory, and processed for a semiquantitative assessment of bacterial isolates. Bacterial findings were correlated with self-assessed pain intensity as recorded by means of a Visual Analogue Scale. Clinical presentation of swelling and presence of exudate in the treated root canals were also linked. RESULTS: Bacteria were recovered from all teeth examined. Gram-negative anaerobic coccoid rods (Prevotella species and Porphyromonas species) were frequent isolates. All teeth in patients who were reported to be in severe pain (Visual Analogue Scale > or = 6) displayed F nucleatum. Nine out of 10 of these teeth also had swelling and exudate in the root canals. Samples from the remaining patients that had teeth with less pain score showed a variable bacterial recovery. None of these teeth displayed F nucleatum. CONCLUSION: F nucleatum appears to be associated with the development of the most severe forms of interappointment endodontic flare-ups.

Acute Disease↗
PubMed2002

A retrospective study of pulpal response in vital adult teeth prepared for complete coverage restorations at ultrahigh speed using only air coolant.

STATEMENT OF PROBLEM: The dental literature has shown a 3% to 25% pulpal necrosis rate as a result of tooth preparation for complete coverage restorations. PURPOSE: The purpose of this retrospective study was to examine clinical and radiographic records for evidence of pulpal necrosis in teeth prepared for complete coverage restorations at ultrahigh speed when air coolant alone was used. MATERIAL AND METHODS: The 1847 teeth in this study (182 fixed partial denture abutment teeth and 1665 single teeth restored with 21 all-ceramic, 1095 metal-ceramic, and 731 all-metal restorations) were prepared with diamond instruments (burs) in a sweeping or painting motion with the use of light pressure (1-3 oz) at ultrahigh speed with air coolant alone from the handpiece. New burs were used for each patient and then discarded. Each bur was used on no more than 4 teeth. All impressions were made with reversible hydrocolloid. Provisional restorations were fabricated on a stone cast and cemented with zinc oxide and eugenol cement. Provisional restorations were removed at 3 to 4 weeks and definitive restorations placed. Between 1970 and 1989, 6 different luting agents (zinc phosphate, resin, glass ionomer, ortho-ethoxybenzoic acid, carboxylate, and polycarboxylate) were used to place definitive restorations. All patients were questioned about symptoms of tooth sensitivity, tenderness, or pain at their regular (4- to 6-month) hygiene recall appointments. Success was defined as any definitively restored teeth that remained free of radiographic evidence of periapical radiolucency and clinical signs and symptoms of pulpal sensitivity or pain recorded in the clinical record. The results were compared with rates of pulpal necrosis for teeth prepared with water coolant as reported in the dental literature published between 1970 and 1997. RESULTS: Of 638 teeth prepared between 1970 and 1979, the pulpal necrosis rate was 2.19% (14 teeth: 12 single teeth and 2 fixed partial denture abutment teeth) (97.81% success rate). Of 1209 teeth prepared between 1980 and 1989, the pulpal necrosis rate was 0.66% (8 teeth: 7 single crown teeth and 1 partial denture abutment tooth) (99.34% success rate). Of 1825 teeth prepared between 1970 and 1989, radiographic evidence of pulpal necrosis was found in 0% (100% success rate). No clinical symptoms of pain or sensitivity were recorded in the patient records for the surviving teeth during the time period of this study, which was conducted in May 2001. No crowns were repaired or removed as a result of carious lesions. No higher incidence of pulpal necrosis relative to the type of luting agent was observed. CONCLUSION: Within the limitations of this retrospective study, it is suggested that tooth reduction procedures can be completed with minimal damage to the pulp when only air coolant from the dental handpiece is used.

Adult↗
PubMed2006

Functional expression of thermo-transient receptor potential channels in dental primary afferent neurons: implication for tooth pain.

Temperature signaling can be initiated by members of transient receptor potential family (thermo-TRP) channels. Hot and cold substances applied to teeth usually elicit pain sensation. This study investigated the expression of thermo-TRP channels in dental primary afferent neurons of the rat identified by retrograde labeling with a fluorescent dye in maxillary molars. Single cell reverse transcription-PCR and immunohistochemistry revealed expression of TRPV1, TRPM8, and TRPA1 in subsets of such neurons. Capsaicin (a TRPV1 agonist), menthol (a TRPM8 agonist), and icilin (a TRPM8 and TRPA1 agonist) increased intracellular calcium and evoked cationic currents in subsets of neurons, as did the appropriate temperature changes (>43 degrees , <25 degrees , and <17 degrees C, respectively). Some neurons expressed more than one TRP channel and responded to two or three corresponding stimuli (ligands or thermal stimuli). Immunohistochemistry and single cell reverse transcription-PCR following whole cell recordings provided direct evidence for the association between the responsiveness to thermo-TRP ligands and expression of thermo-TRP channels. The results suggest that activation of thermo-TRP channels expressed by dental afferent neurons contributes to tooth pain evoked by temperature stimuli. Accordingly, blockade of thermo-TRP channels will provide a novel therapeutic intervention for the treatment of tooth pain.

Animals↗
PubMed2006

Voltage-gated sodium channels confer excitability to human odontoblasts: possible role in tooth pain transmission.

Odontoblasts are responsible for the dentin formation. They are suspected to play a role in tooth pain transmission as sensor cells because of their close relationship with nerve, but this role has never been evidenced. We demonstrate here that human odontoblasts in vitro produce voltage-gated tetrodotoxin-sensitive Na(+) currents in response to depolarization under voltage clamp conditions and are able to generate action potentials. Odontoblasts express neuronal isoforms of alpha2 and beta2 subunits of sodium channels. Co-cultures of odontoblasts with trigeminal neurons indicate a clustering of alpha2 and beta2 sodium channel subunits and, at the sites of cell-cell contact, a co-localization of odontoblasts beta2 subunits with peripherin. In vivo, sodium channels are expressed in odontoblasts. Ankyrin(G) and beta2 co-localize, suggesting a link for signal transduction between axons and odontoblasts. Evidence for excitable properties of odontoblasts and clustering of key molecules at the site of odontoblast-nerve contact strongly suggest that odontoblasts may operate as sensor cells that initiate tooth pain transmission.

Animals↗
PubMed2004

Associations of perceived pain and painless TMD-related symptoms with alexithymia and depressive mood in media personnel with or without irregular shift work.

The aim of the present study was to analyze whether previously emerged pain symptoms and painless temporomandibular disorder (TMD) symptoms are associated with alexithymia and self-rated depression among media personnel in or not in irregular shift work. A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company in irregular shift work (n = 750) and to an equal number of randomly selected controls in regular 8-h daytime work. The questionnaire covered demographic items, employment details, general health experience, physical status, psychosomatic symptoms, psychosocial status, stress, work satisfaction and performance, and health-care use. Studied age groups, marital status, gender or perceived health were not significantly associated with alexithymia in the bivariate analyses. Most studied painless TMD symptoms associated significantly with alexithymia. Alexithymia was also significantly more prevalent among those who reported having more often than average neck pain (P < 0.05), head pain (P < 0.05), and tender teeth (P < 0.01). According to logistic regression, the probability of alexithymia was significantly positively associated with pain symptoms (P < 0.05) and painless TMD-related symptoms (P < 0.01), and significantly negatively associated with female gender (P < 0.01). Additionally, depressive mood was significantly positively associated with dissatisfaction of one's work-shift schedule (P < 0.05), and poorer health experience (P < 0.01). Neither alexithymia nor depression was associated with irregular shift work in itself. In conclusion, depressive mood may be a sign of dissatisfaction and impaired well-being. In the case of perhaps less disabling but common physical symptoms alexithymia as a possible underlying factor may be relevant in the diagnosis and management of such disorders.

Adult↗
PubMed2006

Association between optimism and self-reported facial pain.

OBJECTIVE: The objective of this study was to assess the association between optimism and self-reported facial pain. MATERIAL AND METHODS: Data were obtained for 5,696 subjects born in 1966 in Northern Finland and included in the study of the Northern Finland Birth Cohort. Data on facial pain were collected using a questionnaire. Optimism was measured using the revised version of the Life Orientation Test. RESULTS: The data showed that optimism was inversely associated with facial pain. Associations were found only among non-depressive subjects. CONCLUSIONS: It can be concluded that optimism is an independent psychosocial determinant of pain experience that should be taken into account in assessing the prognosis of facial pain and its treatment.

Adult↗
PubMedDate not supplied

Defining hypnosis.

Explore the source record for details and available documents.

Awareness↗