Assessment of Somatosensory Function, Pain, and Unpleasantness in Two Surrogate Models of Trigeminal Nerve Damage: A Randomized, Double-Blind, Controlled Crossover Study.

AIMS: To assess the pain and/or unpleasantness and the somatosensory changes caused by two experimental models of trigeminal nerve damage (topical application of capsaicin and local anesthetics) in healthy participants using extensive evaluation tools. METHODS: This double-blinded, randomized, placebo-controlled, crossover study included 20 healthy adult participants who underwent three separate sessions of testing. In each session, the psychophysical quantitative sensory testing (QST) and the electrophysiologic electrically evoked trigeminal "nociceptive-specific" blink reflex (nBR) investigations were performed at baseline. Following a 15-minute topical application of 0.1% capsaicin, 5% EMLA, or Vaseline (placebo) agents, the maximum numeric rating scale pain and unpleasantness scores were recorded. Additionally, qualitative sensory testing and somatosensory mapping were performed. The QST and nBR investigations were repeated immediately after each application. Data were analyzed using repeated-measures analysis of variance. RESULTS: Capsaicin application was associated with significantly higher pain and unpleasantness scores when compared to EMLA and Vaseline (P < .001), with varied bidirectional somatosensory changes among the participants and significant loss of thermosensory function (P < .030). EMLA application induced loss of thermal and mechanical somatosensory function (P < .030) and a significant reduction in electrically evoked pain scores on nBR investigation (P < .001). No significant changes were seen in the electrophysiologic component of the nBR after any of the applications (P = .922). CONCLUSION: Topical capsaicin and EMLA application mimicked certain aspects of somatosensory changes seen in trigeminal nerve damage patients and may be used as surrogate models of such changes.

Translation and validation of Hindi version of Geriatric Oral Health Assessment Index.

OBJECTIVE: The aim of the study was to translate and validate the oral health-related quality of life assessment tool named Geriatric Oral Health Assessment Index (GOHAI) into Hindi language for use in the Indian population. METHODOLOGY: The 12-item GOHAI questionnaire was translated into Hindi, back-translated and compared with the original English version. After pilot testing and appropriate changes, the Hindi version was administered to a group of 500 patients visiting the geriatric medicine clinic in All India Institute of Medical Sciences, New Delhi. The questionnaire was re-administered to 29 participants after a gap of minimum 7 days. The measures for reliability and validity were also assessed. RESULTS: Cronbach's α score (0.79) showed excellent internal consistency. Item-scale correlations varied from 0.06 to 0.75. Test-retest correlation on the 29 patients showed excellent results (ranging from 0.748 to 0.946). Lower GOHAI scores were associated with patient's self-perception of nutritional status, perceptive need for prosthesis, number of posterior occluding pair of teeth. Higher GOHAI scores were seen with patients with removable prosthesis than with edentulous or partially edentulous participants. Age group was also found to be a significant factor for GOHAI scores. CONCLUSION: The Hindi version of GOHAI exhibits acceptable validity and reliability and can be used in the elderly Indian population as a measure of oral health-related quality of life.

Association between dental prosthesis need, nutritional status and quality of life of elderly subjects.

PURPOSE: To determine the effect of prosthesis need on nutritional status and oral health-related quality of life (OHrQoL) in elderly and to check the disparity between prosthesis need and prosthesis want in the Indian elderly. METHODS: A total of 946 geriatric participants reporting to a geriatric medicine clinic were recruited in the study. Mini-nutritional assessment (MNA), geriatric oral health assessment (GOHAI) indices, prosthesis need according to WHO criteria, and prosthesis want was recorded along with age, gender, socioeconomic status and posterior occluding pair. RESULTS: Significant associations exist between prosthesis need and age (p = 0.005), MNA (p = 0.006) and GOHAI (p = 0.000). Prosthesis demand too was influenced by age (p = 0.004), posterior occluding pairs (p = 0.000), MNA (p = 0.012) and GOHAI (p = 0.000). GOHAI was negatively correlated with upper (r = -0.445) and lower prosthesis need (r = -0.460). Participants with some prosthesis need had significantly lower MNA and GOHAI scores as compared to those with no prosthesis need. Though prosthesis need was high (79.7 %), demand was low (39.3 %). CONCLUSION: Prosthesis need affects nutritional status and OHrQoL in elderly, and a wide gap exists between need and want of prosthesis.