Barodontalgia during hyperbaric oxygen therapy of an 8-year-old male: A case report.

Barodontalgia, barometric pressure-induced dental pain, may occur during hyperbaric oxygen(HBO2) therapy due to pressure changes. This case report presents an 8-year-old male patient with barodontalgia. The patient declared a severe toothache during HBO2 therapy. The diving medicine specialist referred the patient to the dental clinician immediately. On clinical examination, the pain was thought to be caused by caries lesions of the deciduous teeth in the left maxillary molar region. Tooth extraction was suggested. After extraction, the patient continued hyperbaric oxygen therapy sessions without any pain. The patient was recommended for an intraoral and radiographic examination session one week after the extraction. In conclusion, caries lesions and faulty restorations should be examined before hyperbaric oxygen therapy sessions. Even though barodontalgia is a rare phenomenon, dental examination is essential to avoid these kinds of pain-related complications. All carious lesions and defective restorations must be treated, if necessary. Removal of faulty restorations and management of inflammation as part of the treatment is suggested before exposure to pressure changes.

Evaluating the Effects of Acupuncture Using a Dental Pain Model in Healthy Subjects - A Randomized, Cross-Over Trial.

Acupuncture is a complementary and nonpharmacological intervention that can be effective for the management of chronic pain in addition to or instead of medication. Various animal models for neuropathic pain, inflammatory pain, cancer-related pain, and visceral pain already exist in acupuncture research. We used a newly validated human pain model and examined whether acupuncture can influence experimentally induced dental pain. For this study, we compared the impact of manual acupuncture (real acupuncture), manual stimulation of a needle inserted at nonacupuncture points (sham acupuncture) and no acupuncture on experimentally induced dental pain in 35 healthy men who were randomized to different sequences of all 3 interventions in a within-subject design. BORG CR10 pain ratings and autonomic responses (electrodermal activity and heart rate variability) were investigated. An initial mixed model with repeated measures included preintervention pain ratings and the trial sequence as covariates. The results showed that acupuncture was effective in reducing pain intensity when compared to no acupuncture (ß = -.708, P = .002), corresponding to a medium Cohen's d effect size of .56. The comparison to the sham acupuncture revealed no statistically significant difference. No differences in autonomic responses between real and sham acupuncture were found during the intervention procedures. PERSPECTIVE: This study established a dental pain model for acupuncture research and provided evidence that experimentally induced dental pain can be influenced by either real acupuncture or manual stimulation of needles at nonacupuncture points. The data do not support that acupoint specificity is a significant factor in reducing experimental pain.

Comparative Analgesia Between Acupuncture and Dipyrone in Odontalgia.

The aim of this study was to assess whether the effectiveness of acupuncture is similar to the use of analgesics in the management of toothache. The research included 56 volunteers who were divided into 4 groups: Real Acupuncture group, Placebo Acupuncture group, Real Dipyrone group, and Placebo Dipyrone group. The interventions of the study were performed before the dental care. Inclusion criteria were toothache of pulpal origin with pain scale (Visual Analogue Scale) above 4, absence of medication for the pain, and aged over 18 years. The Real Acupuncture volunteers received a session of acupuncture using piercing needles, while volunteers from the Placebo Acupuncture group received an acupuncture session using non-piercing sham needles. Volunteers from the Real Dipyrone group received a dipyrone tablet and the Placebo Acupuncture group received a tablet with no active ingredient. Before any therapeutic intervention, we collected samples from the volunteers' saliva to analyze the salivary cortisol, the volunteers rated the intensity of their pain using VAS, and we measured their energy level by the Ryodoraku method. After 20 minutes of treatment, all the volunteers' analysis parameters were collected again. The Real Acupuncture group presented a greater reduction of VAS than the reduction obtained by the Real Dipyrone group (p<0.05). There was no statistically significant difference between the groups for the salivary cortisol and energy level variables. It can be concluded that acupuncture was more effective in reducing odontalgia than the dipyrone and that it can be an alternative for odontalgia management.

[TEAS for prevention and treatment of orthodontic toothache and oral dysfunction: a randomized controlled trial].

OBJECTIVE: To observe the clinical efficacy of transcutanclus electrical acupoint stimulation (TEAS) on prevention and treatment of orthodontic toothache and oral dysfunction. METHODS: A total of 85 patients of malocclusions in the preliminary diagnosis were randomly divided into a control group (20 cases), a psychological intervention group (22 cases), a medication group (20 cases) and a TEAS group (23 cases). Orthodontics treatment was given in all the groups. Patients in the control group received no further treatment; patients in the psychological intervention group received comprehensive psychological intervention, including cognitive education and music therapy; patients in the medication group received oral administration of ibuprofen; patients in the TEAS group received TEAS at Juliao (ST 3), Jiachengjiang (Extra) and auricular point Ya (LO1). The treatment was given twice a day, one in morning and one at night, for 7 days. The pain scores of orthodontic toothache and changes of oral dysfunction were observed in all groups. RESULTS: (1) At 5 time points from the 12th hour to the 4th day, the scores of spontaneous pain in TEAS group were lower than those in the control group (all P < 0.01); during the time points, the scores in TEAS group were lower than those in the psychological intervention group (P < 0.05, P < 0.01), which were similar to those in the medication group (all P > 0.05). (2) During the peak cycle of spontaneous toothache, the scores of irritation pain in TEAS group were significantly lower than those in the control group (all P < O.01), regardless of time-point statistics or general statistics; the scores of irritation pain in the TEAS group were also significantly lower than those in the psychological intervention group (all P < 0.01), which were similar to those in the medication group (all P > 0. 05). (3) Compared with control group, the grading of talking disorder in the remaining groups did not change significantly (P > 0.05). (4) Compared with control group, the grading of moderate-severe eating disorder in TEAS group was significantly reduced (P < O.05), which was not different from that in the medication group (P > 0.05). The differences of the grading of moderate-severe eating disorder were not significantly different between the psychological intervention group and control group (P > 0.05). (5) There were 3 cases of digestive system adverse reactions in the medication group. CONCLUSION: TEAS can efficiently prevent orthodontic toothache and oral dysfunction, which is superior to psychological intervention and similar to medication. In addition, it can avoid possible side-effect of medication.

[Preventive and therapeutic effects of TEAS on rabbits with orthodontic toothache].

OBJECTIVE: To explore the action mechanisms of transcutaneous electrical acupoint stimulation (TEAS) on prevention and treatment of orthodontic toothache. METHODS: Twenty-four male New Zealand rabbits were randomly divided into a blank group, an orthodontic group and a TEAS group, 8 rabbits in each one. The orthodontic model of rabbit was made in orthodontic group and TEAS group by bonding brackets and fixing NI-TI screw with ligature wire. After model establishment, the TEAS group was treated with TEAS at ashi points (skin surface corresponding points to the bilateral upper 1st molars) and "Hegu" (LI 4) with dilatational wave, 20 min per treatment, twice a day, totally 2-day consecutive treatment (4 treatments) was provided. The rabbit general behavior, total food intake and threshold of pain were observed; the contents of serum prostaglandin E2 (PGE2), granulocyte macrophage colony stimulating factor (GM-CSF) as well as endorphin (ß-EP) fluid and cholecystokinin-8 (CCK-8) in cerebrospinal fluid (CSF) were detected. RESULTS: Compared with the orthodontic group, the rabbit general behavior, total food intake and threshold of pain in the TEAS group were significantly improved (P<0.05, P<0.01). The serum PGE2 were significantly reduced (P<0.05), while GM-CSF presented reducing trend without statistical significance (P>0.05). The ß-EP in the CSF were increased (P<0.05), while CCK-8 in CSF presented reducing trend without statistical significance (P>0.05). CONCLUSIONS: The preventive and therapeutic effects of TEAS on rabbits with orthodontic toothache are achieved by reducing algogenic substance PGE2 in peripheral nervous system selectively, increasing ß-EP in CSF in central nervous system and keeping the level of anti-opioid pain maintaining substance CCK-8.Both the central and peripheral nervous systems participate in the analgesic effect of TEAS.

Ritual tooth modification among the Baka pygmies in Cameroon.

INTRODUCTION: Ritual tooth mutilation is a relatively understudied human body mutilatory practices. The purpose of the study was to examine the effects of ritual tooth modification, teeth cleaning measures and herbal medications for their oral health problems among the Baka pygmies in Cameroon. MATERIALS AND METHODS: This cross-sectional study was conducted between January and March, 2012 using semi-structured questionnaire as the tool of data collection. Intra-oral examinations were carried out to determine the dental hard tissue loss using Smith and Knight Tooth Wear Index (TWI). RESULTS: Fifty-six pygmies with ritual tooth modification made of 34 males (60.7%) and 22 females (39.3%) with a mean age of 31 years were interviewed and had oral health examination. The reported age at which the tooth modification was done was between 10 and 15 years with mean age as 12 ± 1.66 years. More than half (58.9%) of the participants reported the tooth filing as painful and nearly two-thirds (64.3%) of the participants reported having persistent pain afterwards. The upper right central and lateral incisors were the most commonly modified teeth. A total of 42.9%, 12.5% and 7.1% of the participants had Smith and Knight TWI scores of 2, 3 and 4 respectively. All the participants reported cleaning their teeth at least once-daily with about two-thirds (66.1%) of them doing so with chewing stick. The majority (67.9%) of the participants reported cleaning their teeth for cosmetic reasons [to remove dirt' (60.7%) and 'to remove stains' (7.1%)]. The oral health problems among the participants in form of tooth sensitivity, toothache and dental abscess were treated with plant-based traditional medicines from Irvingia gabonensis, Ricinodendron heudoletti, Pterocarpus soyauxii, Alchornea cordifolia and Piptadeniastrum africanum. CONCLUSION: Ritual tooth modification is a painful mutilatory practice which is culturally significant for the Baka pygmies without health benefit. There is need for intervention to stop this harmful traditional practices among the pygmies. Further studies is recommended to elucidate the medicinal and pharmaceutical benefits of plants used for tooth sensitivity and other oral health problems by the pygmies.

Efecto de la tintura de ajo en odontalgias / Effect of garlic tincture in odontology

Se realiza un estudio para determinar los efectos de la tintura de ajo al 20 por ciento en el tratamiento de odontalgia en el Policlínico Universitario Francisco Castro Ceruto de la ciudad de El Salvador, Guantánamo, en el periodo comprendido enero–diciembre de 2012, donde se empleó en todos los pacientes que acudieron a el servicio de urgencias con pulpitis reversibles que estuvieron de acuerdo en participar en dicha investigación, a la muestra se le aplicó un cuestionario donde se recogieron las variables: sexo, edad, alivio, tiempo de desaparición y reacción adversa medicamentosa (RAM). Obtuvimos que de los 121 pacientes atendidos solo en tres pacientes persistió el dolor, es decir que no desapareció; por otra parte los otros 118 se le alivió el dolor en un período de tiempo de 1-10 minutos. Se comprobó los efectos positivos del mismo, no se encontró ninguna reacción adversa en los pacientes tratados(AU)

A study was erformed to determine the effects of garlic tincture to 20 in the treatment of toothache at the teaching Policlinic Francisco Castro Ceruto in El Salvador, from January to December 2012, used in all patients presenting to the emergency department with reversible pulpitis who agreed to participate in this research, in the sample was applied a questionnaire and variables were collected: sex, age, relief, clearance time and adverse drug reaction (ADR). It was obtained that out of the 121 studied patients only in three patients the pain persisted, not disappeared; moreover the other 118 was reduced pain over a period of time from 1-10 minutes. The positive effects of was found, no adverse reactions in patients treated were found(AU)

A chemical burn from a garlic poultice applied to the face to treat toothache: a case report.

This case report is of a significant chemical burn to the face resulting from the use of an external garlic poultice for toothache. The patient used internet search engines to seek a toothache remedy and did not identify any reports of this complication. This report aims to inform all dentists of the risks of raw garlic application to the skin and also to ensure that in the future any patient using the internet for a toothache remedy will be made aware of the potential risk and how to avoid it.

Acupuncture in the management of acute dental pain.

Acute dental pain is the main reason for seeking dental services to provide urgent dental care; there is consensus about the use of alternative therapies, such as acupuncture, to control dental pain in pre-dental care. This study aimed to evaluate the use of acupuncture in reducing the intensity of acute dental pain in pre-dental care in patients waiting for emergency dental care, and was conducted at the After-Hours Emergency Dental Clinic of Piracicaba Dental School, and at the Emergency Center Dental Specialties I in Piracicaba, São Paulo, Brazil. The sample consisted of 120 patients. The Visual Analog Scale (VAS) was used to measure pain intensity. All patients underwent one session of acupuncture; the points LI4, ST44 and CV23 were selected and were used alone or in combinations. Reduction in pain was observed in 120 patients (mean initial VAS=6.558±1.886, p<0; mean final VAS=0.962±2.163, p<0.00001). The results of this study indicate that acupuncture analgesia could be a technical adjunct to pain control in patients with acute dental pain, contributing to the restoration of health with social benefit.

Orofacial pain: a guide for the headache physician.

Orofacial pain represents a significant burden in terms of morbidity and health service utilization. It includes very common disorders such as toothache and temporomandibular disorders, as well as rare orofacial pain syndromes. Many orofacial pain conditions have overlapping presentations, and diagnostic uncertainty is frequently encountered in clinical practice. This review provides a clinically orientated overview of common and uncommon orofacial pain presentations and diagnoses, with an emphasis on conditions that may be unfamiliar to the headache physician. A holistic approach to orofacial pain management is important, and the social, cultural, psychological and cognitive context of each patient needs to be considered in the process of diagnostic formulation, as well as in the development of a pain management plan according to the biopsychosocial model. Recognition of psychological comorbidities will assist in diagnosis and management planning.

[Controlled observation on combination of Shu-stream and Ying-spring acupoints for toothache].

OBJECTIVE: To compare the therapeutic effect between combination of Shu-stream and Ying-spring acupoints and routine acupoints selected by syndrome differentiation for toothache. METHODS: Eighty-five cases were randomly divided into a combination of Shu-stream and Ying-spring acupoints group (group A, 43 cases) and a routine acupionts group (group B, 42 cases). In group A, according to the corresponding relationship between viscera-meridians and different kinds of teeth, the Shu-stream and Ying-spring acupoints at both sides of the corresponding meridians were sleeted. The group B was treated with acupuncture at Jiache (ST 6), Xiaguan (ST 7), Hegu (LI 4), erjian (LI 2), Neiting (ST 44). Yifeng (TE 17) and Fengchi (GB 20) were added for wind and fire attacking; Lidui (ST 45) and Quchi (LI 11) were added for intense stomach fire; Taixi (KI 3) and Zhaohai (KI 6) were added for deficiency fire flaming up. Electroacupuncture was applied in two groups, once every day, ten treatments constituted one course, the differences of effect and recurrence rate were observed after one course and half a year later. RESULTS: The cured rate were respectively 88.4% (38/43)and 69.0% (29/42) in group A and group B, with a significant difference (P < 0.05). The recurrence rates were respectively 23.7% (9/38) and 55.2% (16/29) in group A and group B, with a significant difference (P < 0.05). CONCLUSION: Both short-term and long-term therapeutic effects of combination of Shu-stream and Ying-spring acupoints are significantly better than those of routine acupoints in treating toothache.

Involvement of Ayurvedic practitioners in oral health care in the United States.

BACKGROUND: Ayurveda, an ancient medical science originating in India, also is practiced in the United States. The authors conducted a study primarily to explore the involvement of Ayurvedic practitioners in treating oral diseases. METHODS: Eighty-five practitioners participated in this cross-sectional survey. The authors obtained self-reported data on demographics of the practitioners, the general and oral health conditions they treated, and the treatment modalities used. They performed descriptive statistical and logistic regression analyses by using statistical software. RESULTS: Participants predominantly were female and white or non-Hispanic, as well as part-time practitioners. Their educational backgrounds ranged from a 5½-year bachelor's degree in Ayurveda to short-term training. Of the 60 respondents who answered the question about treating oral diseases, 25 (42 percent) reported that they did so. Conditions treated were related to oral malodor, gingival or periodontal disease and toothache. Ayurvedic treatments administered for these conditions primarily were preventive in nature. CONCLUSIONS: Ayurvedic practitioners in the United States treat a variety of oral diseases by using predominantly preventive traditional care. Ayurvedic practitioners of Asian origin and those who practiced for a longer duration were more likely to report that they treated oral diseases. Larger, population-based studies are needed to understand more fully the current role of Ayurvedic practitioners in oral health care. Ayurvedic treatment modalities aimed at oral diseases need to be evaluated through rigorous randomized controlled trials for safety and effectiveness. PRACTICE IMPLICATIONS: Patients with limited or no access to oral health care might seek Ayurvedic treatment, and those who have access to conventional oral health care might wish to complement it with Ayurvedic treatment. Practitioners can incorporate preventive Ayurvedic treatments, which are based mainly on natural products, into overall preventive care regimens, if proven safe and effective.

Laserterapia como analgésico para el movimiento dentario ortodóncico / Laser therapy as an analgesic for orthodontic tooth movement

El dolor dentario posterior a la colocación del primer arco activo en las técnicas fijas ortodóncicas se presenta con gran frecuencia. El propósito del presente trabajo es comprobar la efectividad del láser As Ga Al con respecto al dolor en un estudio descriptivo y transversal, donde se estudiaron 100 pacientes divididos en 2 grupos: para el grupo control, 50 casos, y los restantes conformaron el grupo estudio. En el primero se procedió con la colocación de la técnica fija solamente, y en el grupo estudio, además de la técnica fija, se aplicó el láser mencionado con un parámetro analgésico-antiinflamatorio y una potencia de 5 mW. La aplicación fue puntual local, con la fibra óptica, que duró 60 segundos en cada papila interdentaria que estuvo involucrada en el tratamiento de la técnica fija. Tras la evolución de todos los casos a las 24 y 48 h, se les aplicó la escala analógica visual de 3 puntos. Fueron de clasificación tolerable cuando la escala analógica visual osciló entre 0 y 1 (no dolor y dolor leve), y no tolerable cuando osciló entre 2 y 3 (dolor moderado a severo).Se observó que hubo mejoría acerca de la magnitud del dolor referida por parte de los pacientes, con diferencias significativas entre ambos grupos. Se registraron 4 casos con la calificación de tolerable en el grupo control, lo que en el grupo estudio fue de 32 pacientes. De forma general, hubo mejores resultados con los pacientes portadores de la técnica fija de arco recto que con la técnica fija de Ricketts montada. Se encontraron 3 casos con reacciones adversas (mareo en 2 pacientes y pico doloroso en uno solo) los que no fue significativo .Más de la mitad de los pacientes obtuvieron alivio de dolor con 1 o 2 aplicaciones de láser, lo que nos brinda una alternativa terapéutica en combinación con el tratamiento de la técnica fija ortodóncica (AU)

Orthodontic pain is very common in orthodontic bonding techniques after placing the first archwire. The aim of the present work is to determine the effectiveness of the As-Ga-Al laser on this pain in a descriptive, cross-sectional study. A total of 100 patients were studied, divided into 2 groups: 50 cases for the control group, with the remainder making up the study group. The bonding technique only was used for the insertion in the first group, and in the study group, as well as the bonding technique, the aforementioned laser was applied at a power of 5 mW, as an analgesic-anti-inflammatory parameter. it was applied in the immediate exact location with the optic fibre, and lasted 60 seconds, in each interdental papilla that was involved in the bonding technique treatment. A 3-point visual analogue scale (vAS) was applied 24 hours and 48 hours after the treatment. They were classified as tolerable when the vAS varied between 0 and 1 (no pain or mild pain), and intolerable when it varied between 2 and 3 (moderate to severe pain). The patients observed an improvement in the intensity of the pain, with significant differences between both groups. Four cases were classified as tolerable in the control group, whereas 32 patients in the study group were classified as such. The results were generally better in those patients who received a straight-arch bonding technique than in those with the Ricketts sandwich bonding technique. There were 3 cases with adverse reactions (dizziness in 2 patients and painful peak in only one) which were not significant. There was pain improvement in more than half of the patients with 1 or 2 laser applications, thus we recommend it as an alternative treatment in combination with the orthodontic bonding technique (AU)

Evaluating traditional Chinese medicine using modern clinical trial design and statistical methodology: application to a randomized controlled acupuncture trial.

Traditional Chinese medicine (TCM), used in China and other Asian counties for thousands of years, is increasingly utilized in Western countries. However, due to inherent differences in how Western medicine and this ancient modality are practiced, employing the so-called Western medicine-based gold standard research methods to evaluate TCM is challenging. This paper is a discussion of the obstacles inherent in the design and statistical analysis of clinical trials of TCM. It is based on our experience in designing and conducting a randomized controlled clinical trial of acupuncture for post-operative dental pain control in which acupuncture was shown to be statistically and significantly better than placebo in lengthening the median survival time to rescue drug. We demonstrate here that PH assumptions in the common Cox model did not hold in that trial and that TCM trials warrant more thoughtful modeling and more sophisticated models of statistical analysis. TCM study design entails all the challenges encountered in trials of drugs, devices, and surgical procedures in the Western medicine. We present possible solutions to some but leave many issues unresolved.

[Pain and discomfort in orthodontic treatments. Literature review]. / Fájdalom és diszkomfort az ortodonciai kezelés során. Irodalmi összefoglalás.

The experience of pain and discomfort during orthodontic treatment is common. Pain is a subjective response to noxious stimuli, but it is also influenced by age, gender, previous pain experience, emotional factors and stress. The ortodontic treatments such as separation, placement of the arch wire, activation of the fix or removable appliances and debonding cause some degree of pain for the patient. In a prospective study 95% of the patients reported pain experience during orthodontic treatment. The periodontal pain caused by the combination of pressure, ischemia, inflammation and oedema. The pain starts within 4 hours, increases over the next 24 hours, and decrease within 7 days, so it may not be identified by the orthodontist at recall visit. The most common method to measure the intensity of the pain is the NRS (numerical rating scale), where patients can rate their pain intensity from 1 to 10 or 1 to 100. There are many modalities to control orthodontic pain, we can use different analgesic agents, solf-laser irradiation, transcutaneous electrical nerve stimulation and hypnotherapy. The aim of this review to provide an overview on discomfort and pain reaction during orthodontic treatments and discussion of the possible measurement and alleviation of pain.

[The overview of the prevention and treatment of dental disease in ancient China].

About 2000 years ago, our country already had a record about mouth washing. It was one of the earliest countries that invented teeth brushing and the toothbrush. It mentioned many kinds of effective techniques of teeth protection and health improvment such as swallowing the saliva, knocking the teeth and practising Qigong. About 3000 years ago, our country already had records about dental disease and had established the specialty of stomatology and dentistry in the Tang dynasty. The methods of treating toothache by acupuncture and external medicine, treating caries by arsenic trioxide and using silver paste to fill the teeth, using artificial teeth for restoration, and treating periodontosis by teeth-cleaning techniques all took the lead in the world. Traditional Chinese Medicines are still used today to treat toothache and periodontosis in clinic.

Exploring the oral health experiences of a rural population in Sudan.

This paper explores the beliefs of a rural population in the Sudan in relation to the causes of oral diseases and their attitudes towards traditional healers and treatments. Qualitative methods, using ethnography and narrative, explored people's experiences. The study identifies conflicting narratives concerning oral health with coherent cultural beliefs and attitudes appearing to underpin oral health related behaviours.

Comparing the clinical effect of five varying locations of LI.4 acupoint.

LI.4 is a major acupoint but the method of locating it has not been standardized. In fact, description of method for locating this acupoint often varies in the classic and traditional texts. It might signify this point may be varied from one to another person. Our comparative study of locating and subsequent acupuncturing these locations revealed some interesting features of LI.4 from our collected clinical data in that location 1 had a better therapeutic effect for toothache relief and analgesia-anesthesia effect than for headache relief, location 2 was better for headache than toothache relief; locations 3 and 4 had a mixed effect whereas, location 5 seems to have a better chance to get bioenergy (De Qi) as manifested by tingling and numbing sensation at the acupunctured site. Our study also suggested that LI.4 location was about the size of 4 millimeters in diameter instead of a pin-point location, though needle inserted at correct point produced a better result.