Effect of aromatherapy with peppermint essential oil on the gag reflex: a randomized, placebo-controlled, single-blind, crossover study.

BACKGROUND: Sensitive gag reflexes prevent dental patients from receiving appropriate treatment. Aromatherapy helps patients relax during dental procedures. However, the effect of aromatherapy on the gag reflex caused by the stimulation of the oral cavity is unknown. This study aimed to evaluate whether aromatherapy reduces gag reflexes during oral stimulation. METHODS: In this randomized, placebo-controlled, single-blind, crossover study, the gag reflexes of 24 healthy individuals (12 females and 12 males; mean age: 34.3 ± 9.5 years) were quantified. A standard saliva ejector was slowly guided down the participant's throat to determine the maximum tolerance of the gag reflex, and the insertion distance was measured to quantify the gag reflex. All individuals participated in an aromatherapy session with peppermint essential oil and a placebo session with distilled water. The gag reflex was quantified before (baseline) and after each session. Another measurement was performed using nitrous oxide/oxygen inhalation as a positive control. RESULTS: Gag reflex values significantly increased after aromatherapy with both peppermint essential oil and placebo compared to baseline values (paired t-test, P < 0.001 and P = 0.014, respectively). The gag reflex value also increased significantly during nitrous oxide/oxygen inhalation (paired t-test, P < 0.001). There was no significant difference in the increase rate of gag reflex values between the positive control and aromatherapy interventions, but it was significantly lower after the placebo intervention (repeated measures analysis of variance, P = 0.003; post-hoc test, P = 0.83 and P = 0.02). CONCLUSION: Aromatherapy with peppermint essential oil has the potential for reducing gag reflex during dental procedures. TRIAL REGISTRATION: The study was registered in the University hospital Medical Information Network Clinical Trials Registry under the code UMIN000050616 (approved 17/03/2023).

Are acupuncture and dry needling effective in the management of masticatory muscle pain: A network meta-analysis of randomised clinical trials.

BACKGROUND: Several studies have shown that both acupuncture and dry needling are effective in the treatment of musculoskeletal pains. Therefore, the aim of this network meta-analysis (NMA) was to investigate the treatment outcome of acupuncture and dry-needling for masticatory muscle pain (TMD-M) and to compare with active and inactive placebo. MATERIAL AND METHOD: An electronic search was performed to identify randomised controlled trials (RCTs) published until September 2019, comparing dry-needling, acupuncture, and inactive as well as active placebo in patients with TMD-M. Outcome variables were post-treatment pain intensity, pressure pain threshold (PPT), and maximum mouth opening (MMO). The quality of evidence was rated according to Cochrane's tool for assessing the risk of bias. Mean difference was used to analyse via frequentist NMA using STATA-software. RESULTS: Both NMA and direct pairwise meta-analysis have shown that there was no difference between active treatment with either acupuncture or dry-needling when compared to active and inactive placebo in patients with TMD-M with respect to pain intensity, and PPT (p > .05). However, there was a significant increase in MMO following dry-needling when compared to the placebo (very low-quality evidence). CONCLUSION: Despite the short-term positive effect of MMO by dry-needling, this NMA could not show any pain-reducing effect in patients with TMD-M by acupuncture or dry-needling when compared to an active or inactive placebo. Taken together, this NMA indicates that it is the placebo effect that accounts for the majority of the treatment effect of TMD-M, rather than a real therapeutic effect of acupuncture/dry-needling.

Acupuncture and Transcutaneous Electrical Acupoint Stimulation Do Not Suppress Gag Reflex.

Objective: Gagging is a problem for many dental patients, as well as patients undergoing medical procedures, such as intubation. Research to date on the gag reflex has been limited by a lack of objective measures for measuring this reflex. Materials and Methods: A validated quantitative method was used to measure if acupuncture or transcutaneous electrical acupoint stimulation (TEAS) at Pericardium 6 (PC 6) and Stomach 36 (ST 36) suppressed the gag reflex, compared with a sham placebo. The subjects were 60 healthy adults randomly chosen to receive acupuncture, TEAS, or sham-TEAS on PC 6, located on the forearm, and ST 36, located on the lower leg. The gag reflex was measured by inserting a saliva ejector slowly down each participant's throat to determine the maximum tolerance of the gag reflex; the insertion length was used as an index of this reflex. Results: There was a significant difference in pre- and postintervention insertion lengths in all groups (paired t-test; all groups; P < 0.001). The differences in the insertion length among the groups (P = 0.76) and the interaction effect (group × time) were not significant (P = 0.79; 2-way analysis of variance). Conclusions: This study suggested that PC 6 and ST 36 stimulation was no different than placebo for alleviating the gag reflex.

Needling therapies in the management of myofascial pain of the masticatory muscles: A network meta-analysis of randomised clinical trials.

OBJECTIVE: A network meta-analysis (NMA) of randomised clinical trials (RCTs) was performed aiming to compare the treatment outcome of dry needling, acupuncture or wet needling using different substances in managing myofascial pain of the masticatory muscles (TMD-M). METHOD: An electronic search was undertaken to identify RCTs published until September 2019, comparing dry needling, acupuncture or wet needling using local anaesthesia (LA), botulinum toxin-A (BTX-A), granisetron, platelet-rich plasma (PRP) or passive placebo versus real active placebo in patients with TMD-M. RCTs meeting the inclusion criteria were stratified according to the follow-up time: immediate post-treatment to 3 weeks, and 1 to 6 months post-treatment. Outcome variables were post-treatment pain intensity, increased mouth opening (MMO) and pressure threshold pain (PPT). The quality of evidence was rated according to Cochrane's tool for assessing risk of bias. Mean difference (MD) was used to analysed via frequentist NMA using Stata software. RESULTS: Twenty-one RCTs involving 959 patients were included. The quality of evidence of the included studies was low or very low. There was significant pain decrease after PRP when compared to an active/passive placebo and acupuncture. There was a significant improvement of MMO after LA (MD = 3.65; CI: 1.18-6.1) and dry needling therapy (MD = 2.37; CI: 0.66-4) versus placebo. The three highest ranked treatments for short-term post-treatment pain reduction in TMD-M (1-20 days) were PRP (95.8%), followed by LA (62.5%) and dry needling (57.1%), whereas the three highest ranked treatments at intermediate-term follow-up (1-6 months) were LA (90.2%), dry needling (66.1%) and BTX-A (52.1%) (all very low-quality evidence). LA (96.4%) was the most effective treatment regarding the increase in MMO followed by dry needling (72.4%). CONCLUSION: Based on this NMA, one can conclude that the effectiveness of needling therapy did not depend on needling type (dry or wet) or needling substance. The outcome of this NMA suggests that LA, BTX-A, granisetron and PRP hold some promise as injection therapies, but no definite conclusions can be drawn due to the low quality of evidence of the included studies. This NMA did not provide enough support for any of the needling therapies for TMD-M.

Reliability, validity, and sex differences in a quantitative gag reflex measurement method.

A reliable assessment method is required to manage the gag reflex. We tested the inter- and intra-examiner reliability and validity of a quantitative measurement method and evaluated the differences between sexes. This study included 21 healthy adults (10 women, 11 men; mean age, 27.1 ± 9.9 years). An examiner inserted a standard saliva ejector slowly down the participant's throat to determine the maximum tolerance of the gag reflex; the insertion depth was used as an index of gag reflex. The reflex was measured by one examiner during two sessions (S1 and S3) and by a second examiner during one session (S2) under the same conditions. The galvanic skin response (GSR) and heart rate (HR) were recorded during each session to test the method validity. Data were analysed using the intraclass correlation coefficient (ICC), paired t test, and two-way repeated-measures analysis of variance. The ICC of the gag reflex measurements was 0.91 between S1 and S2, and 0.93 between S1 and S3. The GSR and HR increased significantly after the maximum tolerance of the reflex in S1, S2, and S3 (GSR: P < 0.001, P = 0.004, P = 0.001, respectively; HR: all, P < 0.001). Differences in the measurements according to sex and session were not significant. Our method exhibited excellent inter- and intra-examiner reliability and was unaffected by the participants' sex. Measurement revealed significant autonomic reactivity, which is common for this reflex. Consequently, this method may be used in clinical and laboratory-based applications.

The effectiveness of cannabinoids in the management of chronic nonmalignant neuropathic pain: a systematic review.

AIMS: To carry out a systematic review to assess the effectiveness of cannabis extracts and cannabinoids in the management of chronic nonmalignant neuropathic pain. METHODS: Electronic database searches were performed using Medline, PubMed, Embase, all evidence-based medicine reviews, and Web of Science, through communication with the Canadian Consortium for the Investigation of Cannabinoids (CCIC), and by searching printed indices from 1950. Terms used were marijuana, marihuana, cannabis, cannabinoids, nabilone, delta- 9-tetrahydrocannabinol, cannabidiol, ajulemic acid, dronabinol, pain, chronic, disease, and neuropathic. Randomized placebo-controlled trials (RCTs) involving cannabis and cannabinoids for the treatment of chronic nonmalignant pain were selected. Outcomes considered were reduction in pain intensity and adverse events. RESULTS: Of the 24 studies that examined chronic neuropathic pain, 11 studies were excluded. The 13 included studies were rated using the Jadad Scale to measure bias in pain research. Evaluation of these studies suggested that cannabinoids may provide effective analgesia in chronic neuropathic pain conditions that are refractory to other treatments. CONCLUSION: Cannabis-based medicinal extracts used in different populations of chronic nonmalignant neuropathic pain patients may provide effective analgesia in conditions that are refractory to other treatments. Further high-quality studies are needed to assess the impact of the duration of the treatment as well as the best form of drug delivery.

Comparison of self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial temporomandibular disorders by age group: a prospective outcome study.

BACKGROUND: Subjective symptoms of temporomandibular disorders (TMDs) have rarely been studied by age group. We aimed to compare self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial TMDs among three age groups. METHODS: The study population included 179 consecutive patients (151 women and 28 men) who underwent comprehensive clinical examinations at a university-based orofacial pain center. They were classified into myofascial pain subgroups based on the Research Diagnostic Criteria for Temporomandibular Disorders. They were stratified by age group: M1, under 20 years; M2, 20-39 years; and M3, 40 years and older. The patients scored their pretreatment symptoms (first visit) and post-treatment symptoms (last visit) on a form composed of three items that assessed pain intensity and one item that assessed sleeping difficulty. Their treatment options (i.e., pharmacotherapy, physical therapy, and orthopedic appliances) and duration were recorded. All variables were compared between sexes in each group and between the age groups by using the Kruskal-Wallis test, the Mann-Whitney U test, the chi-square test, and analysis of variance (p < 0.05). RESULTS: No significant sex differences were found in any age group. Only sleeping difficulty was significantly different before treatment (p = 0.009). No significant differences were observed in the treatment options or treatment duration. After treatment, the intensity of jaw/face pain and headache and sleeping difficulty was significantly reduced in groups M2 and M3, but only the intensity of jaw/face pain was significantly decreased in group M1. The changes in the scores of pain intensity and sleeping difficulty were not different between the groups. CONCLUSIONS: Pain intensity does not differ by age group, but older patients with myofascial TMDs had greater sleeping difficulties. However, there were no differences between the age groups in the treatment outcomes. Clinicians should carefully consider the age-related characteristics of patients with myofascial TMDs when developing appropriate management strategies.

Comparison of masticatory muscle myofascial pain in patients with and without a chief complaint of headache.

OBJECTIVES: Headaches are a common complaint in temporomandibular disorder (TMD) patients. However, few studies have compared the symptom characteristics between TMD patients with and without a complaint of headache. The aim of this study was to compare subjective symptoms and treatment outcomes between myofascial TMD patients who had a chief complaint of headache and those who did not. METHODS: One hundred sixty one patients underwent comprehensive examinations and scored their pre- and post-treatment symptoms on a form (4 items assessing pain intensity and 1 assessing sleeping difficulty). On the basis of the primary diagnosis, patients were divided into two groups: myofascial pain with and without a chief complaint of headache (MPH and MP). RESULTS: Before treatment, patients in the MPH group scored significantly higher with respect to pain intensity and level of sleeping difficulty than did patients in the MP group (jaw/face pain, P = 0.015; headache, P < 0.001; neck pain, P < 0.001, and difficulty in sleeping, P = 0.005; Mann-Whitney U-test). Patients in the two groups demonstrated similar treatment outcomes, except for neck pain. CONCLUSION: Significant differences in symptom characteristics and outcomes were observed between primarily myofascial TMD patients with and without a chief complaint of headache.

Preclinical assessment of a zwitterionic tantalum oxide nanoparticle X-ray contrast agent.

Tantalum oxide nanoparticles show great potential as the next generation of X-ray contrast media. Recently, we reported advances in tantalum oxide nanoparticles and identified improvements that were required for such particles to progress further. Namely, the viscosity of concentrated particles, the amount of retention in reticuloendothelial (RES) tissues, and the effect of large quantities of particles on the kidneys after administration were all identified as critical factors which needed further study, understanding, and development. Here, we report on a zwitterionic siloxane polymer nanoparticle coating that reduced the viscosity of concentrated solutions of particles by a factor of 5, decreased tissue retention of injected particles by a factor of 10, and, importantly, did not induce pathological responses in the kidneys.

Comparison of subjective symptoms of temporomandibular disorders in young patients by age and gender.

The authors assessed the subjective symptoms of temporomandibular disorders (TMDs) in 167 young patients using self-reported forms, with five ratings for pain intensity and six ratings for difficulty in activities of daily living (ADL), to compare TMD symptoms according to gender and three age groups: group 1: 6- to 12-year-olds (juvenile); group 2: 13- to 15-year-olds (early adolescent); group 3: 16- to 18-year-olds (late adolescent). No significant gender differences were found in the symptoms among the groups, except for headache and neck pain in group 3. Pain intensity and tightness in the jaw/face, headache, and neck pain, as well as the ADL-related difficulty in prolonged jaw opening, eating soft/hard foods, and sleeping significantly differed among the groups (p < 0.01, Kruskal-Wallis test). Therefore, late adolescent patients with TMDs have higher pain intensity in the orofacial region and greater difficulty in ADL than do early adolescent and juvenile patients with TMDs.

Comparison of patients with orofacial pain of different diagnostic categories.

The authors compared the pain intensity and difficulty experienced in performing activities of daily living (ADL) among 237 patients with orofacial pain. The patients underwent comprehensive examinations and recorded their subjective symptoms on a form (five items for pain intensity and six for ADL-related difficulty). On the basis of the primary diagnosis, the patients were divided into the temporomandibular joint dysfunction (TMJ), myofascial pain (MP), neuropathic pain (NP), and fibromyalgia (FM) groups. The intensity of pain in the jaw/face, tightness in the jaw/face, pain in the neck, and toothache significantly differed among the groups (p < 0.01, Kruskal-Wallis test). Compared to other patients, the FM and NP groups reported greater pain intensity, whereas those in the TMJ group reported lesser pain intensity. The ADL-related difficulty was not significantly different among the groups. Thus, compared to pain due to joint-related disorders, myalgic and neuropathic pain seem to be of higher intensity.

Rapid prototyping of robust and versatile microfluidic components using adhesive transfer tapes.

A rapid prototyping technique of microfluidic devices is presented using adhesive transfer tapes. Lab on a chip systems can integrate multiple microfluidic functions in a single platform. Therefore, any rapid prototyping technique should be flexible and robust to accommodate different aspects of microfluidic integrations. In this work, the versatility of using adhesive transfer tapes for microfluidic applications is demonstrated by fabricating a wide range of platform. Prototypes demonstrating microfluidic mixing, dielectrophoretic trapping, complex microchannel networks and biologically relevant high temperature reactions were fabricated in less than 30 min. A novel ready to use world-to-chip interface was also developed using the same fabrication platform. All components (e.g. tapes, electrodes, acoustic sources or heaters) were obtained as finished products alleviating any chemical or clean-room specific processing. Only a 2D CAD software, a CO2 laser cutter and a seam roller was utilized to fabricate the devices. Adhesive transfer tapes provide additional flexibility compared to common double sided tapes as they do not contain any carrier material layer. Demonstrated ability to sustain in a wide range of dynamic physical processes (mechanical, electrical, or thermal) validates the robustness and the versatility of adhesive transfer tapes as an option for developing integrated lab on a chip systems.

Comparison of subjective symptoms among three diagnostic subgroups of adolescents with temporomandibular disorders.

AIM: To compare subjective symptoms among three diagnostic subgroups of young patients with temporomandibular disorders (TMDs). DESIGN: We comprehensively examined 121 patients with TMDs (age ≤20 years; 90 female patients and 31 male patients) who completed self-reported forms for assessing subjective symptoms, which consisted of five items on pain intensity in the orofacial region and six items on the level of difficulty in activities of daily living (ADL) (rating scale, 0-10). They were divided into three diagnostic subgroups: temporomandibular joint (TMJ) problem (JT) group, masticatory muscle pain (MM) group, and the group with a combination of TMJ problems and masticatory muscle pain (JM group). Their symptoms were compared using the Kruskal-Wallis and Mann-Whitney U-tests. RESULTS: The intensity of jaw or face tightness and difficulty in talking and yawning were not significantly different among the groups. However, the MM and JM groups had a significantly higher rating for jaw or face pain, headache, neck pain, tooth pain, and difficulty in eating soft foods (P < 0.01). CONCLUSIONS: Young patients with MM or JM report more intense pain in the orofacial region and have more difficulties in ADL than those with JT problems alone.

Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: The aim of this study is to perform a qualitative and quantitative analysis of the scientific literature regarding the use of acupuncture in the treatment of pain associated with temporomandibular disorders (TMDs). METHODS: By using electronic databases, the goal was to search and evaluate all the randomized controlled trials (RCTs) in which acupuncture was used in the management of pain attributed to these clinical entities. For the meta-analysis, an adequate description of the results' statistical data was required along with a comparison of the treatment with a control group using a placebo or sham. Two independent reviewers evaluated the quality of the studies using the Jadad scale. RESULTS: A total of 8 RCTs were selected, and the quality of only 4 was considered acceptable. These 4 studies showed positive results such as reducing pain, improving masticatory function, and increasing maximum interincisal opening. By combining the studies (n=96) and analyzing the results, it was concluded that acupuncture is more effective than placebo in reducing pain intensity in TMD (standardized mean difference 0.83; 95% confidence interval, 0.41-1.25; P=0.00012). DISCUSSION: The results of this meta-analysis suggest that acupuncture is a reasonable adjunctive treatment for producing a short-term analgesic effect in patients with painful TMD symptoms. Although the results described are positive, the relevance of these results was limited by the fact that substantial bias was present. These findings must be confirmed by future RCTs that improve the methodologic deficiencies of the studies evaluated in this meta-analysis.

Chronic myofascial temporomandibular pain is associated with neural abnormalities in the trigeminal and limbic systems.

Myofascial pain of the temporomandibular region (M-TMD) is a common, but poorly understood chronic disorder. It is unknown whether the condition is a peripheral problem, or a disorder of the central nervous system (CNS). To investigate possible CNS substrates of M-TMD, we compared the brain morphology of 15 women with M-TMD to that of 15 age- and gender-matched healthy controls. High-resolution structural brain and brainstem scans were carried out using magnetic resonance imaging (MRI), and data were analyzed using a voxel-based morphometry approach. The M-TMD group evidenced decreased or increased gray matter volume compared to controls in several areas of the trigeminothalamocortical pathway, including brainstem trigeminal sensory nuclei, the thalamus, and the primary somatosensory cortex. In addition, M-TMD individuals showed increased gray matter volume compared to controls in limbic regions such as the posterior putamen, globus pallidus, and anterior insula. Within the M-TMD group, jaw pain, pain tolerance, and pain duration were differentially associated with brain and brainstem gray matter volume. Self-reported pain severity was associated with increased gray matter in the rostral anterior cingulate cortex and posterior cingulate. Sensitivity to pressure algometry was associated with decreased gray matter in the pons, corresponding to the trigeminal sensory nuclei. Longer pain duration was associated with greater gray matter in the posterior cingulate, hippocampus, midbrain, and cerebellum. The pattern of gray matter abnormality found in M-TMD individuals suggests the involvement of trigeminal and limbic system dysregulation, as well as potential somatotopic reorganization in the putamen, thalamus, and somatosensory cortex.

Randomized clinical trial of acupuncture for myofascial pain of the jaw muscles.

AIMS: To evaluate the effectiveness of acupuncture in treating symptoms associated with myofascial pain of the jaw muscles. METHODS: Twenty-eight subjects over the age of 18 and diagnosed with chronic myofascial pain of the jaw muscles were randomized to receive real (n = 16) or sham (n = 12) acupuncture. Prior to treatment, each subject clenched his or her teeth for 2 minutes. Acupuncture or sham acupuncture was then administered at the Hegu large intestine 4 (LI4) acupoint for 15 minutes. Real acupuncture was given by penetrating the needle through a sticky foam pad at the acupoint. Sham acupuncture was conducted by pricking the skin, without penetration, with a shortened, blunted acupuncture needle through a foam pad placed away from the acupoint. General head and neck pain ratings were obtained before and after treatment on a numerical rating scale. A mechanical pain stimulus on the masseter muscle was given before and after treatment and rated on a visual analog scale to measure pain tolerance level. Paired t tests were performed to detect significant changes in pain levels. RESULTS: Subjects receiving real acupuncture experienced a significant reduction in jaw pain (P = .04), jaw/face tightness (P = .04), and neck pain (P = .04), and a significant increase in pain tolerance of the masseter muscle (P = .001). Subjects were not able to determine whether they received real or sham acupuncture (P = .69). No significant pain reductions were observed in the sham acupuncture group. CONCLUSION: A single acupuncture session using one acupoint at Hegu large intestine 4 significantly reduced most myofascial pain endpoints when compared to sham acupuncture.

Topical review: placebo responses and therapeutic responses. How are they related?

This article presents a comprehensive review of the topic of placebos, with a special focus on placebo analgesia. It includes a discussion of how placebos work (the placebo effect) and how patients react to them (the placebo response). A literature search was performed to identify relevant literature and publications related to the topic, and a qualitative assessment of papers was undertaken based on accepted rules for scientific evidence. The major finding from this review was that concepts about placebo effects and responses have changed dramatically over the years, especially in more recent years. This has occurred primarily as a result of more sophisticated experimental protocols using placebos in clinical studies of patients in pain, as well as various studies involving normal subjects. Our understanding of the biological and psychological mechanisms underlying placebo effects has expanded significantly due to recent developments in the technology of brain imaging. Based on findings from brain-imaging analyses, we now know that placebo analgesia is definitely a real (i.e., biologically measurable) phenomenon. It can be pharmacologically blocked and behaviorally enhanced, and these responses have been demonstrated to be similar to those elicited by administration of "real" analgesic substances. Psychological mechanisms involved in placebo analgesia include expectancy, meaning response, and classical conditioning. This article concludes with an emphasis on understanding therapeutic responses to various treatments for temporomandibular disorders (TMD). Acupuncture and splint therapy can be good examples of powerful placebos in the field of TMD, and both of these are discussed in detail. Present knowledge suggests that every treatment for pain contains a placebo component, which sometimes is as powerful as the so-called "active" counterpart. While the deceptive use of placebos must be considered unethical, every health provider who is treating pain patients must be aware of this important phenomenon in order to harness its huge potential.

The short-term effects of acupuncture on myofascial pain patients after clenching.

AIM: Short-term pain reduction from acupuncture in chronic myofascial pain subjects was evaluated using an 11-point (0 to 10) numeric rating scale, visual analog scale (VAS), and pain rating of mechanical pressure on the masseter muscle. METHODS: A single-blind, randomized, controlled, clinical trial with an independent observer was performed. Fifteen chronic myofascial pain subjects over the age of 18 were randomly assigned into groups: nine subjects received real acupuncture; six subjects received sham acupuncture. Each subject clenched his/her teeth for 2 minutes. Acupuncture or sham acupuncture was administered at the Hegu Large Intestine 4 acupoint. Sham acupuncture was conducted by lightly pricking the skin with a shortened, blunted acupuncture needle through a foam pad, without penetrating the skin. The foam pad visually conceals the needle's point of the entry, so that the subject cannot discern which technique is being used. The subjects rated their general pain on a numeric rating scale. A mechanical pain stimulus was applied with an algometer and the subject rated his/her pain on a VAS. Statistical analysis was performed using the repeated measures anova, paired t-tests, and Fisher's exact test as appropriate. RESULTS: There was a statistically significant difference in pain tolerance with acupuncture (P = 0.027). There was statistically significant reduction in face pain (P = 0.003), neck pain (P = 0.011), and headache (P = 0.015) with perception of real acupuncture. CONCLUSION: Pain tolerance in the masticatory muscles increased significantly more with acupuncture than sham acupuncture.

Oral disease prevalence among HIV-positive American Indians in an urban clinic.

Abstract-According to Centers for Disease Control and Prevention (CDC) estimates, there have been almost 930,000 AIDS cases diagnosed at the end of 2003 in the United States. About 3,000 of those infected were American Indian and Alaska Natives (AI/ANs). Persons with HIV and AIDS have been shown to have increased risk of dental and periodontal disease. Unfortunately, there are no publications on dental disease and AI/ANs with HIV/AIDS. This study addresses this shortcoming by examining the relationship between dental health, drug use, and HIV among AI/AN patients in an urban setting. The study included a consecutive chart review of 51 AI/AN HIV-positive dental patients seen from 2001 to 2004 at the Native American Health Center in San Francisco. Results showed that 55% had moderate or severe periodontal disease, 80.4% had tooth decay, and 88.2% had missing teeth. Substance users had more dental caries or decayed teeth than non-substance users (88% versus 73%). The average rate for decayed, missing or filled teeth (DMFT) among the total sample was 18.73%. This chart review study suggests that dental disease is more prevalent in AI/ANs with HIV/AIDS when compared to the general population and AI/AN data from the Indian Health Service.