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.

Persistent Toothache Despite Multiple Dental-related Treatments: How Could this Be?

Patients with recurrent or persistent dentoalveolar pain usually believe that endodontic treatment or extracting a tooth will alleviate it, and most cannot conceive that the pain might not be tooth related. Understanding that dental procedures of any kind will be ineffective when a tooth-related pathology is ruled out and that a nonodontogenic etiology best explains the "toothache" pain goes against their beliefs. In this article, we present an overview of basic concepts to help manage such cases by briefly outlining possible causes of nonodontogenic pain as well as diagnostic pitfalls that may lead to questionable treatments. The decision to provide dental treatment is justified only when definitive peripheral mechanisms driving the pain are uncovered and the multitude of factors that might contribute to the various presentations of persistent dental pain have been considered. Otherwise, patients might be managed with treatments that are not the norm for those with unremitting tooth pain in general dental practice. We also make suggestions for clinicians to assure that patients with recurrent or persistent dental pain receive a thorough work-up that considers odontogenic and nonodontogenic sources to arrive at the correct diagnosis before treatment, taking psychosocial factors into account when devising the treatment plan.

The lockdown effect: The impact of the COVID-19-related confinement on the nature of dental emergencies and the number of patients seen at the Geneva university hospital's dental clinic.

PURPOSE: The aim of this retrospective case study was to evaluate the impact of the COVID-19 confinement on consultation number and nature of dental emergencies. MATERIALS AND METHODS: The investigators implemented a retrospective case-control study and enrolled a sample of patients who presented to the University Hospital of Geneva for dental emergencies during the COVID-19 confinement from March 16 to April 26, 2020. They were compared to a matched case-control group treated in 2018 and 2019. The predictor variable was the COVID-19 confinement. The outcome variables were consultation number and nature of dental emergencies. Other study variables included age, gender, socio-economic status, delay from symptoms to consultation and type of treatment. Descriptive and bivariate statistics were computed and significance level was set at ≤ 0.05. RESULTS: The study sample was composed of 1104 patients, with 386 in the case-study and 718 in the control group. No significant change in patient numbers was observed. In the case-study group patients were significantly younger (P= 0.004), had a significantly higher proportion of acute toothache and dental infections (P= 0.01), the main reason for consultation was pain or swelling (P= 0.01) and the delay from first symptoms to consultation was shorter compared to the controls (P=0.008). CONCLUSION: The COVID-19 confinement had no impact on the consultation number of dental emergencies. However, changes in emergency type were noted, with an increase in acute toothaches and infections and patients waited less time between the onset of symptoms to consultation.

Estudio observacional transversal sobre el uso de homeopatía en un servicio de urgencias pediátricas / Observational and cross-sectional study on the use of homeopathy in a paediatric emergency care service

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Prevalence of Self-medication Practices for Oral Health Problems among Dental Patients in a dental college: A Descriptive Cross-sectional Study.

INTRODUCTION: Self-medication means the use of medications for the treatment of any disease on their own, without consulting any healthcare professional. At times self-medication can be useful if practiced correctly by saving time and money, whereas disadvantages often occur due to lack of evaluation by trained medical professionals and delay ineffective treatment and can result in unnecessary expenses and drug dependence. This study was conducted to find out the self-medication behavior and its associated factors among patients visiting a dental hospital in Kathmandu. METHODS: A hospital-based, cross-sectional study was conducted on 265 patients in Kantipur Dental College from December 2019 to January 2020 among the patients attending the dental Out Patient Department. Ethical clearance was obtained from the Institutional Review Committee of Kantipur Dental College. A convenience sampling technique was used. Proformas were prepared in English, translated to Nepali and re-translated to English by the back-translation method. Data entry was done in Microsoft Excel and analysis in SPSS 20. Descriptive statistics was done. RESULTS: The prevalence of self-medication practice was found to be 166 (62.6%). Out of total participants, 99 (59.6%) consumed medicines for few days only and the most common triggering factor was found to be toothache in 101 (60.8%) participants. The most common reason for selfmedication was found to be a previous experience of treating similar illnesses. CONCLUSIONS: The prevalence of self-medication was found to be low as compared to the study done in similar settings. Self-medication practice is a sensitive issue that hasn't been given the required consideration.

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.

Managing tooth pain in general practice.

Tooth pain is a common presentation in primary care, with 32.4% of Singaporeans experiencing pain from dental caries in their lifetime. Some systemic conditions can have oral presentations, and oral conditions may be associated with chronic disease. A good history and examination is key in delineating odontogenic from non-odontogenic causes of tooth pain. Primary care physicians should accurately diagnose and assess common dental conditions and make appropriate referrals to the dentist. Common non-odontogenic causes of orofacial pain can be mostly managed in primary care, but important diagnoses such as acute coronary syndrome, peritonsillar abscess and temporal arteritis must not be missed. Ibuprofen has been shown to be effacious, safe and cost-effective in managing odontogenic pain. Antibiotics are indicated when there is systemic or local spread of dental infection. Without evidence of spread, antibiotics have not been shown to reduce pain or prevent subsequent dental infections.

Self-diagnosis & pain management in dental students in Riyadh, KSA.

INTRODUCTION: Self-diagnosis and pain management is a worldwide practice. The current study aims to determine the percentage of dental students and interns who self-diagnose and manage their dental pain and further establish the proportion of students who depend on various resources for diagnosing and treating their condition. METHODS: A cross-sectional, self-administered questionnaire-based study was conducted among the dental students in and around Riyadh. The questionnaire consisted of three parts including: part 1-demographic data; part 2-pain and self-diagnosis; part 3-visiting the dentist and managing the pain. The data were analyzed using the Statistical Package for Social Sciences (SPSS version 22.0). RESULTS: Fifty four percent of the participants were involved in self-diagnosis and managed the pain by themselves. Seventy three percent of the respondents experienced teeth/gum discomfort or any symptoms of an oral health problem, of which 57% searched the symptoms they faced on the internet to arrive at a diagnosis. Besides, 35% of the interns considered internet to be a helpful tool for diagnosing their pain. 16% admitted that they have never visited a dentist. CONCLUSION: We found that a significant proportion of the participants self-diagnosed by using their background or resorting to the internet, at times consulting a dentist to confirm their diagnosis. The students from the health sciences background should refrain from this practice. Efforts should be made to make the population mindful of the potential risks linked to self-medication and diagnosis. Further research should be done with a larger sample size by including the students and interns from different institutions.

Ancillary factors in the treatment of orofacial pain: A topical narrative review.

Ancillary factors, not directly related to treatment, often play a significant role by affecting therapeutic outcome. A search of the literature was conducted including words related to the placebo phenomenon and orofacial diseases. Therefore, critical factors have been grouped into three major categories: (a) the natural course of the diseases; (b) the regression of the symptoms to their mean intensity; and (c) placebo response. This topical narrative review describes the elements mentioned above, provides an up-to-date overview of the hot topics and gaps in the field and indicates developing and future research direction of the orofacial pain field. Such a knowledge might be positively used during daily clinical practice to optimise the management of orofacial pain diseases, as well as in conducting future clinical trials for validating new interventions.

What do people do before going to the dentist? qualitative study of cultural practices of pain relief in primary care

Objective: to describe and classify the main cultural practices used to relieve orodental pain in people who seek emergency dental care in vulnerable urban and rural areas of central Chile. methodology: a sample of 88 adults residing in urban and rural sectors, who received treatment at primary care emergency dental services in three districts of the central area of Chile was studied using a qualitative descriptive approach of sociocultural epidemiological orientation based on grounded theory. interviews were conducted in the waiting room of the emergency service or at the patient's home. empirical saturation and triangulation of temporal data were protected. results: practices of biomedical origin (self-medication and care received at dental emergency services) and socio-cultural practices were documented. they include the use of chemical products (iodine, phosphorus, battery acid, hydrogen peroxide, gasoline, and alcoholic drinks, among others), herbal infusions (buddleja globosa, aloe vera), mechanical-physical techniques (use of cold or heat, massage); subjects also perform the mechanical manipulation of the area with sharp objects, occasionally extracting the tooth itself. practices occur more frequently at home when the person feels the pain in the affected area, and end on the dental chair with the tooth extraction. conclusions: the coexistence of biomedical practices and alternative cultural strategies was observed. these practices complement each other and make people postpone seeking professional dental care, which may worsen their health condition.

Put a Frog in Your Mouth: Toothache 'Cures' from Nineteenth- and Twentieth-Century Ireland.

During the late nineteenth and early twentieth centuries, toothache must have been a common complaint in Ireland, to judge from the number of toothache 'cures' reported as part of The Schools' Collection (SC) or 'Bailiúchán na Scol', a folklore-collecting scheme that was undertaken in the Irish Republic in 1937 and 1938, and upon which this article is based. These cures range from quasi-medical treatments, such as packing the affected tooth with tobacco, to more folkloric, or magico-religious cures, such as licking a frog or pulling out a tooth from a corpse, as well as herbal and mineral remedies.

Midface migraine with concomitant dental disease: A report of two cases.

BACKGROUND: Numerous publications have reported on migraines misdiagnosed as endodontic pathologies. However, reports on the effect that concurrent migraine and endodontic pathology can have on each other and how their respective treatments can also affect each other are limited. CLINICAL PRESENTATION: Two cases are reported that presented with both migraine and periapical pathology. Patient 1 underwent root canal treatment, which partially alleviated both the migraine and odontalgia. Subsequent treatment with sumatriptan provided additional relief. Patient 2 underwent sumatriptan treatment, with no effect. Subsequent root canal treatment provided significant relief. Patients in both cases have shown continued improvement. CONCLUSION: Further research is necessary, but the two cases presented suggest that endodontic pathology and migraine symptoms may be associated and endodontic therapy may have an effect on migraine pain.

Paediatric dental emergencies: a retrospective study and a proposal for definition and guidelines including pain management.

AIM: This was primarily to perform a retrospective analysis of 1000 emergency dental visits in order to characterize the nature of the dental emergency and the treatment provided and secondly to define a guideline for dental emergency treatment in children including pain management. MATERIALS AND METHODS: A retrospective review was conducted of 1000 patients (aged 0-16 years) who visited the dental emergency service of the paediatric dental clinic at the Ghent University Hospital, Belgium over a period of 3 years. Data regarding age, gender, reason for visit, year of visit, consequent appointments and treatment provided were collected. Statistical analysis was carried out using descriptive statistics (frequency distribution) and Chi-square test, with significance level set as P < 0.05. RESULTS: The number of patients visiting with a dental emergency increased annually. Approximately half (50.2%) of all paediatric dental emergency consultations were based on pain due to caries and its consequences. More than a quartile (26.7%) of emergency patients suffered from dental trauma of either primar or permanent teeth. The majority (96.7%) of the patients reported pain, 16.3% of the patients did not necessarily need immediate attention. CONCLUSION: Dental emergencies in a university hospital based setting were predominantly related to caries and trauma. A precise definition of dental emergencies is recommended in order to prevent abuse of paediatric emergency services.

Rhinologic and oral-maxillofacial complications from scuba diving: a systematic review with recommendations.

Rhinologic and oral maxillofacial complications from scuba diving are common, representing approximately 35% of head and neck pathology related to diving. We performed a systematic and comprehensive literature review on the pathophysiology, diagnosis, and treatment of rhinologic and oral maxillofacial pathology related to diving. This included complications due to sinus barotrauma, barodontalgia, odontocrexis, temporomandibular joint dysfunction, partially dentulous patients, and considerations for patients following major head and neck surgery. Of 113 papers accessed, 32 were included in the final synthesis. We created a succinct summary on each topic that should inform clinical decision making by otolaryngologists, dive medicine specialists and primary care providers when faced with pathology of these anatomic sub-sites.

Postdural Puncture Headache Treated With Epidural Blood Patch and Subsequent Resolution of Atypical Odontalgia: A Case Report.

A 37-year-old gravida 5 para 4 with gestational hypertension underwent uneventful repeat cesarean delivery and tubal ligation under combined spinal-epidural anesthesia. On postoperative day 3, she developed a postural headache, unrelieved by caffeine, ibuprofen, and hydration. On postoperative day 8, she returned to the hospital for treatment. An epidural blood patch was administered, providing immediate and complete relief of her headache and bilateral upper and lower dental pain, which she noted arising concomitantly with her headache. We suspect bilateral traction on cranial nerve V2 and V3, secondary to intracranial hypotension after dural puncture, as the cause of her pain.