Analgesics used in dental pain

Pain Control In Dentistry - Complete Dental Oral Guide, Dental Treatment, Dentist :: Incisors And Molars

June 11, 2014 – 06:23 pm

How Can I Treat Wisdom Tooth Pain? (with pictures)

Pain Control in Dentistry
Dental Pain is one of the most common reasons driving patients to seek help from a dentist.

Sr. No.

Pain Presentation

Diagnosis

1.

Pain with hot, cold or sweet stimuli lasting for few seconds

Reversible Pulpitis

2.

Spontaneous, localized pain, pain at night, Pain on eating esp. hot food

Irreversible Pulpitis

3.

Localized pain and swelling

Abscess

4.

Pain, erythema, swelling, inflamed gum over partially erupted tooth

Pericoronitis

5.

Pain due to Broken tooth

Tooth Fracture

6.

Loose tooth

Tooth Luxation

Pain can also arise from non dental sources such as myofunctional pain dysfunctional syndrome, maxillary sinusitis, migraine, neuralgias.

The cause of Pain should be diagnosed, followed by the appropriate dental treatment with drugs playing a secondary supporting role.

Analgesics and Non steroidal anti-inflammatory drugs (NSAID’s) are commonly and routinely prescribed to combat dental pain, with Ibuprofen and Paracetmol being the most common. They are known to block the synthesis of Prostaglandins and inhibit Cyclooxygenase. Preoperative administration of NSAID’s may reduce the need for analgesics postoperatively since they are more effective preventing the synthesis of prostaglandins rather than dealing with pain once prostaglandins are already formed.

To diagnose pain, a detailed history of chief complaint backed by clinical examination (presence of caries/swelling) and investigations (like radiographs) is mandatory.
Pain can be caused by Caries, broken tooth, fractured fillings, exposed dentin, cracked cusp, periapical infection, pocket, sinusitis, pericoronitis, impacted food, acute necrotizing ulcerative gingivitis, dry socket, temporomandibular joint disorders.

SHARP, SHORT, SHOOTING PAIN –
Can be caused usually by fluid movement through open dentinal tubules or initial pulpal inflammation due to caries, dentin exposure due to attrition or recession, fractured cusps, fractured restoration, trauma to tooth.
Pain will be associated with hot, cold or sweet stimuli, pain on eating, pain at night, pain on heat/hot, pain relieved only by medications, pain lasting for few minutes or few hours.
Generalized pain could be generalized dentin sensitivity and hence should be investigated accordingly.
Intermittent sharp, shooting pains could be diagnostic of trigeminal neuralgia.

DULL, TRHOBBING, PERSISTENT PAIN –
Such pain can be due to pocket, food impaction, pericoronitis, temporomandibular joint disorders, maxillary sinusitis, acute necrotizing ulcerative gingivitis.

Journey of Dental Decay and Dental Pain –

Decay or caries generally occurs when food remains embedded inside the tooth for a sufficient period of time to enable bacteria present in the mouth to convert it into acids. Once the decay reaches the inner layer of the tooth i.e. dentin, it gives rise to pain and the patient becomes symptomatic. As the decay travels to the pulp, pulp gets inflamed, pain becomes more pronounced and may manifest as sharp, shooting or dull, throbbing caused by a stimulus or spontaneous. Heat or lying down may aggravate such type of pain.

REVERSIBLE PULPITIS –
Initially decay entering the pulp leads to pulpal inflammation and a condition called as reversible pulpitis. Pain which is reversible on withdrawal of the stimulus causing it, is termed as reversible pulpitis. Such pain lasts only for few seconds. Stimulus elicitating such type of pain is generally cold water or cold food items, sweet foods. It can also be transient sensitivity after scaling or dentin hypersensitivity.

Source: www.incisorsandmolars.com

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