General medical practitioners are quickly called upon to manage acute dental pain in emergency situations, for example, domestically or in the rural areas, where it may not be possible for a dentist to provide immediate treatment. Common acute oral problems are usually easy to diagnose therefore simple management of the situation can reduce the pain and further discomforts until a dentist can be called upon. The history and examination can identify most of these problems. Several dental conditions have typical symptoms with different types of pain. Pain is a complex experience consisting of a specific sensation and the reactions evoked by that feeling.
The management of pain in dentistry encompasses some procedural issues, including the delivery of anesthetic and the management of post procedural pain, as well as pain diagnosis, management strategies for orofacial conditions that cause pain in the face and head, and the management of pain in special populations.
One of the vital qualities of a successful dental practice is appropriate pain management. However, there is a significant question on which drugs will be best for treating acute dental pain. If clinicians were to ask, patients might expect a prescription-strength pain medication (usually an opioid) following any dental procedure that involves potentially significant postoperative pain. Because patient satisfaction is the main concern for dentists, not prescribing an opioid pain medication could cause dissatisfaction among certain patients and lead to negative reviews.
Investigation Of Dental Pain
(history and examnations)
When investigating acute dental pain, the history should focus on the pains: location, type, frequency and duration, onset, exacerbation and remission (for example the response to heat or cold), severity, the area of radiation. Also, associated pathology and referred pain should also be considered.
In the examination of dental pain, there are key body parts that need to be scrutinized to be sure that the pain is of dental origin. The tongue, buccal mucosa, the floor of the mouth, hard palate, teeth and periodontal tissues, tonsils, temporomandibular joints, airway, ears, salivary glands and lymph nodes.
Some Tests That Assists In Diagnosis Of Dental Pain
Pulp sensitivity test: Dry ice is placed on the cervical third (neck region) of the tooth crown. A response to the stimulus indicates that the pulpal tissue is capable of transmitting nerve impulses. No response may indicate pulp necrosis.
Percussion test: Using an instrument handle, the tooth is tapped in the longitudinal axis. A painful reaction suggests possible periapical inflammation.
Mobility test: Holding a tooth firmly on the buccal (cheek) and lingual sides between the fingers enable mobility to be assessed. All teeth have a certain amount of mobility.
Palpation: Careful palpation around the area of concern may reveal tenderness and the type and extent of swelling.
Probing: Placing a fine, blunt probe gently into the gingival sulcus surrounding the tooth enables the health of the gingival tissues to be assessed. Bleeding and sulcus depths greater than 3-4 mm indicate gum disease.
Types Of Dental Pains
The different types of dental pains are: Dull, throbbing, persistent pain and Short, sharp, shooting pain.
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