Dental pain (toothache or odontalgia) is usually the chief
complaint of dental patients following different interventional procedures and
dental diseases. To manage dental pain in clinical practice is a complex part
of dental care. Pharmacological treatment generally prescribed by a dentist to
counter the dental pain can be NASIDS, OTC analgesics and opioid etc. This has
lead the possibility of over prescribing and abuse of analgesics, in particular
the opioid class of medications. On occasion dental pain may be sufficiently
severe to support the use of opioids.
An observational study was performed with certain
objectives which involved both dentist and patients for a 5-day period,
patients were recruited from PEARL Network dentists site. Its objective was to
to evaluate the (1) the post procedural prescriptions pattern of analgesic (Rx
and OTC) and recommendations (OTC) in dental practices (2) to determine
associated effectiveness and side effects of these medications as measured by
patient reported outcomes (PROs).
The inclusion criteria for patient was- 1) Permanent
dentition (erupted 2nd molar teeth). 2) Following one of the seven dental
procedure - (extraction, endodontic therapy, pulp capping, crown preparation,
periodontal surgery, abscess treatment). 3)Expected by the P-I to experience
postoperative pain sufficient to require an analgesic. 4) Able to judge pain
level. 5) Ability and willingness to give verbal consent.
Exclusion Criteria- If someone is under treatment for
medical disorders (dementia, Parkinson's disease, depression, severe anxiety,
or any other medical condition), which according to P-I, would affect the
subject's judgment of postoperative pain. 2) Currently participating in another
dental or medical research study.
Baseline questionnaires were completed by 2765 (99.9%) of
2767 eligible patients, and 2381 (86%) patients responded to the Day 5
follow-up questionnaires.
The estimated data showed NSAIDs, both OTC and
prescribed dosages, could be an adequate
analgesic to treat most postoperative dental
pain. Clinical judgment for the use of opioid should involve the physiological principles related to the
pharmacology of pain and inflammation and may include a central effect.
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