Endodontic Pain: Clinical Factors Lecture 2

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Questions and Answers

What is a characteristic symptom of irreversible pulpitis?

Acute pain following a warm stimuli

Sensitivity to sweet foods

Spontaneous pain (correct)

Pain relieved by percussion

What factor greatly affects the effectiveness of pain treatment?

Clinician's experience

Patient's pain tolerance

Strength of the clinician-patient relationship (correct)

Type of intervention used

What is the average incidence of pulpal anesthesia in patients with irreversible pulpitis receiving anesthetic blocks in a mandibular tooth?

90%

55% (correct)

70%

30%

What is the effectiveness of the inferior alveolar nerve block in patients with irreversible pulpitis?

30-80% Signup and view all the answers

According to the text, which group is at substantially greater risk for many clinical pain conditions?

Women Signup and view all the answers

What is the common risk factor for pain indicated by clinical studies of multiple pain disorders?

Sex Signup and view all the answers

Which type of pain treatment responses may differ for women and men, as suggested by the evidence?

Pharmacological responses Signup and view all the answers

What was the significant finding of a government study regarding drugs removed from the market from 1997-2000?

They posed greater health risks to women Signup and view all the answers

What is the main concern highlighted in the text regarding pain research based on male rodents?

Lack of applicability to human pain biology Signup and view all the answers

What is the trend observed in the inclusion of male and female rodents in pain research from 2015 to 2019?

Inclusion of female rodents increased Signup and view all the answers

According to the information provided, when should an analgesic be started as a preventive strategy?

At the onset of pain Signup and view all the answers

Which factor can influence a patient's response to endodontic procedures?

Genetics, stress, and immune system Signup and view all the answers

What may be necessary if a patient does not have a numb lip during an endodontic procedure?

Additional mandibular block or supplemental injection Signup and view all the answers

What is the study of how genes affect the way medicines work in the body called?

Pharmacogenomics Signup and view all the answers

According to Hsiao-Wu GW et al. (2007), what is recommended to assess local anesthesia effectiveness during root canal therapy?

The use of a cold test or considering the chief complaint Signup and view all the answers

According to Wallace JA et al. (1985), what may pose a problem with anesthesia during endodontic procedures?

Altered thresholds, resting potentials, and excitability of nerves in inflamed tissue Signup and view all the answers

What has been suggested to be associated with a susceptibility to develop symptomatic dental abscesses?

Genetic factors Signup and view all the answers

What may affect the success rate of anesthesia or the development of persistent apical periodontitis?

Variations in specific genes such as SCN10A and DEFB1 Signup and view all the answers

What can pharmacogenomics help predict?

Drug responses and inform medical decisions Signup and view all the answers

Study Notes

Results of clinical studies suggest that patients with irreversible pulpitis have an 8-fold higher failure rate of local anesthetic injections compared to normal control patients. (Hsiao-Wu GW et al., 2007)
Soft tissue signs, such as a numb lip, are inadequate for assessing pulpal anesthesia during root canal therapy. (Hsiao-Wu GW et al., 2007)
The use of a cold test or considering the chief complaint is recommended to assess local anesthesia effectiveness. (Hsiao-Wu GW et al., 2007)
If a patient does not have a numb lip during an endodontic procedure, additional mandibular block or supplemental injection may be necessary. (Text)
Wallace JA et al. (1985) discussed that nerves in inflamed tissue have altered thresholds, resting potentials, and excitability, which may pose a problem with anesthesia during endodontic procedures.
Strategies for achieving local anesthesia include infiltration, nitrous oxide, oral sedation, and additional or supplemental injections. (Text)
Patient factors, such as genetics, stress, immune system, sex, age, environment, and comorbidities, can influence a patient's response to endodontic procedures. (Text and de Sa AR et al., 2007)
Genetic factors have been suggested to be associated with a susceptibility to develop symptomatic dental abscesses. (Text and Menezes-Silva R et al., 2012)
Variations in specific genes, such as SCN10A and DEFB1, may affect the success rate of anesthesia or the development of persistent apical periodontitis. (Text and Karatas E et al., 2023; Antunes LS et al., 2020)
Pharmacogenomics is the study of how genes affect the way medicines work in the body and can help predict drug responses and inform medical decisions. (Text and NIH, 2013)
Factors such as prior painful dental visits, psychological variables, anxiety, severity and type of pain, social-environmental variables, patient compliance, and placebo effect can influence a patient's response to analgesics and endodontic procedures. (Text and Stamer UM et al., 2012)
Women and men may not be affected in the same way by pain disorders. (Fillingim RB et al., 2011)

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Description

Learn about clinical factors related to endodontic pain in this lecture by Paul A. Rosenberg, DDS. Understand the importance of the clinician-patient relationship in pain treatment and the effectiveness of local anesthesia.