Toothache

Severe pain and/or swelling following a root canal treatment appointment are serious sequelae. Information varies or is incomplete as to the incidence of these conditions and related factors. In this study, data were collected at root canal treatment appointments on demographics, pulp/periapical diagnoses, presenting symptoms, treatment procedures, and number of appointments. Patients that then experienced a flare-up (a severe problem requiring an unscheduled visit and treatment) had the correlating factors examined. Statistical determinations were by chi-square analysis with significance at 0.05 or less. Nine hundred forty-six visits resulted in an incidence of 3.17% flare-ups. Flare-ups were positively correlated with more severe presenting symptoms, pulp necrosis with painful apical pathosis, and patients on analgesics. Fewer flare-ups occurred in undergraduate patients and following obturation procedures. There was no correlation between patient demographics or systemic conditio...

This clinical trial tested the efficacy and safety of a professional strip-based whitening system (Crest Whitestrips Supreme) using the manufacturer's recommended 3-week treatment regimen. These strips have a higher concentration, but a similar amount of hydrogen peroxide relative to Crest Professional Whitestrips, because the thickness of the gel on strips is reduced. Tooth whitening was measured using the value-oriented VITA Classic Shade Guide before and after treatment. Twenty-nine subjects were treated with either Crest Whitestrips Supreme or placebo strips that did not contain hydrogen peroxide. Participants in the experimental group achieved a mean lightening of nearly eight VITA shades relative to placebo, with minimal side effects.

Severe pain and/or swelling following a root canal treatment appointment are serious sequelae. Information varies or is incomplete as to the incidence of these conditions and related factors. In this study, data were collected at root canal treatment appointments on demographics, pulp/periapical diagnoses, presenting symptoms, treatment procedures, and number of appointments. Patients that then experienced a flare-up (a severe problem requiring an unscheduled visit and treatment) had the correlating factors examined. Statistical determinations were by chi-square analysis with significance at 0.05 or less. Nine hundred forty-six visits resulted in an incidence of 3.17% flare-ups. Flare-ups were positively correlated with more severe presenting symptoms, pulp necrosis with painful apical pathosis, and patients on analgesics. Fewer flare-ups occurred in undergraduate patients and following obturation procedures. There was no correlation between patient demographics or systemic conditio...

Many different classification systems have been advocated for pulp diseases. However, most of them are based on histopathological findings rather than clinical findings which leads to confusion since there is little correlation between them. Most classifications mix clinical and histological terms resulting in misleading terminology and diagnoses. This in turn leads to further confusion and uncertainty in clinical practice when a rational treatment plan needs to be established in order to manage a specific pathological entity. A simple, yet practical classification of pulp diseases which uses terminology related to clinical findings is proposed. This classification will help clinicians understand the progressive nature of the pulp disease processes and direct them to the most appropriate and conservative treatment strategy for each condition. With a comprehensive knowledge of the pathophysiology of pain and inflammation in the pulp tissues, clinicians may accomplish this task with confidence.

The current diversity of opinions in endodontic diagnosis has been a source of interest and academic debate by clinicians and researchers. Currently, no single pulp testing technique can reliably diagnose all pulpal conditions neither it has been proven to be superior in all aspects. Despite improvements of various aspects of this process, there are no historically dramatic changes, or consensus for pulpal status in health or disease in addition to a lack of relative systematic reviews. In this review, the past, present and future most debated and critically questioned issues of endodontic diagnosis are discussed. The aim of this review is to provide insights in future diagnostic modalities and areas for further study in endodontic practice pertinent to diagnosis.

Methods: A subsample of 767 subjects were selected from a community study (n = 1000) which investigated the association between psychological factors and clinical periodontal attachment level (CAL). The sample included subjects with full-mouth mean CAL ≤2 mm ...

The current diversity of opinions in endodontic diagnosis has been a source of interest and academic debate by clinicians and researchers. Currently, no single pulp testing technique can reliably diagnose all pulpal conditions neither it has been proven to be superior in all aspects. Despite improvements of various aspects of this process, there are no historically dramatic changes, or consensus for pulpal status in health or disease in addition to a lack of relative systematic reviews. In this review, the past, present and future most debated and critically questioned issues of endodontic diagnosis are discussed. The aim of this review is to provide insights in future diagnostic modalities and areas for further study in endodontic practice pertinent to diagnosis.

This study compares the incidence, degree, and length of postoperative pain in 300 endodontically treated teeth, with and without apical patency, in relation to some diagnostic factors (vitality, presence of preoperative pain, group, and mandible of treated tooth). Of the questionnaires received back, apical patency was maintained during shaping procedures with a #10 K-file in one group (n = 115) and not in the other (n = 121). There was significantly less postendodontic pain when apical patency was maintained in nonvital teeth. If pain appeared, its duration was longer when apical patency was maintained in teeth with previous pain or located in the mandible. Maintenance of apical patency does not increase the incidence, degree, or duration of postoperative pain when considering all variables together.

Purpose: The purpose of this study was to compare mineral trioxide aggregate (MTA) with calcium hydroxide (Ca(OH)2) clinically and radiographically as a pulpotomy agent in immature permanent teeth (apexogenesis). Methods: Fifteen children, each with at least 2 immature permanent teeth requiring pulp- otomy (apexogenesis), were selected for this study. All selected teeth were evenly divided into 2 test groups. In

There are times when referred pain makes it difficult to locate the source of odontogenic pain. In those situations, additional evaluation or referral is needed to determine the cause of the chief complaint. This article presents two cases that illustrate the difficulty and frustrations of referred pain for both patients and dentists. After a thorough evaluation and diagnosis, the true sources of the patients' chief complaints were identified and treated, leading to complete resolution of their symptoms. These cases emphasize the importance of listening to the patient, obtaining a detailed dental history, collecting comprehensive diagnostic data, and developing an accurate diagnosis before initiating treatment. When a definitive diagnosis cannot be determined, referral may be necessary to provide the best treatment possible.

Methods: A subsample of 767 subjects were selected from a community study (n = 1000) which investigated the association between psychological factors and clinical periodontal attachment level (CAL). The sample included subjects with full-mouth mean CAL ≤2 mm ...

Pattussi MP, Peres KG, Boing AF, Peres MA, da Costa JSD. Self-rated oral health and associated factors in Brazilian elders. Community Dent Oral Epidemiol 2010; 38: 348–359. © 2010 John Wiley & Sons A/SAbstract –  Objective:  Self-rating provides a simple direct way of capturing perceptions of health. The objective of this study was to estimate the prevalence and associated factors of poor self-rated oral health among elders.Methods:  National data from a cross-sectional population-based study with a multistage random sample of 4786 Brazilian older adults (aged 65–74) in 250 towns were analysed. Data collection included oral examinations (WHO 1997) and struct-ured interviews at elderly households. The outcome was measured by a single five-point-response-scale question dichotomized into ‘poor’ (fair/poor/very poor) and ‘good’ (good/very good) self-rated oral health. Data analyses used Poisson regression models stratified by sex.Results:  The prevalence of poor self-rated oral health was 46.6% (95% CI: 45.2–48%) in the whole sample, 50.3% (48–52.5) in men and 44.2% (42.4–46) in women. Higher prevalence ratios (PR) were found in elders reporting unfavourable dental appearance (PR = 2.31; 95% CI: 2.02–2.65), poor chewing ability (PR = 1.64; CI: 1.48–1.8) and dental pain (PR = 1.44; CI: 1.04–1.23) in adjusted analysis. Poor self-perception was also associated with being men, black, unfavourable socioeconomic circumstances, unfavourable clinical oral health and with not using or needing a dental prosthesis.Conclusion:  Assessment and understanding of self-rated oral health should take into account social factors, subjective and clinical oral symptoms.