Toothache prevalence and associated factors: a population based study in southern Brazil

Objectives:  The aim of this study was to estimate toothache prevalence and associated factors among adult residents in Pelotas, a southern Brazilian city.
Methods:  A cross-sectional population-based study was carried out in individuals aged ≥20 years ( n  = 3353). A multi-stage sampling scheme was adopted, and data collection was performed at participants' homes through standardized pre-tested questionnaires. Toothache in the past 6 months was regarded as the outcome. Socioeconomic and demographic data as well as health-related behavioural data were collected. All analyses were undertaken with a Poisson regression model, following a hierarchical conceptual model.
Results:  The response rate was 93.5% and toothache prevalence was 17.7% (95% CI 16.0–19.3). Multivariable analyses revealed that toothache was more likely to be reported by those with low educational attainment and low family income. Younger subjects, women and black people were also more likely to report toothache. Current smokers and problem drinkers were at increased risk of experiencing toothache in the past 6 months.
Conclusions:  The toothache prevalence reported in the present study is not negligible and should initiate the formulation of preventive policies and support the planning of local oral health services.     

Toothache induced by an angioleiomyoma of the nasolabial groove: a case report

Angioleiomyoma, a benign soft tissue tumor composed of smooth muscle cells and vascular endothelium, occurs most commonly in the extremities, the lower leg being a common site of occurrence. It rarely is found in the head and neck area, especially in the nasolabial groove. Surgical excision is the gold standard for diagnosis and treatment of angioleiomyoma; a preoperative diagnosis may be difficult. Here, a case of angioleiomyoma found in the nasolabial groove and associated with toothache is presented.     

Toothache pain: a comparison of visits to physicians, emergency departments and dentists

BACKGROUND: Researchers' understanding of the use of emergency departments (EDs) and physicians' offices for the treatment of toothaches is limited. The authors conducted a study to explore their use by low-income and minority adults in comparison with the use of traditional dental services. METHODS: Participants included low-income white, African-American and Hispanic adults who had experienced a toothache during the previous 12 months. A stratified random sample of 4,200 households in Maryland participated in a cross-sectional telephone survey. Trained survey staff completed interviews with someone in 272 (68.3 percent) of 398 eligible households. RESULTS: Only 8.7 percent of respondents contacted an ED for toothache pain relief, while 20.1 percent contacted physicians. The majority of respondents who contacted an ED (80.5 percent) or a physician (82.6 percent) also contacted a dentist. Contacts with a dentist were reported by 58.6 percent of respondents. The authors conducted tabular analyses using chi(2) tests of statistical significance (P < .05) and SUDAAN's multivariable logistic regression procedure (Research Triangle Institute, Research Triangle Park, N.C.) (P < .05). CONCLUSIONS: Respondents experiencing toothache pain ultimately sought definitive resolution of their pain from dentists while visiting EDs and physicians for temporary relief. Access to dentists' services was particularly problematic for Hispanics and was exacerbated by health literacy issues. CLINICAL IMPLICATIONS: The elimination of oral health disparities must involve consideration of cultural influences on minority populations, as well as the responsibilities of the dental profession.     

The role of the microscope in 21st century endodontics: visions of a new frontier

In endodontics, the microscope is indispensable. Clinicians are discovering that every facet of endodontics is better, safer, and easier. Microscopic endodontics is a new technology that emphasizes visual information, rather than tactile information. The learning curve can be fairly steep, but it is one worth climbing. Future controlled studies should document an improvement of endodontic outcomes. This is becoming more true as dentistry becomes more extensive and expensive, and needs to last longer and longer. The days of "easy cases" are much fewer, even for the general practitioner. Lastly, there is a groundswell conversation, at least in the endodontic community, that the benefits of the microscope are beyond biology. Clinicians experience a greater sense of personal and professional fulfillment because they are not achieving what is "good enough," but aspiring to "what is possible."     

Pharmacology at the beginning of the 21st century: implications of several new developments for dentistry and current status of the major 20th century dental drugs

This review has highlighted some of the developments in pharmacology likely to impact dentistry as we enter the 21st century. While dentistry will naturally lag behind medicine in the introduction of new drugs, we must constantly explore all information resources available to keep abreast of developments in pharmacology that will affect our patients and our use of drugs in dental practice. This century will abound with new therapies, some of which will hopefully lead us out of our tradition of using rather non-selective, widely distributed chemicals with multiple actions and side effects into an age of highly-selective therapies, including the repair and replacement of defective genetic determinants of disease with healthy ones.