Effect of somatosensory amplification and trait anxiety on experimentally induced orthodontic pain

The perception of pain varies considerably across individuals and is affected by psychological traits. This study aimed to investigate the combined effects of somatosensory amplification and trait anxiety on orthodontic pain. Five‐hundred and five adults completed the State Trait Anxiety Inventory (STAI) and the Somatosensory Amplification Scale (SSAS). Individuals with combined STAI and SSAS scores below the 20th percentile (LASA group: five men and 12 women; mean age ± SD = 22.4 ± 1.3 yr) or above the 80th percentile (HASA group: 13 men and seven women; mean age ± SD = 23.7 ± 1.0 yr) were selected and filled in the Oral Behaviors Checklist (OBC). Orthodontic separators were placed for 5 d in order to induce experimental pain. Visual analog scales (VAS) were administered to collect ratings for occlusal discomfort, pain, and perceived stress. Pressure pain thresholds (PPT) were measured. A mixed regression model was used to evaluate pain and discomfort ratings over the 5‐d duration of the study. At baseline, the LASA group had statistically significantly higher PPT values for the masseter muscle than did the HASA group. During the experimental procedure, the HASA group had statistically significantly higher discomfort and pain. A significant difference in pain ratings during the 5 d of the study was found for subjects in the HASA group. Higher OBC values were statistically significantly positively associated with pain. Somatosensory amplification and trait anxiety substantially affect experimentally induced orthodontic pain.     

Association between optimism and self-reported facial pain

OBJECTIVE: The objective of this study was to assess the association between optimism and self-reported facial pain. MATERIAL AND METHODS: Data were obtained for 5,696 subjects born in 1966 in Northern Finland and included in the study of the Northern Finland Birth Cohort. Data on facial pain were collected using a questionnaire. Optimism was measured using the revised version of the Life Orientation Test. RESULTS: The data showed that optimism was inversely associated with facial pain. Associations were found only among non-depressive subjects. CONCLUSIONS: It can be concluded that optimism is an independent psychosocial determinant of pain experience that should be taken into account in assessing the prognosis of facial pain and its treatment.     

Effect of text message follow-up on patient's self-reported level of pain and anxiety

Objectives:To determine whether a text message reduces the severity of patient self-reported levels of pain and anxiety following initial placement of orthodontic appliances.Materials and Methods:Thirty-nine orthodontic patients were randomly assigned to one of two groups and matched for age, gender, and bracket type (self-ligating vs conventional). The subjects completed baseline questionnaires to ascertain their levels of pain and anxiety before initiating orthodontic treatment. Following the initial appointment, subjects completed the pain questionnaire and anxiety inventory at the same time daily for 1 week. One group received a structured text message showing concern and reassurance, while the second group served as a control and received no postprocedural communication.Results:There was a statistically significant difference in pain in relation to time between the text message group and the control group as it was demonstrated that demonstrated that compared with the text message group, mean pain intensity increased and selfreported discomfort was longer in the control group. Anxiety was determined to be at its peak the day following initial orthodontic appliance placement and gradually tapered off from that time point. No intergroup difference was noted when analyzing anxiety.Conclusions:This study demonstrated that a text message sent from an orthodontic office following initial appliance placement resulted in a lower level of patient''s self-reported pain. Additionally, patient anxiety is at its peak the day following the initial appointment and decreases from that point forward.     

The interdisciplinary approach to oral, facial and head pain

BACKGROUND: Chronic oral, facial and head pain is a common clinical problem, and appropriate diagnosis and management are a challenge for health care professionals. Patients often will first seek the care of dentists because of the pain's localization in the oral cavity and surrounding structures. This article emphasizes the importance of establishing accurate diagnoses and conducting appropriate triage of the patient with complex orofacial pain. CASE DESCRIPTIONS: The authors present two case reports illustrating the complex nature of oral, facial and head pain, and the potential and actual pitfalls in management of this condition. These representative cases demonstrate how orofacial pain--which appears to be localized in the peripheral dental and oral structures--can have extremely complex etiologies involving other anatomical structures, the central nervous system and psychological factors. The reports point to the need for the expertise of a number of specialists in such cases. CLINICAL IMPLICATIONS: If the symptoms and clinical findings do not appear to be consistent with typical oral disease, or if standard treatments do not alleviate the pain, the dental clinician must consider other, more complex orofacial pain diagnoses. The dental professional should not hesitate to make referrals to key specialists or to members of an interdisciplinary team at a pain treatment center who have the expertise to appropriately diagnose and manage chronic oral, facial and head pain.     

The neural mechanisms of oral and facial pain

Pain is a complex and variable phenomenon that can be influenced by many factors. The neural pathways serving pain are not passive conduits, but are part of a dynamic system which can result in different levels of pain resulting from similar injuries under different circumstances. The passage of signals in these pathways may be inhibited or enhanced at almost any level, from the peripheral sensory receptors to the higher centres of the brain. This review will describe recent developments in our understanding of these mechanisms and how this knowledge may be used in controlling pain.     

Instability of self-esteem and affective lability as determinants of self-reported oral health status and oral health-related behaviors

AIM: The aim of the study was to examine the impact of the instability of self-esteem and affective lability on students' self-rated oral health and oral health-related behaviors. METHODS AND MATERIAL: The present study sample consisted of 178 first year medical students. A questionnaire was used to collect information about socio-demographic factors, behavioral factors, self-reported oral health status, the instability of self-esteem, and affective lability. RESULTS: Significant differences were found on the instability of self-esteem and affective lability on the following variables: gender, smoking, anxiety, depression, stress in everyday life, number of extracted teeth, and satisfaction with appearance of one's own teeth (Ps<0.05). The level of instability of self-esteem had a consistent association with the self-reported oral health status and satisfaction with appearance of teeth. The affective lability total score was a determinant of the number of extracted teeth, last toothache, self-rated gingival status, while anger was correlated with the number of current non-treated caries, extracted teeth, toothbrushing, and flossing frequency. CONCLUSIONS: The results indicate there is an increased risk for impaired dental health among subjects with instable self-esteem symptoms or symptoms of anger.     

The self-reported oral health status and behaviors of adults who are deaf and blind

This qualitative study explored perceived oral health, felt need, oral health knowledge and behaviors, and utilization of dental services among a community of deaf and blind adults in Toronto, Canada. Seven adults participated in in depth interviews facilitated by intervenors skilled in communication with people who are deaf and blind. Subjects reported that their oral health was good, however oral health knowledge was poor and daily oral hygiene practices were minimal. Few subjects had ever received dental health education and were largely unaware of how to prevent dental disease. A subsidized dental program enabled subjects to have regular dental visits, though they were concerned about the costs of more complex dental treatment not covered by the program. They also worried about finding an alternative source of care once their eligibility for the program ceased at the age of 65. The presence of the subsidized sympathetic dental program and the facilitative role of intervenors promoted utilization of dental care for many of the subjects who participated in this study. There is a clear need to develop appropriate dental health education programs for this group of people, which would harness the support of the community of deaf and blind people and their intervenors. The interventions need to be sensitive and appropriate for the individual's level of impairment.     

Socioeconomic status and self-reported oral health in Iranian adolescents: the role of selected oral health behaviors and psychological factors

Objectives: This study investigated health inequality for self-reported oral health outcomes among adolescents. The role of oral health behaviors and psychological factors in explaining oral health inequality was investigated using the hypothesis of mediation. Methods: This was a cross-sectional study that used self-completed questionnaires. This study sampled 639 (315 male and 324 female) 15- to 17-year-old adolescents (second and third grade high school students) of both sexes in the city of Sanandaj in the province of Kurdistan, western Iran. Socioeconomic indicators of the study were subjective socioeconomic status, wealth index, and parental education. Oral health behaviors were measured as toothbrushing frequency, dental flossing frequency, and dental visits. Psychological factors were self-esteem, anxiety, and depression. Self-reported oral health outcomes were single item self-rated oral health and the experience of dental pain. Regression analysis was used to test four conditions for the hypothesis of mediation. Results: The results showed that the inequality is present in oral health for some pairs of relationships between socioeconomic status and oral health outcomes. Adjustment for oral health behaviors and psychological factors, individually and simultaneously, led to loss of statistical significance for some pairs of the relationships. However, adjustment for oral health behaviors and psychological factors led to only small changes in the associations between socioeconomic status and self-reported oral health outcomes. Conclusions: This study found a graded oral health inequality, but no strong evidence to support the hypothesis that oral health behaviors and psychological factors mediate oral health inequality for self-reported oral health outcomes.     

Oral health of Bangladeshi women tobacco-with-paan users and self-reported oral pain following tobacco cessation

OBJECTIVES: The study objectives were to assess the oral health status of a sample of UK resident Bangladeshi women tobacco-in-paan users and its relationship to participant age and number of daily paan, to determine the prevalence of oral pain at baseline and at the one-week postcessation follow-up, and to explore the relationship between oral health status and changes in self-reported oral pain at baseline and at the one-week postcessation follow-up. METHODS: Interviews were conducted in Sylheti using fully structured questionnaires and an oral examination was carried out. A quit date was set and nicotine replacement therapy patches (Nicorette 15 mg, Pfizer) were supplied. Age, number of daily paan, and oral pain characteristics, including intensity, frequency, any provoking factors, and associated symptoms were recorded. Oral mucosal lesions (OMLs) and numbers of teeth decayed, missing, filled, and those with recession, abrasion, loss of attachment (LOA), and tooth wear were charted. RESULTS: Fifty-two women took part. The mean age was 42.8 years and number of daily paan with tobacco was 13. Compared to those aged 18-39 years, those aged 40 years and older had poorer oral health. Older adults were significantly more likely to have higher numbers of teeth with recession, abrasion, and LOA greater than 3.5 mm. They were significantly more likely to have an OML at baseline. The prevalence of self-reported oral pain was 26.9 percent at baseline and 51.9 percent at one-week follow-up. Presence of an OML at baseline was a significant predictor of reports of oral pain at the one-week follow-up. Results of stepwise multiple regression analysis confirmed this finding (OR = 3.66; 95% CI = 1.06, 12.621; P = .04). CONCLUSIONS: Reports of oral pain at follow-up during a tobacco cessation program correlate with the presence of OMLs at baseline. Further investigation of this relationship is needed. Access to appropriate dental care, as an aid to successful tobacco cessation, is indicated.     

Plasma beta-endorphin-like immunoreactivity, pain and anxiety following administration of placebo in oral surgery patients

Plasma beta-endorphin was measured in patients undergoing a stressful procedure, the removal of impacted third molars. In patients reporting little pain, endorphin levels increased significantly during surgery, whereas patients reporting pain and anxiety showed little increase in endorphin levels.     

Assessment of oral cancer pain,anxiety, and quality of life of oral squamous cell carcinoma patients with invasive treatment procedure

Purpose

Depending on its stage on diagnosis, oral squamous cell carcinoma (OSCC) might cause excruciating pain and decreased quality of life. As for treatment, the treatment of OSCC might vary from chemotherapy to surgery. The objective of the current study was to assess the preoperative and postoperative oral cancer pain, anxiety, and quality of life of OSCC patients with invasive treatment procedure.

Methods

The current study was conducted by interviewing 21 (10 males; 11 females) patients who had been diagnosed with stage 3 and stage 4 OSCC and about to go through surgery at the inpatient ward of Surgical Oncology Department, Hasan Sadikin Hospital, Bandung, Indonesia. A preoperative and interview was conducted by using the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QOL)-C30, the shortened EORTC QOL Questionnaire for Oesophageal Cancer (OES)18, the visual analog scale (VAS), and the University of California San Francisco (UCSF) Oral Cancer Pain Questionnaire. All data were analyzed to evaluate the preoperative and postoperative effect.

Results

The current study showed a significant decrease of the postoperative oral pain (p?<?0.01) and anxiety level (p?<?0.01), while postoperative patient’ quality of life was significantly (p?<?0.01) increased.

Conclusion

Despite of the invasive procedure that might cause postoperative effect, OSCC patients in the current study showed a better quality of life after cancer removal.

     

Effects of myogenous facial pain on muscle activity of head and neck

This study evaluated the effects of visual input on surface electromyography (sEMG) of some stomathognatic and neck muscles (anterior temporalis, masseter, anterior digastric and sternocleidomastoid muscles) in patients experiencing myogenous facial pain compared with healthy volunteers. All subjects kept the mandible at rest with teeth apart and underwent a 15-s sEMG recording of anterior temporalis, masseter, digastric and sternocleidomastoid muscles. Each recording was carried out with closed and then open eyes. The sEMG activity of each muscle was compared between the two groups. In the study group, anterior temporalis, masseter and sternocleidomastoid sEMG with closed eyes showed higher values compared with controls (p < 0.05). In the study group, left and right anterior temporalis (p < 0.003) and right digastric (p < 0.03) sEMG with open eyes showed higher values than sEMG with closed eyes. In the control group no significant differences were observed between closed and open eyes. In patients with myogenous facial pain, visual input appears to be associated with a significant increase in the sEMG activity of some head and neck muscles.