Meeting abstract

Perspectives on Menagement of Dental Pain

P. Coulthard

Abstract

Menagement of pain in dental patients is important. Effective menagement of pain requires an understanding of basic pain mechanisms. The traditional view that pain could be adequately described as resulting from the acrivity in a dedicated pathway originating in peripheral nociceptors has changed. Now a more complex view takes into account the plasticity of the conduction pathways and describes a process that starts with a stimulus and leads to both a sensory and emotional response. This contemporary understanding of pain systems helps clinicians manage pain better. For example, the mechanisms underlying primary hyperalgesia suggest ways to provide optimum pain relief by using a multi-drug approach. Similary, the phenomenon of wind-up, whereby peripheral input may be simplifield as much as twenty times, has lead to the concept of preemptive analgesia and an understanding of the importance of timing analgesic dosing, and the search of novel agents that may block central sensibilisation. The choice of analgesics available to dentists to proscribe or recommend is vast but simple protocols based on best clinical evidence can provide straightforward guidance. Analgesic choice will depend largely on the pain intensity reported or anticipated but will also take into account the patients gneral health. Paracetamol, NSAIDs and codeine are useful for ambulatory dental patients. The dosage and timing of drug administration are important but so too is the information made available to the patient. For example, an understanding of how a patients preoperative anxiety may also exaggerate their postoperative pain emphasises the importance of preoperative menagement of anxiety by simple means as providing appropriate information.

Keywords

Hrčak ID:

2723

URI

https://hrcak.srce.hr/2723

Publication date:

15.9.2003.

Article data in other languages: croatian

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