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Beecroft EV, Edwards D, Allison JR. Other Secondary Headaches: Odontogenic Pain and Other Painful Orofacial Conditions. Neurol Clin 2024; 42:615-632. [PMID: 38575270 DOI: 10.1016/j.ncl.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
This article discusses extremely common odontogenic pain conditions, which may occasionally present to the neurology clinic mimicking headache, and other uncommon orofacial pain conditions, which may do the same. Typical presentations, investigative strategies, and management are discussed, as well as highlighting key diagnostic criteria and the importance of involving oral or dental specialists where diagnostic uncertainty exists.
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Affiliation(s)
- Emma V Beecroft
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom.
| | - David Edwards
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - James R Allison
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
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Edwards D, Rasaiah S, Kirkevang LL, Vaeth M, Stone SJ, Obara I, Durham J, Whitworth J. The use of medicaments in the management of symptomatic irreversible pulpitis: A community-based cohort study. Int Endod J 2024; 57:416-430. [PMID: 38214015 DOI: 10.1111/iej.14020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
AIM To investigate patient outcomes from either pulpotomy or pulpectomy for the management of symptomatic irreversible pulpitis, with and without application of antibiotic/corticosteroid pastes in urgent primary dental care settings in the United Kingdom. METHODOLOGY All patients receiving intervention for symptomatic irreversible pulpitis in three different primary care settings were invited to participate. Pre-operatively, data regarding patients' numerical ratings scale (NRS), pain score (0-10), analgesic use, oral-health impact profile-14 (OHIP-14) and need for time away from work were collected. For 7 days post-operatively, participants recorded their NRS pain score, global rating of change score, medication use and their ability to work. Analysis used a mixed-effects model with post hoc Tukey's multiple comparisons test for continuous data and chi-squared or Fisher's exact test for categorical data. To test the effect of the corticosteroid/antibiotic paste, pulpectomy and pulpotomy groups were combined following Mantel-Haenszel stratified analysis or a weighted average of the difference between pulpotomy and pulpectomy with and without the use of corticosteroid/antibiotic paste. A binary composite score was constructed using pre- and post-operative data, whereby overall treatment success was defined as: (i) patients did not return for treatment due to pain by day seven; (ii) at day three, there was a 33% (or 2-points) reduction in NRS pain score; (iii) there was a change score of +3 in global rating; (iv) the patient was no longer using analgesia and able to return to work. RESULTS Eighty-five participants were recruited, with 83 completing follow up. Overall treatment success was 57%, with 25% of participants returning for more treatment due to inadequate pain relief. Overall treatment success did not differ between the two groups (p = .645), although patients self-reported greater improvement with an antibiotic/corticosteroid dressing for global rating of change (p = .015). CONCLUSIONS This study identified limited evidence of improved outcomes using antibiotic/corticosteroid dressings in the management of symptomatic irreversible pulpitis in the emergency setting. Further clinical research is needed to understand if these medications are beneficial in affording pain relief, above that of simple excision of irreversibly inflamed pulp tissue.
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Affiliation(s)
- David Edwards
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Sabrina Rasaiah
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Michael Vaeth
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Simon J Stone
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ilona Obara
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - John Whitworth
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Xie Z, Jiang W, Liu H, Chen L, Xuan C, Wang Z, Shi X, Lin Z, Gao X. Antimicrobial Peptide- and Dentin Matrix-Functionalized Hydrogel for Vital Pulp Therapy via Synergistic Bacteriostasis, Immunomodulation, and Dentinogenesis. Adv Healthc Mater 2024:e2303709. [PMID: 38431770 DOI: 10.1002/adhm.202303709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/20/2024] [Indexed: 03/05/2024]
Abstract
The preservation of vital pulps is crucial for maintaining the physiological functions of teeth; however, vital pulp therapy (VPT) of pulpitis teeth remains a substantial challenge due to uncontrolled infection, excessive inflammation, and limited regenerative potential. Current pulp capping agents have restricted effects in the infectious and inflammatory microenvironment. To address this, a multifunctional hydrogel (TGH/DM) with antibacterial, immunomodulatory, and mineralization-promoting effects is designed. The antimicrobial peptide (AMP) and demineralized dentin matrix are incorporated into the hydrogel, achieving sustainable delivery of AMP and a cocktail of growth factors. In vitro results show that TGH/DM could kill endodontic microbiota, ameliorate inflammatory responses of human dental pulp stem cells (hDPSCs), and prompt odontogenic differentiation of inflammatory hDPSCs via activation of peroxisome proliferator-activated receptor gamma. In vivo results suggest that TGH/DM is capable of inducing M2 phenotype transformation of macrophages in mice and fostering the regeneration of the dentin-pulp complex in inflamed pulps of beagle dogs. Overall, this study first proposes the synergistic regulation of AMP and tissue-specific extracellular matrix for the treatment of pulpitis, and the advanced hydrogel provides a facile and effective way for VPT.
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Affiliation(s)
- Zhuo Xie
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Wentao Jiang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Hui Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Lingling Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Chengkai Xuan
- School of Biomedical Science and Engineering, National Engineering Research Centre for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510006, P. R. China
| | - Zhenxing Wang
- School of Biomedical Science and Engineering, National Engineering Research Centre for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510006, P. R. China
| | - Xuetao Shi
- School of Biomedical Science and Engineering, National Engineering Research Centre for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510006, P. R. China
| | - Zhengmei Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
| | - Xianling Gao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, P. R. China
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Gardner J, Huang B, Ip RHL. Oral health knowledge is associated with oral health-related quality of life: a survey of first-year undergraduate students enrolled in an American university. BMC Oral Health 2023; 23:961. [PMID: 38044424 PMCID: PMC10693701 DOI: 10.1186/s12903-023-03721-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Oral health knowledge forms part of oral health literacy that enables individuals to inform appropriate oral health decisions and actions. Oral health-related quality of life (OHRQoL) characterizes self-perception of well-being influenced by oral health. This study aimed to examine the relationship between oral health knowledge and OHRQoL. METHODS A random sample of 19-to-24-year-old first-year undergraduate students (n = 372) in Minnesota, United States of America was used. Each student was assessed with an online survey using the Comprehensive Measure of Oral Health Knowledge (CMOHK) and the OHRQoL items of the World Health Organization (WHO) Oral Health Questionnaire for Adults. Relationships between OHRQoL parameters and CMOHK together with other covariates were assessed using ordinal regression models. Associations between OHRQoL parameters were examined with the Kendall's tau-b method. RESULTS Dry mouth (45%) was the most reported OHRQoL issue. The respondents showing good oral health knowledge were less likely to experience speech or pronunciation difficulty (β=-1.12, p = 0.0006), interrupted sleep (β=-1.43, p = 0.0040), taking days off (β=-1.71, p = 0.0054), difficulty doing usual activities (β=-2.37, p = 0.0002), or reduced participation in social activities due to dental or oral issues (β=-1.65, p = 0.0078). CONCLUSIONS This study suggested a protective effect of better oral health knowledge on specific OHRQoL issues. In addition to provision of affordable dental services, university-wide oral health education can be implemented to improve OHRQoL in undergraduate students.
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Affiliation(s)
- Jenna Gardner
- School of Dentistry, University of Minnesota Twin Cities, 515 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Boyen Huang
- School of Dentistry, University of Minnesota Twin Cities, 515 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Ryan H L Ip
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
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