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The effectiveness of pain relieving treatments given for acute dental pain has been evaluated after 24 hours in 172 patients who presented to a dental hospital emergency department. Patients were contacted by telephone the day after attendance and graded their pain on a scale from 1 (no pain) to 5 (pain much worse). The mean pain scores for each diagnosis of cause of pain were calculated and related to the treatment given. Some 76% of patients were in pain due to the ravages of dental caries of periodontal disease. Overall, 87% received marked or total pain relief and this appeared to depend upon decompression of inflamed tissue. Oral administration of antimicrobial drugs alone produced little or no pain relief within 24 hours and anti-inflammatory analgesics offer poor pain control in these circumstances.

Severe dental attrition has several causes but may be the result of bruxism in neurological or psychological disturbances. Rett's syndrome is an uncommon but increasingly recognised neurological disorder, characterised by acquired microcephaly, progressive dementia, bruxism, and loss of purposeful movements of the hands. A patient with Rett's syndrome who demonstrated masseteric hypertrophy, bruxism, and severe attrition is reported.

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