An Analysis of Current Analgesic Preferences for Endodontic Pain Management

Mickel, Andre; Wright, Andrew; Chogle, Sami; Jones, Jefferson J.; Kantorovich, Igor; Curd, Francis M.

doi:10.1016/j.joen.2006.07.015

Cited by 28 publications

(22 citation statements)

References 29 publications

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“…(Fig. 2) Non-opioids were more preferred by the dentists when compared to opioids similar to former studies conducted in Nigeria (2013) and America (2006) which may be due to the chances of developing tolerance to opioids or the negative side effects like respiratory depression, mental clouding, Constipation and sedation 6,7 . (Fig.3) The medical condition of the patient should be assessed before proceeding with the dental treatment as it may lead to potential complications when analgesics are prescribed which can be due to drug interactions.…”

Section: Resultssupporting

confidence: 77%

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2016

IJPSR

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Aim: The objective of this survey was to assess the awareness pattern of analgesic administration and the various factors impacting the prescription of analgesics. Materials and methods: Pretested interviewer administered questionnaire was distributed to 100 study subjects consisting of post graduates and dental practitioners in Chennai. The questionnaire was designed to contain questions regarding the most commonly prescribed analgesic in various dental procedures and the various factors taken into account by the dentist while prescribing these analgesic drugs. The data was analysed using SPSS software. Results: In this study, the most commonly prescribed analgesic was paracetamol (78%). 63 % of the dentists preferred non-opioids, 28% preferred opioids and the remaining 9% prescribed both opioids and non-opioids.87% of the dentists have chosen combinations of analgesics. The most commonly prescribed combination was paracetamol with diclofenac(59%). 83% of the dentists preferred topical analgesics. 94% of the dentists took into account, the medical condition of the patient while prescribing analgesics. Special care for pediatric patients was given by 97% of the dentists. Among factors like age, gender, economic status and type of procedure, 97% of dentists considered the age, 16% considered the gender, 44 % considered the economic status of the patient and 94% considered the type of procedure for which the analgesic was prescribed. Conclusion: This study could give light to the prescribing pattern of analgesics in a dental office as many new drugs are introduced and many are banned due to their side effects.

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Section: Resultssupporting

confidence: 77%

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2016

IJPSR

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“…18 NSAIDs block the cyclooxygenase enzyme in the pathway that produces prostaglandins, resulting in lower levels of inflammation. 19,20 Multiple study results showed that NSAIDs used as premedication reduces pain and inflammation.…”

Section: Jaypeementioning

confidence: 99%

Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

Wali¹,

Siddiqui²,

Qamar³

et al. 2012

International Journal of Prosthodontics and Restorative Dentistry

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Pain is considered to be the major cause for seeking emergency endodontic treatment. Pain management is of vital importance in endodontics with no exception. Local anesthesia is considered to be the primary method to control pain. An effective local anesthesia cannot be obtained if pulp is inflamed. Clinician prescribes nonsteroidal anti-inflammatory drugs (NSAIDs) as premedication on a routine basis for mild to moderate pain to reduce pulpal inflammation before injecting anesthesia. These drugs are beneficial in providing relief from pain and inflammation in irreversible pulpitis and helps in providing effectiveness of inferior alveolar nerve block. Moreover, they have a short half life, which would make them ideal for a single dosage prior to the management of severe pain. Aim To conduct a randomized-placebo controlled clinical trial to compare the effectiveness of premedication with analgesics vs placebo for success of inferior alveolar nerve block in irreversible pulpitis. Materials and methods The study consisted of 80 adult patients attending operative Outpatient Department in Baqai Dental College. Informed Consent was obtained from each participant. Subjects were randomly divided in four groups comprising of 20 subjects in each group. Group A received piroxicam (Feldene 20 mg, Pfizer), group B received diclofenac potassium (Fastaid Plus, 50 mg platinum pharmaceutic), group C received naproxen sodium (Synflex 550 mg, ICI), and group D received a placebo drug becefol (Abbott). Medication was given 1 hour before initiating endodontic treatment. After 1 hour of oral administration of tablets, inferior alveolar nerve block using 1.8 ml of 2% lidocaine containing 1: 200,000 epinephrine was given. After 15 minutes, access cavity preparation was initiated and patients were asked to inform if they experienced pain. Patients were excluded from the study if they experienced pain but if the patient did not feel pain endodontic treatment was continued. p-value was set at 0.05. Data was analyzed by using Chi-square test (SPSS 19). Results The result showed that out of 80 patients who participated in the study, success rate for piroxicam came out to 90% (10 male and 8 female patients), followed by diclofenac potassium with 75% success rate (9 male and 6 female patients), naproxen sodium with 35% success rate (3 male and 4 female patients) and placebo with 10% success (1 male and 1 female patient). Conclusion The current study concludes that premedication given 1 hour before injecting anesthesia is helpful in reducing pain intensity and thus causing inferior alveolar nerve block to be effective. How to cite this article Wali A, Siddiqui TM, Qamar N, Khan R, Jawaid N. Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis. Int J Prosthodont Restor Dent 2012;2(1):5-9.

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“…However, only 1 study has surveyed the analgesic prescription preferences of endodontists [12]; furthermore, strategies for endodontic pain management have not been formulated. Many practitioners confuse the need for analgesics for pain relief with the prescription of antibiotics [13].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic and Analgesic Prescription Patterns among Dentists or Management of Dental Pain and Infection during Endodontic Treatment

Maslamani

Sedeqi

2017

Med Princ Pract

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Objective: The aim of this study was to determine prescription patterns of antibiotics and analgesics among dentists in the management of dental pain and infection for medically healthy patients undergoing endodontic management. Materials and Methods: This descriptive cross-sectional survey was based on a structured questionnaire. The questionnaire collected data on age, gender, years of experience, and the qualifications of dentists. Feedback on prescription patterns for antibiotics and analgesics was collected for a number of clinical scenarios. Participants' choices regarding the type, dose, and duration of antibiotics/analgesics were recorded. Completed questionnaires were analyzed using the Statistical Package for Social Sciences (SPSS; version 24) to determine relationships between prescription patterns, age, gender, and educational qualification. Results: Of the 227 participants surveyed, 190 (83.7%) did not prescribe antibiotics for patients complaining of severe pain. There were significant associations between age and years of experience and antibiotic prescription for pain management (p = 0.035 and 0.04, respectively). Of the participants, 199 (87.7%) never prescribed antibiotics for reversible pulpitis with normal periapical area; there was a statistical significance in relation to gender (p = 0.044). Amoxicillin 500 mg was prescribed most of the time (51.5%). Diclofenac K (50 mg) was prescribed by 41% of the participants, while 39.2% of the participants very often prescribed ibuprofen (600 mg). Conclusion: Most dentists prescribed analgesics and antibiotics as recommended, but more education on the proper use of these medicines is needed for dentists and patients.

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An Analysis of Current Analgesic Preferences for Endodontic Pain Management

Cited by 28 publications

References 29 publications

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Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

Antibiotic and Analgesic Prescription Patterns among Dentists or Management of Dental Pain and Infection during Endodontic Treatment

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