Pain Threshold, C-Reactive Protein and Efficiency of Local Anesthesia in Addictive Drug Abusers with Impacted Lower Third Molar Tooth

Abstract

Objective:The aim was to assess the pain threshold, C-reactive protein (CRP) level and efficiency of local anesthesia for surgical removal of impacted lower third molar in addictive drugs abuse patients. Patients and Methods:The study comprised forty male patients indicated for surgical removal of impacted lower third molar. They were 20 addicts with a mean age of 29.7 ± 8.57 years and 20 age matched non addicts who served as control. The visual analogue scale for pain was assessed and CRP measured before and after surgery. Results:The most common addictive drugs were bango, hashish and pills. Most of the addict patients had medical problems. Addict patients had higher dental affection and poorer dental hygiene. The operation time tended to be longer for addicts. Addicts required two local anesthesia carpules and showed more fear and anxiety. Before surgery the level of CRP in the addict patients was higher than that of control which increased after surgery in both being significant for the non addicts. The VAS significantly reduced after the first injection of local anesthesia in control and second injection in addicts. Conclusion:Addict patients have a hyperalgesic state and lower pain threshold than non addict patients. They require higher doses of local anesthesia during oral surgical procedures. They are more anxious and irritable and when visiting dental clinics and should be treated cautiously. Care must be taken when dealing with addict patients as they have more co morbidities. Regular visits to dentists are recommended for addicts to avoid dental problems.