The Journal of the American Dental Association
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Review Comparative Study
Selecting new drugs for pain control: evidence-based decisions or clinical impressions?
Selecting drugs for pain control in dentistry should be based on scientific research rather than clinical impressions. This article highlights the scientific attributes of analgesic medications that make them practical for treating postoperative dental pain. ⋯ Selecting drugs for the short-term relief of postoperative dental pain should be based on a careful assessment of all relevant pharmacological characteristics of a given agent, especially those related to maximum dosage, duration of action and efficacy.
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An experience of poorly managed pain related to dental treatment can lead patients to avoid or postpone treatment. The development of new pain management strategies equips dental clinicians with additional treatment options that can provide more effective pain relief ⋯ Providing appropriate treatment after dental surgery requires a careful medical history and an educated anticipation of the level of pain the patient may encounter. New analgesic options are available and should be considered, particularly combination analgesics, which can provide faster onset and prolonged duration of action and can combat pain at multiple sites of action.
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Randomized Controlled Trial Comparative Study Clinical Trial
The analgesic efficacy of valdecoxib vs. oxycodone/acetaminophen after oral surgery.
The authors conducted two studies to compare the analgesic efficacy and safety of the cyclooxygenase, or COX, -2-specific inhibitor, valdecoxib, with oxycodone/ acetaminophen in patients who have undergone oral surgery. ⋯ The current standard of care for alleviating acute pain after oral surgery has rested largely on conventional nonsteroidal anti-inflammatory drugs or opioid/analgesic combination products. The studies reported here suggest that the COX-2-specific inhibitor valdecoxib offers an efficacious and safe alternative to other analgesics used to treat pain after oral surgery.
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An estimated 35 million Americans experience significant apprehension about dental procedures, while an additional 10 to 12 million are considered to be "dental phobic" and avoid needed dental care altogether. Nitrous oxide is a general anesthetic used at subanesthetic concentrations to reduce anxiety during dental procedures. The purpose of this study was to characterize mood changes during nitrous oxide inhalation in patients with different levels of preoperative dental anxiety. ⋯ Regardless of their preoperative anxiety level, patients experienced a number of mood-altering effects during nitrous oxide inhalation, the majority of which could be considered pleasant. Ratings of an unpleasant nature decreased markedly in patients with high anxiety. These findings suggest that nitrous oxide may be an effective therapy in reducing patient anxiety during dental procedures.