The Effects of Dexamethasone on the Time to Pain Resolution in Dental Periapical Abscess
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/12/2018 |
| Start Date: | January 2017 |
| End Date: | December 2019 |
| Contact: | Susanne Olkkola, MEd, MPA |
| Email: | solkkola@aemrc.arizona.edu |
| Phone: | 520-626-8819 |
An individual's quality of life can be seriously affected by the severity of dental pain. The
emergency department is a common place to find those seeking relief from their dental pain-
often times seeking removal of the affected tooth, dental anesthetic injections or oral pain
medications. There are a number of dental infections that cause this type of debilitating
pain. One such dental infection is termed periapical abscess. This infection involves the
tooth pulp. These infections can arise in three ways: introduction through a defect in the
enamel and dentin; from a periodontal pocket or an adjacent tooth; or hematogenous seeding of
the pulp from mechanical irritation. As this disease process continues there are a number of
complications including chronic pain and, more seriously, the spread of infection into deep
spaces which can be a life threatening condition.
The Emergency Department treatment of this infection includes pain control, antibiotics and
dental referral for ultimate management of the infection.
The purpose of our study is to investigate whether the addition of oral steroids will alter
the time until patient experiences improvement in their dental pain. Steroids are a commonly
used anti-inflammatory that is used in the Emergency Departmentfor the purpose of pain relief
from throat pain. As the pain from periapical infection is thought to be largely from the
pressure we speculate that the anti-inflammatory effects of steroids may decrease the
inflammation thus the pressure and may ultimately lead to a decrease in time until the
patient experiences some relief from their pain.
emergency department is a common place to find those seeking relief from their dental pain-
often times seeking removal of the affected tooth, dental anesthetic injections or oral pain
medications. There are a number of dental infections that cause this type of debilitating
pain. One such dental infection is termed periapical abscess. This infection involves the
tooth pulp. These infections can arise in three ways: introduction through a defect in the
enamel and dentin; from a periodontal pocket or an adjacent tooth; or hematogenous seeding of
the pulp from mechanical irritation. As this disease process continues there are a number of
complications including chronic pain and, more seriously, the spread of infection into deep
spaces which can be a life threatening condition.
The Emergency Department treatment of this infection includes pain control, antibiotics and
dental referral for ultimate management of the infection.
The purpose of our study is to investigate whether the addition of oral steroids will alter
the time until patient experiences improvement in their dental pain. Steroids are a commonly
used anti-inflammatory that is used in the Emergency Departmentfor the purpose of pain relief
from throat pain. As the pain from periapical infection is thought to be largely from the
pressure we speculate that the anti-inflammatory effects of steroids may decrease the
inflammation thus the pressure and may ultimately lead to a decrease in time until the
patient experiences some relief from their pain.
Inclusion Criteria:
Patients included if they had clinical diagnosis of pulpitis/dental apical abscess and
physical exam revealed pain with percussion of the affected tooth/teeth plus or minus
evidence of periapical abscess (gingival erythema, swelling, draining pus). Written
informed consent was obtained from each patient prior to enrollment in the study.-
Exclusion Criteria:
1. Younger than 18 years old
2. Immunosuppression : HIV patient, transplant patient, chemotherapy
3. History of diabetes
4. Recent (<1 month) or chronic steroid use
5. Hospitalization required due to intractable vomiting/pain
6. Pregnancy, self report
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