title: Comparison of preoperative pain and medication use in emergency patients presenting with irreversible pulpitis or teeth with necrotic pulps.
abstract: OBJECTIVE
  This retrospective study compared differences in preoperative pain and medication use in patients with moderate to severe pain who sought emergency endodontic care for teeth with irreversible pulpitis and for symptomatic teeth with necrotic pulps.
  
  
  METHODS
  A total of 323 patients seeking emergency endodontic treatment completed questionnaires regarding their biographical information, pain, pain history, and medications. Teeth were tested for vitality, mobility, percussion, and palpation pain. Lymphadenopathy was also evaluated.
  
  
  RESULTS
  Patients with irreversible pulpitis waited significantly (P <.05) longer before seeking emergency care (9 days vs 4 days) than patients with symptomatic teeth with necrotic pulps. No differences (P >.05) were found between the groups in terms of analgesic or antibiotic use and pain relief from preoperative narcotic medications. Nonnarcotic analgesics were reported to significantly reduce pain more often in patients with symptomatic teeth with necrotic pulps. There were sex differences in the group of patients with irreversible pulpitis: More women than men were taking analgesic medications and, in the group having symptomatic teeth with necrotic pulps, more men than women reported pain relief from their analgesic medications.
  
  
  CONCLUSIONS
  Patients with irreversible pulpitis wait longer to seek emergency treatment. A majority (81%-83%) of emergency patients with moderate to severe pain will have taken some type of medication(s) to help control their pain, and more women than men with irreversible pulpitis will take an analgesic. By taking their preoperative medication(s), this group of patients will get relief 62% to 65% of the time; furthermore, more men than women with symptomatic teeth with necrotic pulps will experience pain relief.
authors.affiliation: Advanced Endodontics, College of Dentistry, The Ohio State University, Columbus 43218-2357, USA. nusstein.1@osu.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Nusstein
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003790:Dental Pulp Necrosis / Q000188:drug therapy / Q000503:physiopathology*; D003791:Dental Pulp Test; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D010173:Palpation; D010474:Percussion; D011671:Pulpitis / Q000188:drug therapy / Q000503:physiopathology*; D012189:Retrospective Studies; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D014086:Tooth Mobility / Q000503:physiopathology; D014098:Toothache / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000900:Anti-Bacterial Agents