Preoperative pain and medications used in emergency patients with irreversible acute pulpitis or acute apical periodontitis: a prospective comparative study.
OBJECTIVE
To determine the pain characteristics of and medications used for patients seeking emergency care for irreversible acute pulpitis (IAP) or acute apical periodontitis (AAP).


METHODS
General (age, sex, weight, general health) and specific (pain intensity, localization, tooth mobility, lymphadenopathy, use of medications) information was noted in 209 patients who appeared for emergency care in 2 dental centers of Dakar with either IAP or AAP. Statistical analysis was performed with the Mann-Whitney and chi-square tests.


RESULTS
The sample comprised 97 IAP patients (46.4%) and 112 AAP patients (53.6%); there were no significant differences between the 2 groups with respect to age, sex, or weight. Of the involved teeth, 62% were mandibular and 38% were maxillary. IAP patients waited 6.6 +/- 5.3 days before seeking an emergency consultation versus 5.0 +/- 3.8 days for AAP patients (P < .05). Severe pain was reported in 75% of the IAP and 76% of AAP patients (not significant). Percussion and apical palpation were painful only in AAP, in 98% and 40% of patients, respectively. Mobility and adenopathies were noted only in AAP, in 87% and 46% of patients, respectively (P < .001). Seventy-five percent of IAP patients and 80% of AAP patients used medications, mainly non-narcotic analgesics, which offered relief in 62% of IAP patients and 46% of AAP patients.


CONCLUSIONS
Patients with IAP waited longer than those with AAP before seeking treatment. Self-medication offered better relief in cases of IAP than in cases of AAP. Pain to percussion and palpation, lymphadenopathies, and dental mobility were strong indicators for AAP.
Touré
Babacar
B
Department of Conservative Dentistry and Endodontics, Faculty of Medicine, Pharmacy, and Dentistry, University Cheikh Anta Diop, Dakar, Senegal. babacartoure@sentoo.sn
Kane
Abdoul Wakhabe
AW
Diouf
Abdoulaye
A
Faye
Babacar
B
Boucher
Yves
Y
D000328:Adult; D004630:Emergencies; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D010485:Periapical Periodontitis / Q000150:complications / Q000188:drug therapy*; D011671:Pulpitis / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors; D014098:Toothache / Q000188:drug therapy*