title: Effect of Ibuprofen on masking endodontic diagnosis.
abstract: BACKGROUND
  An accurate diagnosis is of upmost importance before initiating endodontic treatment; yet, there are occasions when the practitioner cannot reproduce the patient's chief complaint because the patient has become asymptomatic. Ibuprofen taken beforehand may "mask" or eliminate the patient's symptoms. In fact, 64%-83% of patients with dental pain take analgesics before seeing a dentist. The purpose of this study was to examine the possible "masking" effect of ibuprofen on endodontic diagnostic tests.
  
  
  METHODS
  Forty-two patients with endodontic pain underwent testing (cold, percussion, palpation, and bite force measurement) and then received either placebo or 800 mg ibuprofen. Both patients and operators were blinded to the medication received. One hour later, diagnostic testing was repeated and compared with pretreatment testing.
  
  
  RESULTS
  Ibuprofen affected testing values for vital teeth by masking palpation 40%, percussion 25%, and cold 25% on affected teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis. There was no observed masking effect in the placebo group on palpation, percussion, or cold values. When nonvital teeth were included, the masking effect of ibuprofen was decreased. However, little masking occurred with the bite force measurement differences.
  
  
  CONCLUSIONS
  Analgesics taken before the dental appointment can affect endodontic diagnostic testing results. Bite force measurements can assist in identifying the offending tooth in cases in which analgesics "mask" the endodontic diagnosis.
authors: Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota.
authors: Jason K
authors: JK
authors: Read
authors: Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota.
authors: Scott B
authors: SB
authors: McClanahan
authors: Department of Endodontics, University of North Carolina-Chapel Hill School of Dentistry, Chapel Hill, North Carolina.
authors: Asma A
authors: AA
authors: Khan
authors: Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, Minnesota.
authors: Scott
authors: S
authors: Lunos
authors: Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota. Electronic address: bowle001@umn.edu.
authors: Walter R
authors: WR
authors: Bowles
mesh_terms: D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D001732:Bite Force; D003080:Cold Temperature; D003782:Dental Pulp / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000502:physiology; D010173:Palpation; D010474:Percussion; D010485:Periapical Periodontitis / Q000175:diagnosis*; D010919:Placebos; D011671:Pulpitis / Q000175:diagnosis*; D019553:Tooth, Nonvital / Q000503:physiopathology; D014098:Toothache / Q000175:diagnosis* / Q000188:drug therapy; D014159:Transducers; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D010919:Placebos; D007052:Ibuprofen
keywords: Analgesic; apical periodontitis; bite force transducer irreversible; pulpitis