Recently, a self-rating measure for pain perception based on imagined painful daily life situations, the Pain Sensitivity Questionnaire (PSQ), has been developed and shown to correlate with experimentally obtained pain intensity ratings in healthy subjects. Here, we assessed the validity of the PSQ for investigation of general pain perception (ie, pain perception outside the site of clinical pain) in chronic pain patients. PSQ scores were obtained in 134 chronic pain patients and compared to those of 185 healthy control subjects. In a subgroup of 46 chronic pain patients, we performed experimental pain testing outside the clinical pain site, including different modalities (heat, cold, pressure, and pinprick) and different measures (pain thresholds, pain intensity ratings). Results show that PSQ scores were significantly correlated with both experimental pain intensity ratings (Pearson's r=0.71, P<.001) and experimental pain thresholds (r=-0.52, P<.001). In addition, chronic pain patients exhibited significantly elevated PSQ scores as compared to healthy controls, consistent with the generalized increase of experimentally determined pain perception that has repeatedly been reported in chronic pain patients. These results demonstrate that the PSQ constitutes a valid self-rating measure of pain perception outside the clinical pain site in chronic pain patients and might serve as an alternative to experimental assessment of pain perception outside the clinical pain site in situations where experimental pain testing is not feasible.
Competency-based education, introduced approximately 10 years ago, has become the preferred method and generally the accepted norm for delivering and assessing the outcomes of undergraduate (European) or predoctoral (North America) dental education in many parts of the world. As a philosophical approach, the competency statements drive national agencies in external programme review and at the institutional level in the definition of curriculum development, student assessment and programme evaluation. It would be presumptuous of this group to prescribe competences for various parts of the world; the application of this approach on a global basis may define what is the absolute minimum knowledge base and behavioural standard expected of a 'dentist' in the health care setting, while respecting local limitations and values. The review of documents and distillation of recommendations is presented as a reference and consideration for dental undergraduate programmes and their administration.
Objectives The German Society of Craniomandibular Function and Disorders recommends that patients suffering from temporomandibular dysfunctions should practice sports in order to compensate for everyday stress. This raises the question as to what extent competitive athletes develop temporomandibular dysfunctions or whether their athletic activities protect them. With the present literature review, the authors intend to give an overview of the currently available publications on this topic. Materials and methods A literature research in the PubMed and Google Scholar databases was performed to filter out the currently available publications on the topic ‚sports, and temporomandibular dysfunction. Results Out of 114 available articles, seven met the inclusion criteria. Two other relevant articles were found in the list of references, so that in total, nine publications were picked for the review. In case numbers ranging from eight to 347 subjects, a temporomandibular dysfunction was detected with a prevalence between 11.7% and 100% for athletes and between 11.11% and 14.3% for non-athletes. Different kinds of sports were evaluated, all of them contact sports: basketball, handball, wrestling, boxing, karate, mixed martial arts, field hockey, water polo, and soccer. One study compared athletes with and without consumption of anabolic steroids, regardless of the type of sport. The level of athletic performance varied across the different studies. Conclusions Currently, studies dealing with the effect of competitive sports on temporomandibular dysfunction are scarce. Inconsistent methodological procedures permit only limited comparability. Clinical relevance A general trend, however, can already be discerned: professional athletes suffer from temporomandibular dysfunctions more frequently than non-athletes.
Pain perception studies in migraine patients have shown trigeminal and peripheral pain facilitation during the migraine attack. We were interested in differences of trigeminal and peripheral pain perception between migraine patients during the migraine interval and healthy subjects. Perception of electrical pain stimulation was measured in 20 migraine subjects outside a migraine attack (10 migraine with aura and 10 migraine without aura) and in 20 healthy subjects. We recorded sensory and pain thresholds, pain ratings after suprathreshold stimulation, and pain rating after two trains of repetitive stimulation (i.e., pain facilitation). Migraine subjects showed a significantly higher pain rating after suprathreshold stimulation in the trigeminal region as compared to healthy subjects (4.8 ± 1.6 versus 3.8 ± 2.2, p < 0.04 after Bonferroni correction) but not in the peripheral region. Furthermore, migraine subjects showed a pain facilitation after repetitive trigeminal stimulation whereas healthy subjects showed a pain habituation. We observed no significant differences between migraine subjects and healthy subjects for all parameters in the peripheral stimulation. Migraine patients with and without aura did not differ in any parameter. All subjects showed decreased sensory and pain thresholds after trigeminal as compared to peripheral stimulation. Migraine subjects show an increased pain perception after trigeminal but not after peripheral pain stimulation as compared to healthy subjects. This phenomenon is probably due to the observed pain facilitation after painful trigeminal stimulation.
Background The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remain a major challenge for dental practitioners and affected patients. Objectives To present the results of a literature‐based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients. Methods In 2018, electronic literature searches were carried out in PubMed, Cochrane Library and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant papers. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus. Results Based on the contents of the 77 articles identified in the search, the current knowledge about clinical characteristics, epidemiology, aetiology, diagnostic process, differential diagnosis and management of OD is summarised. Conclusions Occlusal dysesthesia exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counselling, defocusing, cognitive behavioural therapy, supportive drug therapy and certain non‐specific measures. Irreversible, specifically an exclusively dental treatment approach must be avoided.
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