ObjectivesAssessment of dental pain severity is very challenging in dentistry. Previous studies have suggested that elevated salivary alpha amylase may contribute to increased physical stresses. There is a close association between salivary alpha amylase and plasma norepinephrine under stressful physical conditions. The aim of this study was to evaluate the relationship between pain severity and salivary alpha amylase levels in patients with symptomatic irreversible pulpitis.Materials and MethodsThirty-six patients (20 females and 16 males) with severe tooth pain due to symptomatic irreversible pulpitis were selected. The visual analogue scale (VAS) score was used to assess the pain severity in each patient. Unstimulated whole saliva was collected, and the level of alpha amylase activity was assessed by the spectrophotometric method. Statistical analysis was performed using SPSS 13.ResultsThe level of alpha amylase was significantly increased in the saliva in association with pain severity assessed by VAS. The salivary alpha amylase was also elevated with increased age and in males.ConclusionsThere was a significant correlation between the VAS pain scale and salivary alpha amylase level, which indicates this biomarker may be a good index for the objective assessment of pain intensity.

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Background and aims. Anticariogenic effects of different mouthrinses have been shown previously. In this in vitro study the anticariogenic effects of polyphenol extract of green tea with 0.05% fluoride, 0.2% chlorhexidine and fluoride-chlorhexidine were compared.Materials and methods. This in vitro study was performed on 50 maxillary premolars in 5 groups: 1) normal saline; 2) a 10% solution of green tea polyphenol extract; 3) 0.05% fluoride; 4) 0.2% chlorhexidine; and 5) fluoride-chlorhexidine. Each tooth was placed in a tube which contained a cariogenic solution. Every day the teeth were washed (depending on the experimental groups) with 5 mL of mouthrinse solution. The depth of the caries was measured under a polarized light microscope. Data were analyzed using SPSS 13.0 with Kolmogorov-Smirnov, one-way ANOVA and Tukey tests.Results. The mean and standard deviation (in µm) of caries depth were 194±16.43, 175±17.94, 142±9.34, 155±13.27, and 144±8.57 in groups 1 to 5, respectively, with significant differences between the groups (P<0.001). Tukey test showed that although there was no significant difference in the depth of caries in groups 1 and 2 (P>0.001), they were significantlyless than those in groups 3 to 5 (P<0.001). There was no significant difference between decay depth of groups 3, 4 and 5 (P>0.001).Conclusion. The anticariogenic effect of fluoride-chlorhexidine was the highest among the groups. Although green tea showed higher cariostatic effects than normal saline, in comparison with other mouthrinses, it is less effective. More re-search is strongly recommended for clinical use of green tea as an anticariogenic agent.

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From the clinical point of view, it is of paramount significance to prevent misdiagnosis of similar presentations as pulp and periapical lesions, which may lead to mistreatment and thus complications.