A Novel Pain Relief Approach for the Treatment of Multiple Dental Caries and Pulpitis

Abstract

Anxiety and stress toward treatment can hamper treatment completion in patients with dental caries and pulpitis. Therefore, effective management of post-treatment pain is important because poor pain management can lead to patient dissatisfaction. Ultrasound-guided nerve blocks provide good postoperative analgesia in maxillofacial surgeries. These surgeries can be performed under general or local anesthesia without complications. Here, we present the case of a patient with dental phobia who was successfully treated with these techniques. The patient was a 22-year-old woman with a history of manic-depressive illness who presented with 23 decayed teeth. She had previously undergone vital pulp therapy; however, post-treatment pain led to treatment-related stress, and the patient discontinued the dental treatment. She preferred the dental treatment to be completed with as little pain as possible and wanted to avoid a pulpectomy. The patient's history of heavy use of non-steroidal anti-inflammatory drugs (NSAIDs) made her resistant to NSAIDs. As a result, the analgesic effect of NSAIDs could not be expected. After intravenous midazolam and propofol sedation, an ultrasound-guided inferior alveolar nerve block was performed bilaterally, and 0.375% ropivacaine was used as a local anesthetic. The patient did not complain of postoperative pain, and no post-operative analgesics were required.

Super Minimally Invasive Pulp Therapy for Severe Pulpitis: A Report of Two Cases

“…Sufficiently strong analgesia has been proven to be effective in surgery for malignant tumors and large-scale surgery for jaw deformity [ 29 , 30 ]. Our findings are consistent with those of a previous study, which demonstrated that favorable outcomes can be expected with sufficient analgesia even in dental caries treatment [ 26 ]. UGTNB can be expected to sufficiently improve the patient’s chief complaint of severe tooth pain due to pulpitis.…”

“…Dentists are required to alleviate tooth pain due to pulpitis, which is the patient’s chief complaint. In the case of SMIP, the pain caused by pulpitis can be greatly reduced because pain relief is achieved with UGTNB [ 26 ]. The analgesic effect of UGTNB is strong and lasts for approximately 24-72 hours [ 27 ].…”

Maintaining Tooth Vitality With Super Minimally Invasive Pulp Therapy

“…Ultrasound-guided nerve blocks have been effectively used peri- or post-operatively. This analgesic method has many benefits compared with nonsteroidal antiinflammatory drugs and opioids [ 13 , 14 ]. UGTNB is applied in patients with maxillofacial fractures or those undergoing oral cancer surgery to exert a strong analgesic effect for approximately 24-72 h [ 14 ].…”