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Local Anesthesiology
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Pain • It is perhaps the most commonly experienced symptom in dentistry. • Yet, a precise definition of pain does not exist as pain has a subjective/ psychophysiological aspect (a painful stimul ... i for one individual may not be painful for another) • Arbitrarily, pain can be defined as any unpleasant experiences may it be emotional, mechanical/physical or chemical with or without tissue damage. Dual nature of Pain • Pain like other sensations (touch, hot, cold, etc.) has a physioanatomical aspect which explains the physiological processes and anatomical parts involved in Pain Perception. • In addition pain also has a Psychophysiological aspect that is unique to each individual. it explains the psychological factors associated with Pain Reaction. Theories of pain 1. Specific theory: • Developed by Descarets in 1644 • Describes pain systems as a straight-through channel from the skin to the brain • Presence of specific nerve ending for pain perception called Nociceptors. • These nociceptors once activated carry the unpleasant experience to “Pain Center” within the brain 2. Pattern Theory • Developed by Goldscheider • Pain are produced by the summation of sensory input 3. Gate control theory • – Proposed by Melzack and Wall • Claims the existence of a so called “gate” in the spinal cord that controls the passage of information from periphery to brain • The information that travel faster have higher priority to pass the gate and arrive at brain 4. Hydrodynamic Theory • Provides explanation for dentinal pain and sensitivity • Dentinal Sensitive is caused by direct stimulation of sensory nerve ending in the dentin which are primarily located near the pulp • Yet the most sensitive part of the tooth is at DEJ where no nerve endings exist • Hydrodynamic theory suggest that the nerve endings near the pulp are stimulated due to the movement of dentinal fluids present in dentinal tubules Classification of Pain • Acute pain: • Sudden onset, 1st pain • Sharp, localized and throbbing • Information carried through A delta fibers which are large and thinly myelinated neurons (100m/s) • Chronic Pain: • Long lasting pain • Dull and aching pain • Information carried through C – fibers which are small and unmyelinated neurons ( 0.5-2m/s) Pathway of Pain • Describes how a certain stimuli can travel from periphery ( skin or tooth) to brain and be interpreted as pain • Most of painful stimuli in dentistry are mechanical (a stimuli that causes physical injury to tissue) and can be further aggravated by inflammation and its chemical modifiers [Show More]
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MOH/HAAD/DHA/DHCC/OMSB/SLE/QCHP/NHRA PROMETRIC EXAMS AND NOTES FOR PHARMACY,MEDICAL LAB,PHYSIOTHERAPY,BASIC ECG AND PSYCHIATRIC WITH 100% VERIFIED ANSERS AND CALCULATIONS UPDATED 2023/2024 FOR JAN AND DECEMBER EXAMS
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