IADR Abstract Archives

Unmasking the Difficult Endodontic Diagnosis

Objective: An accurate diagnosis is of upmost importance before initiating endodontic treatment.  There are occasions when the practitioner cannot reproduce the patient’s chief complaint because the patient is now 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 “masking” effect of ibuprofen on endodontic diagnostic tests. 

Method: 42 patients with endodontic pain underwent endodontic testing (cold, percussion, palpation, bite force measurement), and then received either placebo or 800 mg ibuprofen.  Both patient and operator were blinded to medication received.  One hour later, diagnostic testing was repeated and compared to pre-treatment testing.

Result: Ibuprofen affected testing values in patients by masking palpation 40% and percussion 25% on affected teeth with symptomatic IRP and symptomatic apical periodontitis.  There was no observed masking effect in the placebo group on palpation or percussion values.  One symptomatic patient in the ibuprofen group tested normal to percussion and cold after taking the ibuprofen.  Little masking, however, occurred with the bite force measurement differences. 

Conclusion: Analgesics taken before the dental appointment can affect endodontic diagnostic testing results.  Bite force measurements can provide valuable information to identify the offending tooth in cases where analgesics “mask” the endodontic diagnosis.

Division: IADR/AADR/CADR General Session
Meeting: 2013 IADR/AADR/CADR General Session (Seattle, Washington)
Location: Seattle, Washington
Year: 2013
Final Presentation ID: 939
Abstract Category|Abstract Category(s): Pharmacology/Therapeutics/Toxicology
Authors
  • Bowles, Walter  ( University of Minnesota, Minneapolis, MN, USA )
  • Read, Jason  ( University of Minnesota, Minneapolis, MN, USA )
  • Khan, Asma A.  ( University of North Carolina, Chapel Hill, NC, USA )
  • SESSION INFORMATION
    Poster Session
    Dental and Oral Therapeutics
    03/21/2013