Definition of Pain
What is pain?
A unique experience that is reported subjectively
What type of trait is avoidance of pain?
Avoidance of pain is a strong, innate trait.
What are the three types of pre-appointment medications used to modify a patient’s pain tolerance to treatment?
Anti-anxiety drugs
Anti-inflammatory drugs
Local anesthesia agents
What type of pain is caused by injury or dysfunction of the sensory nerves in the central or peripheral nervous systems?
Neuropathic Pain
What type of communication is important for those are anxious or fearful? What needs to be established with these patients?
Positive, trust
What valuable function does pain serve?
Pain serves a protective function, i.e. burn response
What is one of the most common consequences of avoiding dental visits in order to avoid pain potential?
May lead to emergency-based dental visits, which are inherently more complex and likely more painful. Such patterns of behavior and emergency treatment reinforce the association of pain with dental experience...a vicious cycle!
What are the differences between acute pain and chronic pain?
Acute pain: lasting a few seconds to 6 months, generally caused by damage from injury or disease, expected recovery, strong motivation to seek treatment
Chronic pain: persists for more than 6 months with out without an identifiable cause and may increase risk of depression as patients may lose hope of getting better
What type of pain is related to mental or emotional factors that affect the experience of pain and how is it different from nociceptive and neuropathic pain?
Pain disorders associated with psychogenic factors; diagnosed less frequently than nocicipetive and neuropathic pain. Affected individuals may report pain beyond typical intensities and durations
What emotional words should be avoided? What words should be used?
“Pain” and “hurt”
“Discomfort” and “tenderness”
Name three variables that may influence a person's experience of pain.
Gender, social roles, attitudes, degree of power, physical health, expectations, ethnic/cultural norms, genetics, social relationships, behavior, social influence, mental health, previous experiences, environmental factors, hormones, personality traits, values, age, emotional status, learned responses, time of day, etc.
Give two primary examples of pain as a protective response of the body.
1. The Withdrawal Reflex
2. Memory
What is sensory modality?
The ability of stimulus to be detected by specific receptors. Allows the brain to detect various conditions: hearing, sight, touch, taste, sound, temperature, pressure differences, chemical conditions
Which aspects of the nervous system are activated in response to pain?
The CNS simultaneously directs activation of the sympathetic nervous system
What are three ways to minimize pain while giving local anesthesia?
Gentles and rapport
Vocal sedation
Use topical anesthetic
Use proper technique for each injection
Evaluate each patient individually
Use proper equipment
Appropriate infection control measures
Give patient sense of control
Pain perception is not necessarily described proportional to what?
The intensity of physical injury or harm
How can a hygienist endure patient comfort and compliance?
Identify factors that contribute to painful experience and protective strategies
Somatic pain and visceral pain are two types of pain under what broader classification of pain? Which of the two do we focus on with local anesthesia?
Nociceptive pain; somatic pain
What is the main reason individuals avoid dental appointments, and what common dental emergency is often a result?
Fear, syncope
What are the five pain control strategies and methods?
1. Remove the stimulus
2. Block the stimulus pathway
3. Raise pain threshold to prevent pain reaction
4. Depress the central nervous system to prevent pain reaction
5. Use psychosomatic methods to affect pain perception and reaction
The International Association of the Study for Pain (IASP) defines pain as “…An unpleasant sensory and emotional experience associated with actual or potential tissue damage…” Is this completely accurate, why or why not?
No; the experience of pain is a valuable and important response that serves a protective function, thus has a very positive benefit
What are the differences between pain threshold and pain tolerance?
Pain threshold: the point at which a stimulus first produces a sensation of pain. It is innate and reproducible in individuals, usually similar for most people, and is an objective perception.
Pain tolerance: an individual's reaction to painful stimuli, indicating the amount of pain an individual is willing to endure. It varies, is influenced by many factors including analgesics, and is subjective.
What are nociceptors? What does it mean when nociceptors are described as polymodal?
Nocicpetors are sensory receptors that detect injury in the body, are activated by injury, and do not adapt to stimulation
Polymodal means that nociceptors are triggered by all types of stimuli, including thermoreceptors, mechanoreceptors, and chemoreceptors
What is the main point of pain management?
Treat every patient as a unique individual with his or her own reactions to pain
What acronym is used to minimize patient anxiety and fear, and what does each letter stand for?
Prepare by utilizing relaxation techniques such as focused breathing, distraction, and muscle relaxation
Rehearse procedures allowing patients to practice control and self-calming techniques
Empower patients with strategies that give them control during procedures
Praise patients for using specific coping techniques that are helpful to them