Monitoring and Managing Pain and Physiological Stress During Dental Procedures: Roles of Dentists, Dental Assistants, and Nurses

Authors

  • Fadwa Monawar Alotaibi
  • Saleh Ali Hassan Alyami
  • Alqarni, Abdullah Ali H
  • Alhilali, Abdulhadi Mohammed S.
  • Duaa Yousef I Nunu
  • Maha Madallah F Alanazi
  • Hamidah Lafi A Alhazmi
  • Hamdah Laila Ayed Alhazmi
  • Alruwaili, Rasmiah Rajaa M
  • Alanazi, Mashael Humaidan M
  • Shuruq Shime Alenezi

DOI:

https://doi.org/10.22399/ijcesen.4569

Keywords:

pain management, physiological stress, dental procedures, dentists, dental assistants, nurses

Abstract

Effective monitoring and management of pain and physiological stress during dental procedures is critical to ensuring patient comfort and satisfaction. Dentists play a pivotal role by employing various pain management strategies, including local anesthetics and sedation techniques tailored to each patient's needs. They assess the patient's medical history, anxiety levels, and pain thresholds to create a customized approach. Dental assistants contribute by preparing the treatment area, providing emotional support, and monitoring the patient's vital signs during the procedure. Their training in recognizing signs of discomfort allows them to alert the dentist promptly, ensuring immediate attention is given to any signs of pain or distress. Nurses, especially those with experience in dental settings, contribute to pain management by educating patients about what to expect during procedures and discussing post-operative care. They assist in developing comprehensive pain management plans that may include the prescription of analgesics and advising on non-pharmacological methods such as relaxation techniques. Collaboration among dentists, dental assistants, and nurses is essential in creating a multi-disciplinary approach to managing pain and psychological stress. By sharing information and utilizing their individual expertise, the dental team can foster a supportive environment that promotes overall well-being and enhances the patient's experience.

References

[1] Chua KP, Waljee JF, Gunaseelan V, Nalliah RP, Brummett CM. Distribution of opioid prescribing and high-risk prescribing among U.S. dentists in 2019. Am J Prev Med 2022;62(3):317–325.

[2] Dawson T, Pahlke S, Carrasco-Labra A, Polk DE. Patient values and preferences for managing acute dental pain elicited through online deliberation. JDR Clin Trans Res Published online August 4, 2023. doi: 10.1177/23800844231174398.

[3] Hersh EV, Moore PA, Grosser T, et al. Nonsteroidal anti-inflammatory drugs and opioids in postsurgical dental pain. J Dent Res 2020;99(7):777–786.

[4] Quinn PD, Fine KL, Rickert ME, et al. Association of opioid prescription initiation during adolescence and young adulthood with subsequent substance-related morbidity. JAMA Pediatr 2020;174(11):1048–1055.

[5] Oklahoma opioid prescribing guidelines. Oklahoma State Department of Health 2017.

[6] Suda KJ, Zhou J, Rowan SA, et al. Overprescribing of opioids to adults by dentists in the U.S., 2011–2015. Am J Prev Med 2020;58(4):473–486.

[7] Schroeder AR, Dehghan M, Newman TB, Bentley JP, Park KT. Association of opioid prescriptions from dental clinicians for US adolescents and young adults with subsequent opioid use and abuse. JAMA Intern Med 2019;179(2):145–152.

[8] Miroshnychenko A, Ibrahim S, Azab M, et al. Corticosteroids for managing acute pain subsequent to surgical extraction of mandibular third molars: a systematic review and meta-analysis. JADA 2023;154(8):727–741.e10.

[9] New York City emergency department discharge opioid prescribing guidelines. The New York City Department of Health and Mental Hygiene 2013.

[10] Acute Pain Management With Opioid Alternatives After Dental Procedures: Recommendations From the Veterans Health Administration, Office of Dentistry Veterans Health Administration Central Office, Office of Dentistry; 2020.

[11] Lee B, Zhao W, Yang KC, Ahn YY, Perry BL. Systematic evaluation of state policy interventions targeting the US opioid epidemic, 2007–2018. JAMA Netw Open 2021;4(2):e2036687.

[12] Guyatt GH, Oxman AD, Kunz R, et al. ; GRADE Working Group. What is “quality of evidence” and why is it important to clinicians? BMJ 2008;336(7651):995–998.

[13] Harbaugh CM, Nalliah RP, Hu HM, Englesbe MJ, Waljee JF, Brummett CM. Persistent opioid use after wisdom tooth extraction. JAMA 2018;320(5):504–506.

[14] Hoppe JA, Nelson LS, Perrone J, Weiner SG. Opioid prescribing in a cross section of US emergency departments. Ann Emerg Med 2015;66(3):253–259.e1.

[15] Phillips AL, Thiese MS, Freeman M, Kartchner R, Hegmann KT. Implementation of an opioid guideline impacts on opioid prescriptions, adverse outcomes, and an association with a state opioid-related fatalities. J Occup Environ Med 2019;61(8):653–658.

[16] Opioid prescribing: acute and postoperative pain management. American Association of Oral and Maxillofacial Surgeons Revised January 2023.

[17] National Academies of Sciences-Engineering-Medicine. Framing Opioid Prescribing Guidelines for Acute Pain: Developing the Evidence The National Academies Press; 2020.

[18] Sterne JAC, Hernán MA, McAleenan A, Reeves BC, Higgins JPT. Chapter 25: Assessing risk of bias in a non-randomized study. In: Higgins JPT, Thomas J, Chandler J, et al. , eds. Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021) Cochrane; 2021.

[19] Washington emergency department opioid prescribing guidelines. Washington State Department of Health 2020.

[20] Stein BD, Taylor EA, Sheng F, Dick AW, Vaiana M, Sorbero M. Change in per capita opioid prescriptions filled at retail pharmacies, 2008–2009 to 2017–2018. Ann Intern Med 2022;175(2):299–302.

[21] Statement on the use of opioids in the treatment of dental pain (2016). American Dental Association House of Delegates American Dental Association. 2016.

[22] Higgins JPT, Savovic J, Page MJ, Elbers RG, Sterne JAC. Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JPT, Thomas J, Chandler J, et al. , eds. Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021) John Wiley & Sons; 2021.

[23] Utah clinical guidelines on prescribing opioids for treatment of pain. Utah Department of Health 2009.

[24] Miroshnychenko A, Azab M, Ibrahim S, et al. Corticosteroids for managing acute pain subsequent to surgical extraction of mandibular third molars: a systematic review and meta-analysis. JADA 2023;154(8):727–741.e10.

[25] Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC clinical practice guideline for prescribing opioids for pain: United States, 2022. MMWR Recomm Rep 2022;71(RR-3):1–95. doi: 10.15585/mmwr.rr7103a1.

[26] Miroshnychenko A, Ibrahim S, Azab M, et al. Injectable and topical local anesthetics for acute dental pain: 2 systematic reviews. JADA 2023;154(1):53–64. e14.

[27] Miroshnychenko A, Ibrahim S, Azab M, et al. Acute postoperative pain due to dental extraction in the adult population: a systematic review and network meta-analysis. J Dent Res 2023;102(4):391–401.

[28] Opioid prescribing guidelines. Massachusetts General Hospital.

[29] Roberts RM, Bohm MK, Bartoces MG, Fleming-Dutra KE, Hicks LA, Chalmers NI. Antibiotic and opioid prescribing for dental-related conditions in emergency departments: United States, 2012 through 2014. JADA 2020;151(3):174–181.e1.

[30] Acute postoperative pain opioid prescribing guidelines. University of Minnesota School of Dentistry 2017.

[31] Utah clinical guidelines on prescribing opioids for treatment of pain. Utah Department of Health 2009.

[32] Owens PL, Manski RJ, Weiss AJ. Emergency department visits involving dental conditions, 2018. Statistical Brief #280. Agency for Healthcare Research and Quality August 2021.

[33] Chapter 27 of Title 54.1 of the Code of Virginia: Dentistry. Virginia Department of Health Professions Board of Dentistry 2019.

[34] Rosoff DB, Smith GD, Lohoff FW. Prescription opioid use and risk for major depressive disorder and anxiety and stress-related disorders: a multivariable mendelian randomization analysis. JAMA Psychiatry 2021; 78(2):151–160.

[35] Policy on opioid prescribing (2018) American Dental Association. October 2018.

[36] Cothron A, Diep VK, Shah S, et al. A systematic review of dental-related emergency department among Medicaid beneficiaries. J Public Health Dent 2021;81(4): 280–289.

[37] Okunseri C, Dionne RA, Gordon SM, Okunseri E, Szabo A. Prescription of opioid analgesics for non-traumatic dental conditions in emergency departments. Drug Alcohol Depend 2015;156:261–266.

[38] Moore PA, Dionne RA, Cooper SA, Hersh EV. Why do we prescribe vicodin? JADA 2016;147(7):530–533.

[39] Guidelines for prescribing pain medications for outpatient procedures. University of Pittsburgh School of Dental Medicine. Commitment to opioid-free pain management 2019.

[40] Khouja T, Zhou J, Gellad WF, et al. Serious opioid-related adverse outcomes associated with opioids prescribed by dentists. Pain 2022;163(8):1571–1580.

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Published

2024-11-30

How to Cite

Fadwa Monawar Alotaibi, Saleh Ali Hassan Alyami, Alqarni, Abdullah Ali H, Alhilali, Abdulhadi Mohammed S., Duaa Yousef I Nunu, Maha Madallah F Alanazi, … Shuruq Shime Alenezi. (2024). Monitoring and Managing Pain and Physiological Stress During Dental Procedures: Roles of Dentists, Dental Assistants, and Nurses. International Journal of Computational and Experimental Science and Engineering, 10(4). https://doi.org/10.22399/ijcesen.4569

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Section

Research Article