Department of Orthodontics, Postgraduate Dental Education Centre, Orebro, Sweden.
Int J Paediatr Dent. 2010 May;20(3):193-200. doi: 10.1111/j.1365-263X.2010.01040.x.
Interceptive extractions of deciduous canines are, from a patient perspective, poorly investigated.
To describe pain, discomfort, and dental fear in connection to extractions of the deciduous canines, indicated as an orthodontic treatment procedure.
Thirty-two Swedish children aged 7-9 years had all four deciduous canines extracted over three occasions. The children rated procedural and postoperative pain on visual analogue scales. Acceptance of injections and extractions was assessed by the treating dentists. Analgesic consumption and recovery time for drinking and eating was reported by parents. Dental fear was assessed using the Children's Fear Survey Schedule questionnaire.
Procedural pain showed low median levels, although some individuals reported high values. Boys reported significantly more pain at appointments when two (as opposed to one) canines were extracted. Postoperative pain levels were low and use of analgesics sparse. Dental fear paralleled norm values and did not increase from pre- to post-extraction.
Pain management routines during extractions of this kind should be revised. Single tooth extractions seem to be preferable to extractions of two canines at the same appointment. Extraction of four deciduous canines should not cause major postoperative inconvenience; these extractions neither triggered nor increased dental fear.
从患者的角度来看,对于乳牙拔除的干预治疗研究较少。
描述乳牙拔除过程中的疼痛、不适和牙科恐惧,该过程被视为一种正畸治疗程序。
32 名 7-9 岁的瑞典儿童分三次拔除了全部四颗乳磨牙。儿童使用视觉模拟量表评估治疗过程中的疼痛和术后疼痛。治疗牙医评估儿童对注射和拔牙的接受程度。父母报告了止痛药的使用情况以及恢复饮水和进食的时间。使用儿童恐惧调查量表问卷评估牙科恐惧。
尽管有些人报告了较高的疼痛值,但治疗过程中的疼痛显示出较低的中位数水平。与拔除一颗乳磨牙相比,当同时拔除两颗乳磨牙时,男孩在预约时报告的疼痛更明显。术后疼痛水平较低,止痛药的使用也很少。牙科恐惧与正常水平平行,且在拔牙前后没有增加。
这种类型的拔牙过程中的疼痛管理方案应进行修订。单次拔牙似乎比在同一就诊时拔除两颗乳磨牙更可取。拔除四颗乳磨牙不应引起术后明显的不便;这些拔牙既不会引发也不会增加牙科恐惧。