Semester

Fall

Date of Graduation

2019

Document Type

Thesis

Degree Type

MS

College

School of Dentistry

Committee Chair

Daniel McNeil

Committee Member

Mark Byron

Committee Member

Bryan Weaver

Abstract

Introduction

Dentists frequently treat and manage patients with acute dental pain. Patients often seek care to treat their pain. As a part of that treatment, it is common for providers to use both prescription and non-prescription medications in the management of the patient’s dental pain. This study focused on understanding the patient’s knowledge, history and expectations regarding prescription and non-prescription medication in the management of their dental pain.

Methods

A self-report survey was developed, using Likert-type scales, consisting of 32 items, including standardized, psychometrically-tested instruments. The survey was administered to 108 adult outpatients who reported to the West Virginia University School of Dentistry urgent care clinic.

Results

Expected pain relief ratings of six opioid medications was compared to that of five non-opioid medications (including four that are over-the-counter drugs). Expected relief from opioid medications (M = 7.89, SD = 1.86) was significantly higher than that of non-opioid medications (M = 4.98, SD = 2.0), with greater pain relief expected from the opioid medications versus non-opioid ones, t(37) = 7.30, p < .0005. Across all 108 patients, the average dental pain level, on a 0-10 scale, was 5.42 (SD = 2.68); of these patients, 39 expected that an opioid prescription would be necessary for their present dental pain relief. A binary logistic regression was conducted with pain level as the predictor and expectation of an opioid as the outcome variable. The model was significant, χ2(1, N = 108) = 9.86, p = .002, indicating that pain level could distinguish whether patients would expect an opioid medication prescription at their appointment, with higher pain levels associated with greater expectation of an opioid. The expected pain relief rating of opioid medications was compared to the combination of ibuprofen/acetaminophen; the mean for the opioid medications was 7.69 (SD = 2.23), while the mean for ibuprofen/acetaminophen combination mean was 5.92 (SD = 2.62). As predicted, these means differed significantly, with greater pain relief associated with opioid medications, t(38) = 4.12, p < .0005.

Conclusions

Patients believe that opioids provide superior dental pain relief than non-opioid medications. With higher dental pain levels, patients’ expectation to receive an opioid pain medication is greater. In general, urgent care dental patients have limited knowledge of both opioid and non-opioid analgesic medications.

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