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Biomedical subjects

J A Gerschman

Publications and source records attributed to J A Gerschman.

18 recordsLinked to original sources
PubMed2000

Chronicity of orofacial pain.

Acute and chronic orofacial pain continues to be poorly understood and managed. The National Health and Medical Research Council of Australia (NHMRC) 1999 report on acute pain management promotes the development of evidence based clinical practice guidelines aimed at improving both the quality of health care and health outcomes in medical and dental practice in Australia. Nerve signals arising from sites of tissue or nerve injury lead to long term changes in the central nervous system and the amplification and persistence of pain. These nociceptor activity-induced neuronal changes known as central sensitization, have important clinical implications in the development of new approaches to the management of persistent pain. These findings and implications are discussed in relationship to poorly managed and understood conditions such as oral dysaesthesia, burning mouth syndrome, atypical facial pain/atypical odontalgia, peripheral nerve injury, deafferentation and phantom tooth syndrome.

Acute Disease↗
PubMed1997

Temporomandibular disorders. Part I: A comparison of symptom profiles in Australian and Finnish patients.

Variability in the assessment methods of patients seeking treatment for musculoskeletal disorders of the masticatory system confounds comparative assessment of different studies. In this study, presenting symptom profiles were assessed in 40 Australian and 42 Finnish patients with temporomandibular disorders. The symptom parameters of these patients were compared with those of 40 Australians reporting acute dental pain and were assessed with reference to response to conservative management. A self-administered anamnestic questionnaire was used in a standard, systematic, and comparative way to assess demographic data, general health status, and symptom parameters according to type, frequency, severity, duration, location, impact on the patients' lives, urgency for need of treatment, and possible initiating factors. It was found that the two nationalities studied had similar presentations of cardinal symptom profiles. Statistically significant differences in major presenting symptoms were found between patients with temporomandibular disorders and those with acute dental pain, but not between patients who responded rapidly as opposed to slowly to conservative therapy. It was concluded that the presenting symptom profiles were similar for the two nationalities and were not related to treatment outcome.

Activities of Daily Living↗
PubMed1997

Temporomandibular disorders: Part II. A comparison of psychologic profiles in Australian and Finnish patients.

Recent recommendations regard musculoskeletal disorders of the masticatory system as dual-axis disorders, but little comparative data of psychologic factors across different pain populations are available. In this study, presenting psychologic profiles were assessed in 40 Australian and 42 Finnish patients diagnosed with temporomandibular disorders. Findings were compared with those of a group of Australian patients reporting acute dental pain and with reference to response to conservative management. The psychologic testing instrument incorporated cognitive, motivational/affective, and illness behavior variables, and it was based on validated general pain questionnaires (Coping Strategies Questionnaire and Illness Behavior Questionnaire). This instrument was found internally reliable in the majority of its subscales in the group studies and provided comparable data to other pain populations. Significant differences in the presenting psychologic profiles were found according to nationality, type of pain suffered, and treatment outcome. Affective disturbance, hypochondriasis, lack of cognitive control, and feeling ill with symptoms were identified in discriminant function analysis as potential predictors of treatment outcome, and they correctly classified 79% of the Australian and 87% of the Finnish patients with temporomandibular disorders. It was concluded that psychologic profiles differed in the two nationalities and were related to treatment outcome. The concept of multiaxial assessment was supported.

Activities of Daily Living↗
PubMed1997

Psychophysical subtypes of temporomandibular disorders.

This study presents an approach to the classification of temporomandibular disorders (TMD) based on acknowledgement of the interaction of physical, psychologic, and social factors using a multidimensional instrument that has been previously validated. The psychometric properties of this instrument were reevaluated in 140 women with TMD. Multidimensional clustering identified three subgroups of patients with TMD, including a highly distressed, psychosocially maladaptive group; a moderately distressed, behaviorally functional group; and a predominantly physical disorder group with an unremarkable psychosocial profile. These groups were termed maladaptive, adaptive, and uncomplicated, respectively, according to the constellation of predominant symptoms and psychosocial profiles of each cluster. The groups showed no consistent differences in pain frequency, use of medication, or duration of pain. This finding supports earlier work that suggested the prominence of three subtypes of this disorder according to both physical illness and psychosocial illness impact parameters.

Activities of Daily Living↗
PubMed1994

Low level laser therapy for dentinal tooth hypersensitivity.

A comparative double blind study testing low level laser therapy (Gallium/Aluminium/Arsenide laser [GaAlAs]) against placebo was carried out in the management of dentinal tooth hypersensitivity. Subjects demonstrating dentinal hypersensitivity and complying with strict selection criteria were randomly assigned to an active and placebo group. Low level laser therapy was applied for one minute to both the apex and cervical area of the tooth; and reapplied at one week, two-week and eight-week intervals. Dentinal hypersensitivity was rated at each visit. There were 28 subjects in the placebo group and 22 and 21 subjects, respectively, in the tactile sensitivity and thermal sensitivity groups. Comparisons between the groups were conducted using independent groups t-test. In both the tactile and thermal sensitivity groups differences between the active and placebo groups were significant from the first week and increased further in the second and eighth weeks. The mean value of thermal sensitivity decreased 67 per cent (p < 0.001) compared with placebo (17 per cent) and tactile sensitivity decreased 65 per cent (p = .002) compared with placebo (21 per cent) at eight weeks. Results demonstrate that the GaAlAs laser is an effective method for the treatment of both thermal and tactile dentinal hypersensitivity. There were no reported adverse reactions or instances of oral irritation.

Adolescent↗
PubMed1991

Role of depressive illness in the outcome of treatment of temporomandibular joint pain-dysfunction syndrome.

The aim of this study was to assess the role of a depressive illness in the outcome of the treatment of patients with temporomandibular joint pain-dysfunction syndrome. One group was considered psychiatrically normal and the other had a concurrent depressive illness. The latter group was subdivided equally to produce three treatment groups: one undergoing occlusal splint therapy, one receiving antidepressant medication, and the third having a combination of occlusal splint and antidepressant therapy. The results showed clearly that there was a significant difference in response in the nonpsychiatric and combined-therapy depressed groups in comparison with the two depressed groups treated either with occlusal splint or with antidepressant therapy. The combined therapy led to resolution of the painful problem and the depression, whereas the single therapies were only partly successful in relieving the pain-dysfunction syndrome. The preexisting duration of this painful problem did not influence the response to therapy.

Adolescent↗
PubMed1984

Orofacial pain.

Pain or discomfort in the orofacial region usually has an organic and easily detectable cause. When an organic cause is absent or its magnitude is less than expected after the degree of concern expressed by the patient, a psychiatric factor must be considered. In such cases psychiatric treatment should be arranged to complement any necessary organic therapy.

Facial Neuralgia↗
PubMed1984

The use of acupuncture as an alternative dental analgesic in an individual with multiple allergies.

Reports of the use of acupuncture in the extraction of teeth date back to 1958. There have been many conflicting findings relating to the efficacy of dental acupuncture with few effective controlled studies evaluating these claims. It is clear however that acupuncture analgesia which is adequate for dental extractions may be produced in some individuals. Patients with atopic diseases have in common an inherited predisposition to develop hypersensitivity to allergens in the environment which are harmless to most people. Atopic diseases include common human allergic disorders such as hayfever, asthma, eczema, urticaria, gastro-intestinal food reactions as well as rarer conditions. It has been reported that acupuncture may be of advantage in such individuals who may be hypersensitive to routine methods of producing analgesia. A case is described of the use of acupuncture analgesia in an atopic individual who was being managed by the department of oral surgery, Danderyds Hospital. Two lower molar teeth were successfully surgically extracted. The case is described in detail and recommendations are made for further research and clinical use of acupuncture analgesia.

Acupuncture Therapy↗
PubMed1977

Oro-facial pain.

Oro-facial pain is commonly acute, and of dental origin. There are numerous other less common, but clinically identifiable types of oro-facial pain which can be attributed to an organic cause, and which usually respond to the appropriate treatment. There is a small proportion of oro-facial pain problems, however, which are chronic and which are found to have a psychogenic element of greater or lesser magnitude, and treatment is aimed at psychological or psychiatric therapy. The interim results of an ongoing study of chronic oro-facial pain of psychogenic origin are described in this presentation.

Adolescent↗
PubMedDate not supplied

Effect of electronic dental anesthesia on pain threshold and pain tolerance levels of human teeth subjected to stimulation with an electric pulp tester.

The effect of electronic dental anesthesia on pain threshold and pain tolerance levels of human teeth subjected to stimulation with an electric pulp tester was evaluated. Subjects (n = 120) were randomly assigned to one of four experimental groups (baseline, placebo, square wave, and postsynaptic wave). Symptom-free right-sided maxillary incisor teeth were tested for anesthesia with an electric pulp tester. Electrostimulation significantly increased the pain perception threshold and pain tolerance level with both the square wave and postsynaptic wave. The postsynaptic wave was more effective than the square wave. Presented at the Satellite Symposium on Advances in the Management of Acute and Chronic Facial Pain associated with the 6th World Congress on Pain, Melbourne, Australia, 1990.

Adolescent↗