The Effects of Dexamethasone on the Time to Pain Resolution in Dental Periapical Abscess
The Effects of Dexamethasone on the Time to Pain Resolution in Dental Periapical Abscess
An individual's quality of life can be seriously affected by the severity of dental pain. The
 emergency department is a common place to find those seeking relief from their dental pain-
 often times seeking removal of the affected tooth, dental anesthetic injections or oral pain
 medications. There are a number of dental infections that cause this type of debilitating
 pain. One such dental infection is termed periapical abscess. This infection involves the
 tooth pulp. These infections can arise in three ways: introduction through a defect in the
 enamel and dentin; from a periodontal pocket or an adjacent tooth; or hematogenous seeding of
 the pulp from mechanical irritation. As this disease process continues there are a number of
 complications including chronic pain and, more seriously, the spread of infection into deep
 spaces which can be a life threatening condition.

 The Emergency Department treatment of this infection includes pain control, antibiotics and
 dental referral for ultimate management of the infection.

 The purpose of our study is to investigate whether the addition of oral steroids will alter
 the time until patient experiences improvement in their dental pain. Steroids are a commonly
 used anti-inflammatory that is used in the Emergency Departmentfor the purpose of pain relief
 from throat pain. As the pain from periapical infection is thought to be largely from the
 pressure we speculate that the anti-inflammatory effects of steroids may decrease the
 inflammation thus the pressure and may ultimately lead to a decrease in time until the
 patient experiences some relief from their pain.
Inclusion Criteria:

 Patients included if they had clinical diagnosis of pulpitis/dental apical abscess and
 physical exam revealed pain with percussion of the affected tooth/teeth plus or minus
 evidence of periapical abscess (gingival erythema, swelling, draining pus). Written
 informed consent was obtained from each patient prior to enrollment in the study.-

 Exclusion Criteria:

 1. Younger than 18 years old

 2. Immunosuppression : HIV patient, transplant patient, chemotherapy

 3. History of diabetes

 4. Recent (<1 month) or chronic steroid use

 5. Hospitalization required due to intractable vomiting/pain

 6. Pregnancy, self report