Recent
pain research advances show promise in their application to the relief of acute and chronic clinical dental
pain. Regional
electroanalgesia, or
transcutaneous electrical stimulation, has been used successfully in the treatment of
pain associated with
peripheral nerve injuries. Electrical stimulation of teeth also may prove useful as a
pain control technique during operative dentistry procedures. Another exciting research finding is the discovery of endogenous or natural
pain-suppressing pathways in the brain. There are recent demonstrations that natural-occurring
opiate-like compounds and receptors exist in the brain. The elucidation of stimuli and behavioral responses which will activate these specific descending
pain control pathways may lead to exciting new methods of
pain relief. Thus, both regional
electroanalgesia and the discovery of endogenous
pain-suppressing pathways offer the possibility of the future expanded use of non-pharmacological
pain control techniques. The proper evaluation of new
pain control techniques requires the development of better methods of measuring and assessing the multidimensional aspects of the
pain experience. Category scales which scale the suprathreshold range of
pain from threshold to tolerance levels can be used with both experimental and clinical
pain. Sensory Decision Theory has been applied to the analysis of categorical
pain responses. This method distinguishes between sensitivity to stimulus intensity and response bias, or the patient's willingness to report a given intensity as painful. Another promising method for scaling
pain is the use of ratio-scaling methods with verbal
pain descriptors. Verbal descriptors of
pain may provide the best method of scaling different dimensions of the
pain experience. Reliable and objective descriptor scales have been developed which separate
pain along two dimensions: sensory intensity and affect, or unpleasantness. By using cross-modality matching procedures, specific numerical values can be calculated for each verbal descriptor. These scales have been used to measure the intensity and unpleasantness associated with tooth pulp evoked experimental and clinical
pain, and should be extremely useful in the evaluation of acute and chronic dental
pain. They will be important experimental and clinical adjuncts in determining the efficacy of non-pharmacological
pain control methods such as regional
electroanalgesia,
biofeedback, relaxation-suggestion and
hypnosis.