The Comparison of Supraperiosteal Nerve Block With Opiate Analgesia in Alleviating the Pain of Toothache

Study Overview
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Brief Summary
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This study will compare the degree of pain control provided by two techniques for persons with toothache in an emergency department. The two techniques include; standard oral narcotic pain medication numbing the tooth with local anesthetic by needle injection

Detailed Description
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Background: Toothache is a common complaint among patients presenting to the emergency department. There are two commonly employed methods of alleviating this severe form of pain. Oral opioid analgesia is the most commonly utilized strategy for treating this pain. However, many emergency physicians and dentists employ a local anesthetic technique known as supraperiosteal nerve block. This study will compare the relative efficacy of these techniques. Patients meeting enrollment criteria will be randomized to either receive a supraperiosteal nerve block or oral hydrocodone 10 mg/acetaminophen 650 mg. They will otherwise be managed identically. Reduction of pain scores between entry and 30 minutes post intervention will be compared as well as numeric pain scores obtained by phone contact 24 hours later. Secondary outcomes will include the proportion of individuals from each group filling prescriptions for pain medication and the number of pain pills taken.

Official Title
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The Comparison of Supraperiosteal Nerve Block With Opiate Analgesia in Alleviating the Pain of Toothache

Conditions
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Toothache

Intervention / Treatment
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* Drug: hydrocodone/acetaminophen
* Drug: bupivacaine (supraperiosteal nerve block)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Involvement of a single tooth Percussive tenderness of the crown of the suspect tooth Exclusion Criteria: Age younger than 18 years Women who are breast feeding Allergy or intolerance to hydrocodone, bupivacaine or acetaminophen Pregnancy Involvement of multiple teeth Pain resulting from pericoronitis. Pain resulting from dental trauma occurring less than 90 days prior Pain of more than 96 hours duration Facial or neck swelling or tenderness Alteration in phonation Cognitive impairment Concurrent use of opiate analgesics Impairment of liver function Consumption of more than 4 grams of acetaminophen in the past 24 hours. Patients who are visually impaired.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: oral<br>administration of oral analgesia | Drug: hydrocodone/acetaminophen<br>* oral hydrocodone 10 mg/acetaminophen 650 mg<br>* Other names: Vicodin;|
| Experimental: Dental Block<br>Administration of supraperiosteal nerve block to effected tooth | Drug: bupivacaine (supraperiosteal nerve block)<br>* Administration of Bupivacaine 0.5% 2 ml adjacent to tooth root<br>* Other names: Marcaine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS determination of pain at 30 minutes following intervention |  | 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric scale report or pain Number of prescribed analgesic pills taken |  | 24-36 hours following intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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toothache, regional anesthesia, emergency department