Sommaire
Dental Pain
Douleur dentaire
1. Systematic Reviews and Meta-Analysis
| ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture |
| ☆☆ | Evidence for effectiveness of acupuncture |
| ☆ | Limited evidence for effectiveness of acupuncture |
| Ø | No evidence or insufficient evidence |
1.1. Muller 2023
Müller M, Schmucker C, Naumann J, Schlueter N, Huber R, Lederer AK. Acupuncture in management of acute dental pain - A systematic review and meta-analysis. Jpn Dent Sci Rev. 2023 Dec;59:114-128. https://doi.org/10.1016/j.jdsr.2023.02.005
| Background | Acute dental pain is a common issue leading to dental consultation. Besides causal therapy, patients are treated with acupuncture, but efficacy in acute dental pain is still not clarified. |
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| Objective | We aimed to evaluate results of recent research to estimate the efficacy of acupuncture compared to pain-relieving approaches in treatment of acute dental pain. |
| Methods | A systematic review of controlled trials being published between database inception and 2020 were conducted to evaluate the efficacy of acupuncture (alone or as complementary therapy) compared to local anesthesia or conventional analgesic medications in acute dental pain (intraoperatively and postoperatively) and to clarify whether acupuncture reduces the use of postoperative analgesic medications. |
| Results | Of 1672 publications, 23 publications met the inclusion criteria. From these, 11 randomized controlled trials (n = 668) reported on the efficacy of acupuncture on postoperative acute dental pain. Patients, who received acupuncture, showed lower pain scores postoperatively compared to sham acupuncture (Relative Risk -0.77, 95% Confidence interval -1.52 to -0.03). |
| Conclusions | Overall, the results suggest a potential role of acupuncture in improving acute dental pain intraoperatively and postoperatively as well as improving the efficacy of local anesthesia, but the results are limited due to methodological shortcomings emphasizing the necessity for future high-quality research. |
1.2. Ernst 1998
Ernst E et al. The effectiveness of acupuncture in treating acute dental pain: a systematic review. British Dental Journal. 1998. 184(9):443-447. [58386].
| Objective | Acupuncture is frequently advocated as an effective treatment of dental pain. The question whether or not it is effective for this indication remains controversial. The aim of this systematic review therefore was to assess the effectiveness of acupuncture in dental pain. |
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| Methods | Data Sources: Four electronic databases were searched: Medline, Embase, Ciscom, and the Cochrane Library. Only controlled trials were included in this review. Data Extraction: Information was extracted from included studies and entered on standard forms independently by both authors. Methodological quality was assessed using the Jadad score. |
| Results | 16 such studies were located. The majority of these trials imply that acupuncture is effective in dental analgesia. However, important questions remain unanswered. |
| Conclusion | It is concluded that acupuncture can alleviate dental pain and that future investigations should define the optimal acupuncture technique and its relative efficacy compared with conventional methods of analgesia. |
2. Clinical Practice Guidelines
| ⊕ positive recommendation (regardless of the level of evidence reported) Ø negative recommendation, (or lack of evidence) |
2.1. Japanese Society of Orofacial Pain (JSOP, Japan) 2021 Ø
Japanese Society of Orofacial Pain. Hi Shigen-sei Shitsu Shinryo Gaidorain Kaiteiban. Clinical Practice Guideline for Non-Odontogenic Toothache . 2021. Re- vised edition. https://jorofacialpain.sakura.ne.jp/ . Accessed Jan,[in Japanese] . Cited by Okawa Y, Yamashita H, Masuyama S, Fukazawa Y, Wakayama I. Quality assessment of Japanese clinical practice guidelines including recommendations for acupuncture. Integr Med Res. 2022 Sep;11(3):100838. https://doi.org/10.1016/j.imr.2022.100838
| Non-Odontogenic Toothache : No recommendation because of no evidence |
2.2. American Academy of Pediatric Dentistry (AAPD) 2018 ⊕
Pain Management in Infants, Children, Adolescents and Individuals with Special Health Care Needs. American Academy of Pediatric Dentistry (AAPD). 2018:9p. [198272].
| Studies have shown efficacies for pediatric pain management with other techniques such as relaxation and breathing exercises, transcutaneous electrical nerve stimulation, acupuncture, counterstimulation, virtual reality, and music therapies. Additional research is need on these interventions to measure their effectiveness. Nonpharmacologic techniques (e.g., distraction) should carefully be considered as potentially valuable interventions for pain management. |
2.3. Aetna (insurance provider, USA) 2018 ⊕
Acupuncture. Aetna (insurance provider, USA). 2018. 73P. [188029].
| Aetna considers needle acupuncture (manual or electroacupuncture) medically necessary for any of the following indications:Post-operative dental pain |
2.4. U.S. Navy Bureau of Medicine and Surgery (USA) 2013 ⊕
Acupuncture. U.S. Navy Bureau of Medicine and Surgery. 2013.17p. [180539].
| Category A (fair to high quality evidence): Authorized and recommended for routine use. Postoperative dental pain. Category B (limited evidence): Authorized but not recommended for routine use (consider as adjunct). Acute pain including dental pain . |
