Lecture Synopsis

 

Differential Diagnosis of Persistent Pain Following Root Canal Treatment
Speaker: Associate Professor Donald Nixdorf

Synopsis:

Using root canal treatment as a model of surgical pain in humans, this lecture will review the common and uncommon reasons pain persists following root canal treatment. It will also review the diagnostic process, classifi cation of orofacial pain, and highlight the level of evidence related to supporting the ability to accurately categorise patients with orofacial pain complaints.

 

Diagnosing Persistent Non-odontogenic ‘Tooth’ Pain
Speaker: Associate Professor Donald Nixdorf

Synopsis:

The complaint of ‘tooth’ pain is one of the most common reasons why patients seek dental care. While dentists are well equipped to address pain arising from odontogenic etiologies, they are less so when the patient’s complaint of ‘tooth’ pain is not the emanating from the tooth in question - or any tooth at all. This lecture covers the necessary clinical information that needs to be collected to diagnose the majority of non-odontogenic etiologies for pain presenting as emanating from a tooth when the source is not the tooth.

 

How Applicable Are Pragmatic Trials?
Speaker: Associate Professor Donald Nixdorf

Synopsis:

This lecture will review what a pragmatic trial is and what it is not, as well as discuss the advantages and limitations of this approach to addressing research questions.

 

Pragmatic Trials in Pain Research - Discussion of Ongoing National Dental PBRN trials
Speaker: Associate Professor Donald Nixdorf

Synopsis:

Following the previous presentation on the topic of pragmatic trials, this lecture will dive deeper into the topic with an emphasis of how previous trials inform the development of future trials. Also, this lecture will detail an ongoing study assessing pain following root canal treatment and report on emerging data from that trial.

 

Individualising Care to Optimise Outcomes for Patients with Chronic Orofacial Pain
Speaker: Associate Professor Donald Nixdorf

Synopsis:

In an eff ort to tie all the topics presented together, this lecture will stress the connection between diagnosis, as well as contributing factors, and treatment outcomes. It will include examples from clinic practice and research trials to elaborate on how this may be put into action within regular practice.


Temporomandibular Disorder and Chronic Overlapping Pain Conditions
Speaker: Dr Tan Hee Hon

Synopsis:

Temporomandibular Disorders (TMD) is a group of Musculoskeletal Painful Conditions that affect the Stomatognathic System. Often patients who suff er from TMD are affected by other chronic painful conditions. The understanding of the inter-relationships of these painful conditions can aff ect our management of Temporomandibular Disorders in the dental practice. The comprehension of Temporomandibular Disorders will allow a better understanding of Chronic Pain.


Chronic Pain as a Disease Entity and Not a Symptom
Speaker: Dr James Tan Wen Tien

Synopsis:

Acute pain has a useful protective warning function and is thought of as a symptom of underlying injury or disease. It is however wrong to think of chronic pain in terms of longer lasting acute pain. Chronic pain serves no useful physiological function and may not be related to any underlying injury or disease. Our current understanding of the pathophysiology of chronic pain indicates that there are profound changes in the central nervous system in a patient with chronic pain in particular the process of central sensitisation. It is also clear that chronic pain is no diff erent to other chronic diseases and is able to cause signifi cant impairment to a patient’s function and quality of life. The application of the holistic biopsychosocial model of pain to the management of a chronic pain patient leads to the utilisation of a multi-modal multidisciplinary team framework which can signifi cantly help to improve the patient’s functioning and quality of life.


Psychiatric and Psychological Challenges in Pain Management
Speaker: Dr Lui Yit Shiang

Synopsis:

Severe chronic pain may carry consequences including psychological distress, job loss, social isolation and is highly co-morbid with depression and anxiety. Ignoring psychological component or adopting purely anatomical approach to pain care, may damage therapeutic relationship and introduce mistrust and blame. It demoralises patients who may feel blamed, disbelieved and unhelped. Patients with chronic orofacial pain may present with predominant or attendant psycho-emotional challenges. These challenges will be discussed and may include hypochondriacal presentation like somatisation, disease conviction as well as anxiety disorder. Psycho-pharmacological treatment consideration in this population and pain management from psychiatric point of view will also be touched on.


Gut-Brain-Microbiota Interaction in Irritable Bowel Syndrome
Speaker: Dr Kewin Siah Tien Ho

Synopsis:

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterised by recurrent abdominal pain or discomfort associated with constipation, diarrhea or mixed bowel habits. It is now evident that IBS is a multi-factorial complex of changes in microbiota and gut-brain axis. In Singapore, a recent community study showed that 1 in 5 Singaporean may suff er from IBS. The gut-brain-axis has a central function in the perpetuation of IBS and the microbiota plays a critical role. The gut-brain axis (GBA) consists of bi-directional communication between the central and the enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions. Both clinical and experimental evidence suggests that enteric microbiota has an important impact on GBA, interacting not only locally with intestinal cells and ENS, but also directly with CNS through neuroendocrine and metabolic pathways. In clinical practice, evidence of gut-brain-microbiota interactions comes from recent advances in brain imaging and gut microbiota research. In particular, IBS can be considered an example of the disruption of these complex relationships, and a better understanding of these alterations might provide new targeted therapies.


Neuropathic Pain: Diagnosis and Management
Speaker: Dr Tay Kwang Hui

Synopsis:

Neuropathic pain refers to pain arising as a direct consequence of lesions aff ecting the somatosensory system. Neuropathic pain is often challenging as they are often chronic in nature and respond poorly to conventional analgesics. This talk gives an overview on the clinical features suggestive of neuropathic pain and some of the treatment options for commonly occurring neuropathic pain conditions in the head and neck region.


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