Understanding Dental Pain and Brain Function

There’s been a new discovery in dental anesthesia, helping professionals better understand dental pain and hopefully how to limit it. While local anesthesia has been used in dentistry for over a century, no one ever understood how the pain is associated with brain mechanisms. According to a recent Dental Tribune article, new research has now pinpointed the brain regions that appear to play a large role in dental pain and its relief.

Scientists set out to investigate the brain activity and functional connectivity patterns after an anesthetic nerve block was applied during continuous noxious dental stimulation. The pain relief was found to be accompanied by a significant reduction of activity in the posterior insula with an enhanced connectivity to the midbrain. These results confirm previous studies that have shown that direct electrical stimulation of this region of the brain evokes bodily pain sensations. The study involved 28 male participants with an average age of 27. Subjects were subjected to repetitive electrical stimuli to their left mandibular canine. In the first stage, participants received 30 stimuli for 5 minutes. Half of the subjects then received a submucosal injection of 4% articaine and the other half was given a sodium chloride placebo. The second stage of the study included the application of electrical tooth stimulation for 16 minutes, with subjects indicating pain offset by pressing an alarm ball. The brain activity from before and after the injection of the anesthetic was then compared.

The participants who received the articaine injection experienced pain relief approximately 4.5 minutes later. Logically, the group receiving the placebo showed no similar responses. Further analysis confirmed a distinct role of the posterior insula and midbrain in dental pain and its relief. The findings were presented at the 2015 International Association for Dental Research general session on March 12. Further understanding of how the body reacts to dental pain can only assist professionals in continuing to improve techniques and anesthesia in the ultimate effort to minimize discomfort. With pain and fear so closely connected, reducing pain could go a long way in helping the millions of individuals suffering from dental phobia so that they can access the dental care they need and deserve.