Patient Management
Natalie Turner, DDS
Resident
The University of Toledo Medical Center, Toledo, OH
University of Toledo Medical Center, Toledo, OH
Toledo, Ohio, United States
Michael P. Nedley, DDS, DDS
University of Toledo
Purpose: The purpose of this pilot study was to formulate a protocol for a randomized control trial identifying mechanism(s) underlying latent inhibition (LI) of dental fear and examine whether individual ethnic differences could account for disparities observed in oral health and dental fear. This study aims to determine mechanisms through which pre-exposures condition dental fear acquisition, recall and retention.
Methods: Thirty healthy male and female volunteers aged 6 to 31 years enrolled across two sites. Participants completed conditioning tasks to assess pain sensitivity via a cold pressor test and dental startle task (air puff stimulation) through custom polyvinylsiloxane mouthpieces.
Results: Descriptive statistical analyses determined the upward limits for the startle task (mean=54 psi and maximum=60 psi). The cold pressor task revealed 12˚C having the largest mean of 157.53s (5˚C 119.7s, 7˚C 123.0s). Differences between ethnicity and cold test were not significant (5˚C F=.885 P=.424, 7˚C F=.791 P=.463, 12˚C F=.245, P=.785). Self-reported ethnicity revealed 37% Hispanic or Latinos, 57% not Hispanic or Latino and 7% unknown or not reported. Differences between ethnicity and stopping psi for the startle task were not significant (F=1.143 P=.334).
Conclusions: This pilot study determined protocol feasibility for the formal study to test hypotheses regarding the mechanisms through which pre-exposure interventions result in LI of conditioning to a noxious oral stimulus. More participants (≥100 people) will be enrolled for a more robust analysis.