Kurzfassung

About 60% of the population are afraid of painful dental treatment or of dental injection. One possibility to make an injection more comfortable is topical anaesthesia. Lidocaine is a well-known and established topical anaesthetic agent in dental treatment. In addition pain can be influenced by placebo mechanisms such as experience, expectation or classical conditioning. It is known that the pharmacological effectiveness of pharmaceuticals can be boost up to 50% by using placebo mechanisms....About 60% of the population are afraid of painful dental treatment or of dental injection. One possibility to make an injection more comfortable is topical anaesthesia. Lidocaine is a well-known and established topical anaesthetic agent in dental treatment. In addition pain can be influenced by placebo mechanisms such as experience, expectation or classical conditioning. It is known that the pharmacological effectiveness of pharmaceuticals can be boost up to 50% by using placebo mechanisms. The aim of the study is to constitute the consequence of information (positive/neutral) to the pharmacological effectiveness of lidocaine/placebo on the oral mucosa in the context to open-hidden-paradigm in dental anesthesia under the influence of dentist-patient-relationship.
In an experimental conditioning design (8 groups) we are testing 88 healthy volunteers (41 male, 47 female) in a double blind, randomised trial. Participants´ anxiety and behaviour to pain perception as well as probands’ anxiety and pain behaviour are checked with special questionnaires (MDAS, STAI), for self-estimation we use visual analogue scales (VAS). We investigate the change of pain sensitivity provoked by PinPrick instruments on the oral mucosa (frontal vestibule of the mandible) according to the factors substance (placebo/lidocaine), verbal instruction (positive/neutral) and open/hidden application (eye mask) among base- and testline. The verbal instruction is reinforced by the conditioning stage. Participants who are instructed positive, experience a reduction of pain in PinPrick-testing, unbeknown that the intensity of pain stimulus is reduced. PinPrick-rating is documented on a visual analogue scale. We use ANCOVA for statistic analysis and investigate the data of the collective as well as split up under the focus of dentist-patient-relationship.
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