Skip to main content
Anesthesia Progress logoLink to Anesthesia Progress
. 1998 Winter;45(1):22–28.

Perceived need for local anesthesia in tooth drilling among Anglo-Americans, Chinese, and Scandinavians.

R Moore 1, I Brødsgaard 1, T K Mao 1, M L Miller 1, S F Dworkin 1
PMCID: PMC2148943  PMID: 9790006

Abstract

This study explored ethnic differences in perceptions of pain and the need for local anesthesia for tooth drilling among age- and gender-matched Anglo-American, Mandarin Chinese, and Scandinavian dentists (n = 129) and adult patients (n = 396) using a systematic qualitative research strategy. Semistructured qualitative interviews determined: (a) the relative frequency of use or nonuse of anesthetic for similarly specified tooth drilling, (b) the reasons for nonuse of anesthetic as reported by dentists about their patients, and (c) the distribution of reasons for not using anesthetic. American dentists (n = 51) reported that about 1% of their adult patients did not use anesthetic compared with 90% among Chinese (n = 31) and 37.5% among Scandinavian dentists (n = 40). Of patients, Americans (n = 112) reported 6% nonuse of anesthetic for tooth drilling compared with 90% of 159 Chinese and 54% of 125 Scandinavians. Reasons among Anglo-Americans and Scandinavians were similar (ranked): the sensation was tolerable, to avoid numb feelings afterwards, and fear of injections. Danish patients were an exception; the fact that they had paid extra and out-of-pocket for anesthetic ranked second. In contrast, Chinese dentists made their decisions not to use anesthetics because they explained drilling as only a suan or "sourish" sensation, whereas injections were described as "painful." It was concluded that ethnic pain beliefs and differences in health-care systems are powerful psychosocial variables that affect pain perception and the perceived need for anesthetic.

Full text

PDF
27

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BEECHER H. K. Relationship of significance of wound to pain experienced. J Am Med Assoc. 1956 Aug 25;161(17):1609–1613. doi: 10.1001/jama.1956.02970170005002. [DOI] [PubMed] [Google Scholar]
  2. BEECHER H. K. The measurement of pain; prototype for the quantitative study of subjective responses. Pharmacol Rev. 1957 Mar;9(1):59–209. [PubMed] [Google Scholar]
  3. Dworkin S. F., Chen A. C. Pain in clinical and laboratory contexts. J Dent Res. 1982 Jun;61(6):772–774. doi: 10.1177/00220345820610062401. [DOI] [PubMed] [Google Scholar]
  4. Koopman C., Eisenthal S., Stoeckle J. D. Ethnicity in the reported pain, emotional distress and requests of medical outpatients. Soc Sci Med. 1984;18(6):487–490. doi: 10.1016/0277-9536(84)90005-4. [DOI] [PubMed] [Google Scholar]
  5. Lipton J. A., Marbach J. J. Ethnicity and the pain experience. Soc Sci Med. 1984;19(12):1279–1298. doi: 10.1016/0277-9536(84)90015-7. [DOI] [PubMed] [Google Scholar]
  6. Melzack R., Wall P. D. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(3699):971–979. doi: 10.1126/science.150.3699.971. [DOI] [PubMed] [Google Scholar]
  7. Moore R. A., Dworkin S. F. Ethnographic methodologic assessment of pain perceptions by verbal description. Pain. 1988 Aug;34(2):195–204. doi: 10.1016/0304-3959(88)90166-2. [DOI] [PubMed] [Google Scholar]
  8. Moore R., Brødsgaard I., Mao T. K., Kwan H. W., Shiau Y. Y., Knudsen R. Fear of injections and report of negative dentist behavior among Caucasian American and Taiwanese adults from dental school clinics. Community Dent Oral Epidemiol. 1996 Aug;24(4):292–295. doi: 10.1111/j.1600-0528.1996.tb00862.x. [DOI] [PubMed] [Google Scholar]
  9. Moore R. Dentistry in Denmark: a public and private blend of dental policy and delivery. J Am Dent Assoc. 1982 May;104(5):661–669. doi: 10.14219/jada.archive.1982.0267. [DOI] [PubMed] [Google Scholar]
  10. Moore R. Ethnographic assessment of pain coping perceptions. Psychosom Med. 1990 Mar-Apr;52(2):171–181. doi: 10.1097/00006842-199003000-00005. [DOI] [PubMed] [Google Scholar]
  11. Moore R., Miller M. L., Weinstein P., Dworkin S. F., Liou H. H. Cultural perceptions of pain and pain coping among patients and dentists. Community Dent Oral Epidemiol. 1986 Dec;14(6):327–333. doi: 10.1111/j.1600-0528.1986.tb01084.x. [DOI] [PubMed] [Google Scholar]
  12. Weinstein P., Shimono T., Domoto P., Wohlers K., Matsumura S., Ohmura M., Uchida H., Omachi K. Dental fear in Japan: Okayama Prefecture school study of adolescents and adults. Anesth Prog. 1992;39(6):215–220. [PMC free article] [PubMed] [Google Scholar]
  13. Wirth D. P. The significance of belief and expectancy within the spiritual healing encounter. Soc Sci Med. 1995 Jul;41(2):249–260. doi: 10.1016/0277-9536(94)00312-h. [DOI] [PubMed] [Google Scholar]

Articles from Anesthesia Progress are provided here courtesy of American Dental Society of Anesthesiology

RESOURCES