Emergency pulpotomy in relieving acute dental pain among Tanzanian patients

Setting: School of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania.Study design: Longitudinal study.Participants: 180 patients who presented with dental pain due to acute irreversible pulpitis during the study period between July and August 2001.Treatment and evaluation: Patients were treated by emergency pulpotomy on permanent posterior teeth and were evaluated for pain after one, three and six week's post-treatment. Pain, if present, was categorised as either mild or acute.Of the patients with treated premolars, 25 (13.9%) patients did not experience pain at all while 19 (10.6%) experienced mild pain. None of the patients with treated premolars experienced acute pain. Among 136 patients with treated molars 56 (31%) did not experience any pain, 76 (42.2%) experienced mild pain and the other 4 (2.2%) suffered acute pain.The short term treatment success of emergency pulpotomy was high being 100% for premolars and 97.1% for molars, suggesting that it can be recommended as a measure to alleviate acute dental pain while other conservative treatment options are being considered.In Tanzania, it is estimated that over 85% of dental patients seek dental care due to painful tooth conditions, and that over 90% of the treatment rendered is tooth extraction [1]. A total of 159,660 extractions were conducted in 1993 and 99,636 extractions in 1995 in the 20 regions of Tanzania, the majority of them due to dental caries [2]. These extractions are unjustifiably too many and therefore the situation needs to be rectified. Thus, any strategy aiming at improving emergency oral health services in Tanzania should at least strive at minimising the number of undue extractions performed.Previous studies [3-6] have shown that emergency pulpotomy is very effective in relieving acute dental pain caused by acute pulpitis. The emergency pulpotomy procedure includes the removal of the coronal pulp exposed by caries, cleaning the cavity, dressing the access cavity and filling with