Question

Write a comprehensive, detailed essay for each question. Be sure to explain all terms/concepts and provide support for your arguments from information in the textbook (or from the on-line Pain Module). Each essay should be typed, double-spaced and should not exceed 2 pages in length. Using the gate-control theory, devise a plan to minimize pain during your next visit to the dentist.

Answer 1

Gate-control Theory: -

This theory was described by Melzack and Wall in 1965.Gate-control Theory was the first to clearly articulate the existence of a pain-modulating system by Melzack in 1996.This theory proposed that stimulation of the skin evokes nervous impulses that are then transmitted by three systems located in the spinal cord. These are the following: -

• The substantia gelatinosa in the dorsal horn
• the dorsal column fibers
• the central transmission cells act to influence nociceptive impulses.

This theory was the first theory to suggest that psychological factors play a role in the perception of pain. The theory guided research toward identifying cognitive - behavioral approaches to pain management.

Plan to minimize pain during your next visit to the dentist: -

• Non-pharmacologic nursing activities can assist in pain relief, usually with low risk to the patient.
• The gate control theory of pain proposes that stimulation of fibers that transmit non-painful sensations can block or decrease the transmission of pain impulses.
• Several pain relief strategies, including rubbing the skin and using heat and cold, are based on this theory.
• Massage, which is generalized cutaneous stimulation of the body, it may have an impact through the descending control system.
• Massage also promotes comfort because it produces muscle relaxation.
• Transcutaneous electrical nerve stimulation (TENS) uses a battery-operated unit with electrodes applied to the skin to produce a tingling, vibrating, or buzzing sensation in the area of pain.
• A mechanical device is available that performs this vibratory action very effectively and consistently (eg. Vibra-Ject).
• The two sensory cells in the oral cavity most likely associated with the pain reduction phenomenon created by vibration like that generated by the VibraJect include free nerve endings and mechanoreceptors, or tactile nerves.
• There are mainly two types of sensory cells available in oral cavity, those are associated with pain reduction phenomenon created by vibration. these are: - (i)Free nerve endings

(ii)mechano-receptors or tactile nerves

• Ice and heat therapies may be effective pain relief strategies but in some conditions heat should not be applied to a painful area that is the site of acute untreated infection.