Pharmacologic and Non-Pharmacologic Approaches to Dental Pain Management in Elderly Patients: Insights from Primary Care Settings in Nigeria

Résumé fourni par la source

Dental pain can impair eating, sleep, communication, and quality of life in older adults, yet evidence on its management in Nigerian primary healthcare centres (PHCs) is limited. This study assessed the pharmacologic and non pharmacologic approaches reported by elderly patients who sought care for dental pain in selected Nigerian PHCs and described their treatment outcomes. A descriptive cross sectional survey was conducted among 187 adults aged 60 years or older who had experienced dental pain during the preceding 12 months. Government-owned PHCs serving urban and peri-urban communities were purposively selected based on accessibility and patient volume, and within these facilities, participants were recruited using systematic sampling. All data on management and outcomes were self-reported by patients and collected through a pretested, interviewer administered questionnaire. While respondents reported use of both analgesics and antibiotics, specific drug types were not consistently documented. Most commonly, participants described receiving paracetamol and nonsteroidal anti-inflammatory drugs for pain, and amoxicillin or metronidazole when antibiotics were provided. However, the questionnaire did not record drug type, dose, or indication in detail, and no assessment of the appropriateness of prescribed medications was possible from the available data. The data were analysed in SPSS version 27 using frequencies, percentages, and chi square tests at p < .05. Analgesic only care was the principal treatment for 71.1% of respondents, and 47.0% reported antibiotic use. Non pharmacologic measures were infrequently reported, including counselling (12.0%) and warm saline rinses (8.0%). Definitive procedures were uncommon: extraction, filling, and scaling were reported by 3.7%, 2.7%, and 1.6% of respondents, respectively. Complete pain relief was reported by 18.2%, partial relief by 55.1%, and no relief by 26.7%; 65.8% experienced recurrent pain. Educational level was associated with treatment outcome (p = .019), whereas age and sex were not. Management was dominated by short term pharmacologic relief, with limited non pharmacologic support and definitive care. Age sensitive prescribing, structured oral health counselling, prompt referral, and access to essential dental treatment should be integrated into PHC services.

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