Changes in tooth pulpal detection and pain thresholds in relation to jaw movement in man

Abstract

The effect of jaw movements on pulpal sensory thresholds to electrical stimulation was studied in healthy humans. The movements consisted of repeated jaw opening and closing at two different frequencies (1 and 3 s −1). The detection/perception and pain thresholds of an upper or lower central incisor were determined by stimulation with monopolar constant current pulses at two different durations (0.5 and 5.0 ms). In the absence of jaw movement, the control (baseline) pain threshold was significantly higher than the detection threshold, and both thresholds were significantly decreased with an increase of the stimulus pulse duration. During jaw movement, pulpal detection and pain thresholds were significantly elevated, independent of the duration of the stimulus pulse. The jaw movement-related increase in detection thresholds was significantly dependent on the rate of cyclical jaw movements and on the site of stimulation. An increase in pulpal sensory thresholds was observed with stimulation of the lower incisor only; there was no change in thresholds for the upper incisor. Pulpal detection thresholds were significantly more elevated during jaw movement than pulpal pain thresholds. The results indicate that the reduction in pulpal sensitivity is related to the jaw movements. The effect of jaw movement on pulpal detection thresholds was segmentally restricted. In contrast, modulation of the pulpal pain thresholds was considerably weaker. The jaw movement-related suppression of pulpal sensitivity may be explained by activation of segmental afferent-induced inhibition, corollary efferent barrage from motor to sensory areas, or a combination of both.