Caffeine is showing promise as a tool to help manage dental pain

By Emma Yasinski

If a recently published study is any indication, dentists who don’t already offer their patients coffee in the waiting room, may soon be adding a Keurig to their arsenal of tools designed to help patients manage dental pain.

Writing in the September 2018 edition of Psychopharmacology, the official journal of the European Behavioural Pharmacology Society, Dr. Burel R. Goodin and his colleagues reviewed the caffeine consumption of 62 adults, and found that “individuals who habitually consume greater amounts of caffeine as part of their daily diets demonstrate diminished sensitivity to painful stimuli….”

 

Dr. Burel R. Goodwin, University of Alabama at Birmingham
Dr. Burel R. Goodin, University of Alabama at Birmingham

The study participants, who were adults between 19 and 77 years old, were asked to log their consumption of caffeine – including coffee, tea, soda, energy drinks, and chocolate – for seven consecutive days.

On average, the group consumed 170 milligrams of caffeine a day, roughly equal to a Starbucks “Short;” while some participants consumed upward of 400 milligrams, about the same as a Starbucks “Venti.”

On the final day, participants reported to a laboratory where they were exposed to pain stimuli and measured for their tolerance.

According to Psychopharmacology:

Data analysis revealed that greater self-reported daily caffeine consumption was significantly associated with higher heat pain threshold (β = .296, p = .038), higher heat pain tolerance (β = .242, p = .046), and higher pressure pain threshold (β = .277, p = .049) in multiple regression models adjusted for covariates.

Translation: Caffeine not only stimulates alertness; it also is a prophylactic against pain.

 

Two Adenosine Receptors

The results, albeit obtained in a laboratory setting, seem profound.

Caffeine is the most widely consumed psychoactive substance in the world. For some time now, researchers have been aware, as Dr. Goodin notes, that caffeine administered acutely in a laboratory environment or as a medication adjuvant has properties that help alleviate pain. Dr. Goodin, an associate professor of psychology at the University of Alabama at Birmingham, specializes in pain-related behavioral medicine.

In 2016, a group of researchers from Iran and Egypt conducted a literature review of the few studies that have been conducted on caffeine’s potential ability to mitigate pain.

The conclusions are a little more complicated than simply sipping a cup of coffee before a painful dental procedure.

Some studies have found that giving low doses of caffeine in conjunction with other analgesics such as antidepressants, acetaminophen, or non-steroidal anti-inflammatory drugs, can be helpful for relieving postoperative dental pain, postpartum pain, and headaches.

The impact when caffeine is added to opioid treatments is not clear.

Scientists believe the pain-reducing effects are due to caffeine’s impact on two adenosine receptors. Adenosine, a neurotransmitter that can make us sleepy, has four subtypes of receptors in our central nervous system. Caffeine competes with, and inhibits, the action of adenosine on these receptors. Blocking two of these types of receptors, A1 and A2A, seems to minimize pain in neuropathic and inflammatory models.

The study authors emphasized that we still have a long way to go in understanding caffeine’s potential for pain relief, but there is a renewed interest in its effects. They hope that future studies will investigate its impacts on short-term pain as opposed to chronic pain.

Dr. Goodin, on the other hand, emphasizes that there may be a variety of ways to use diet to manage pain. “Diet can actually be a useful intervention for decreasing pain sensitivity,” he recently told The New York Times. “It’s not just caffeine. A study has shown, for example, that a plant-based diet can actually help increase pain tolerance.”

 

Author: Contributing writer Emma Yasinski received her Master of Science (MS) in science and medical journalism from Boston University. Her articles have also appeared at TheAtlantic.com, Kaiser Health News, NPR Shots, and Genetic Engineering and Biotechnology News

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