Differences in pain tolerance

I have two adopted children. My son is not as affected by dental pain as my daughter, who is the same age. Can you explain this difference?

Question:

I have noticed a wide variety of pain tolerance and reaction to anesthesia among my patients. Although dentistry has improved pain management, a clear pattern of pain tolerance has yet to be established.

Men and women may have different sensitivities to anesthetic. Patients typically receive doses of general anesthesia based on their body weight. Women generally receive less anesthetic than men because they are usually smaller. Gan et al. (1999) gave the same amount of general anesthetic and painkiller to men and women. Women recovered from the anesthesia much faster than men.

For children, the expectancy of dental pain is often unrealistic. In a study by Mares et al. (1997), 67 percent of the children overestimated expected pain and 12 percent underestimated it. However, this same study found no statistical difference between the way boys and girls experience dental pain. Interestingly, it was observed that health care workers consoled girls more often than boys. This is probably a cultural artifact. Moore et al. (1998) noted that descriptions of pain varied among races. Ethnic beliefs about the perceived need for local dental anesthetic varied as well.

Even with exciting advances in pain management, too many people still associate the word dentist with pain. Dionne et al. (1998) revealed that 30 percent of survey respondents were anxious about pain and anesthesia prior to a dental visit. Dentists know that pain, whether real or imagined, prevents people from scheduling dental appointments. This is why "gentle dental care" and "we cater to cowards" are popular marketing slogans.

References:

Gan et al., "Sex differences seen with anesthesia (working title)" Anesthesiology (1999) 90:1283-1287.

Dionne et al., "Assessing the need for anesthesia and sedation in the general population" J. Am. Dent. Assoc. (1998) 129 (2):167- 173.

Mares et al., "Children pain during dental treatment" Acta Medica (1997) 40(4):103-108.

Moore et al., "Acute pain and use of local anesthesia: Tooth drilling and childbirth labor pain beliefs among Anglo-Americans, Chinese, and Scandinavians" Anesth. Prog. (1998) 45(1):29-37.

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