Learning about pain and how to deal with it is the focus of a new study that applies a biopsychosocial model to coping with chronic pain by reframing the reaction to pain without the stress or fear of causing re-injury and further pain.

Research by Hayley Leake, the 2021 champion of the “Australian Survivor” reality TV series, shows that patients can apply the following three concepts while coping with pain: Pain does not mean that my body is damaged; Thoughts, emotions and experiences affect pain; and I can retrain my overprotective pain system.

“Chronic pain is experienced by one in five Australians, and when pain persists, it can disrupt every aspect of life — including school or work, social and family connections and physical and mental health,” said Leake, a doctoral student at the University of South Australia. She said that pain is the brain’s “protective output” in response to threat. “Threat may take many forms, not just what’s happening in your body, but also your thoughts, emotions and context.”

Leake recalled that during an appearance on “Survivor,” she stood on narrow, wooden pegs for nearly five and a half hours. To manage the resulting pain, she repeated to herself, “My feet are strong; my body is safe; this is not dangerous.” Her research gave her an understanding of the pain mechanism and how resilient human beings are. She also believed it reduced her pain during her feat on “Australian Survivor.”

The Australian athlete and researcher used a mixed-methods approach to educate 97 study participants in pain science. Her study, published in The Journal of the International Association for the Study of Pain, claims her methods helped patients recover from chronic pain by learning that it does not mean that their bodies are injured. The study found that emotion and stress can worsen the perception of pain, but this perception can be reframed as overprotection that can be reduced.

Leake said it is a misconception that pain reflects tissue damage and hopes pain sufferers can cope by “reframing knowledge of pain.”

“Teenagers report feeling uncertain and anxious about their diagnosis of chronic pain; they want a further explanation beyond just a label. It is important we help them make sense of their pain,” Leake said.

If teens learn that pain does not indicate damage to tissue, she said, they may not fear re-injury, thus “helping them move and start to recover sooner.” By understanding how stress can affect pain, Leake said, teens can address how these are intertwined.

Leake’s study identified several objectives in teaching how to understand pain. Her method instills the belief that pain is a protector, the pain system can become overprotective, pain is a brain output and not an accurate marker of tissue state, there are many potential contributors to anyone’s pain, we are all bioplastic (adaptable to change) and pain education is treatment.

“Reframing perceptions of pain is key,” Leake said. “Instilling hope that change is possible can make all the difference to a young person struggling with chronic pain.”

Edited by Siân Speakman and Kristen Butler

Chalky, discolored teeth in children have long worried dentists and parents. An international team of researchers has now found the condition may be triggered by common childhood illnesses.

A study published in Frontiers of Physiology noted that one in five children has visibly discolored enamel, known as chalky enamel, on their teeth. For more than 100 years, researchers had sought to determine the origin of this source of severe tooth decay and toothache, which can lead to dangerous abscesses, orthodontic issues and tooth extraction.

Bernhard Gottlieb, a European physician and dentist, first studied chalky teeth in 1920 when he showed that only some parts of some teeth were affected.

Chilean and Australian researchers have now determined that this hypomineralization of teeth happens when the enamel in growing children is contaminated by albumin, which is a protein in blood and the tissue fluid that surrounds developing teeth.

They found that this condition is triggered by childhood diseases.

“The result is a sort of ‘mineralization blockage,’ which is highly localized to the areas on individual teeth that become chalky enamel spots,” said study co-author Mike Hubbard of the University of Melbourne. “This discovery allows us to correct 40 years of medico-dental dogma which blamed defective enamel-forming cells.”

“What this dogma couldn’t explain is why chalkiness affects only one or a few teeth in a child’s mouth,” Hubbard added. “We’ve shown instead that albumin leaks in occasionally at weak spots, binding to enamel-mineral crystals and blocking their growth. It’s not a system-wide problem but a very localized one.”

Chalky teeth, according to the researchers, are triggered by routine conditions such as fever. Now they want to find the underlying causes, including genetics, pathogens and environment, and then spread the word to parents, dentists and other child healthcare professions.

“We can’t yet prevent chalky teeth from developing in the first place, but if health professionals catch them early — when they first enter the mouth — then we dentists can usually save them,” study co-author Vidal Perez of the University of Talca, Chile, said.

Genetic anomalies and nutrition issues may be at the root of chalky teeth, the researchers believe. They focused on molars, having noted that they are especially prone to decay. “They are hidden away at the back of our mouths, with grooves that catch food, and they’re harder to clean,” Perez said. Hypomineralization of a tooth multiplies its tendency to decay by a factor of 10, which the team qualified as a “silent epidemic” that causes suffering.

Hubbard found that despite the fluoridation of water supplies and a significant reduction in child tooth decay, there are still children with unexplained decay. The study’s researchers found that fluoride protects against decay of normal tooth enamel but has hardly any effect on chalky molars in both developed and developing countries.

Hubbard points out that the study may lead to a strategy for addressing this global problem. “This new avenue of research could one day eliminate about half of childhood tooth decay, along with its disturbing costs to affected individuals and society,” he said.

Edited by Richard Pretorius and Kristen Butler