Anticipated and experienced pain associated with endodontic therapy.
BACKGROUND
The authors compared the levels of anticipated and experienced pain of patients who received endodontic therapy, or ET, with selected patient and dental characteristics.


METHODS
Sensory and affective pain outcome measures (pain and unpleasantness) were evaluated by 333 adult patients immediately before and after dental school faculty or residents performed ET. Dentists provided clinical evaluations and a pulpal diagnosis for each tooth and then rated the level of their patients' pain during treatment.


RESULTS
Before ET, 43 percent of all patients anticipated high outcome levels, yet only 22 percent experienced high pain levels, and only 18 percent experienced high unpleasantness levels. Outcome levels did not differ by tooth type, pulpal diagnosis, ET history or dental care attendance. Women were significantly more likely to anticipate higher pain and unpleasantness levels than were men. Experienced outcome levels, however, did not differ by sex. Anticipated and experienced outcome levels significantly decreased with increasing age. Dentists' evaluation of their patients' pain levels correlated more highly for female than for male patients.


CONCLUSIONS
Pain experienced during ET often is less than anticipated. Younger people anticipate and experience higher pain levels. Women are more likely than men to anticipate, but not necessarily experience, higher pain levels. Dentists are more closely attuned to the pain experiences of their female patients. Clinical Implications. Practitioners could better prepare younger patients and female patients for ET and improve pain communication with male patients. Findings suggest that patients perceive each ET experience as new, implying that dentists should manage patients who have had ET in the past as carefully as those receiving ET for the first time.
Watkins
Catherine A
CA
Department of Preventive and Community Dentistry, Iowa City, Iowa 52242-1010, USA.
Logan
Henrietta L
HL
Kirchner
H Lester
HL
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016854:Dental Anxiety / Q000145:classification; D003790:Dental Pulp Necrosis / Q000503:physiopathology; D003812:Dentist-Patient Relations; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000523:psychology*; D011671:Pulpitis / Q000503:physiopathology; D012390:Root Canal Therapy / Q000009:adverse effects; D012677:Sensation / Q000502:physiology; D012737:Sex Factors; D013315:Stress, Psychological / Q000145:classification; D016896:Treatment Outcome