Pain experienced by patients during periodontal maintenance.
BACKGROUND
The aims of this study were to determine: 1) the degree of pain experienced by patients during probing and debridement; 2) whether the treating hygienists could estimate the degree of pain experienced by the patients; and 3) whether the patients' pain responses could be predicted by factors such as the patients' age, gender, number of residual periodontal lesions, and answers to a questionnaire on dental anxiety.


METHODS
Prior to periodontal maintenance procedures, two groups of 20 adult patients to be treated by two hygienists completed an anxiety questionnaire. Subsequently, measurements of probing depths were performed, followed by pain ratings by each patient using a visual analog scale (VAS). The hygienists also completed a VAS, estimating the pain level they perceived their patient to have experienced. The same protocol was repeated for instrumentation (debridement).


RESULTS
Most patients showed low pain responses to both probing and instrumentation. However, using an arbitrary threshold of VAS > or = 40 mm, 20% to 33% of the patients had a significant pain experience. The hygienists were quite accurate in their relative estimates of their patients' pain experiences. Regression analyses disclosed that significant portions of the pain responses could be predicted by the patients' answers to one of the dental anxiety questions.


CONCLUSIONS
Recognition of patients who are likely to experience significant pain during periodontal treatment may be facilitated by the use of one question on dental anxiety. During treatment, the ability to gauge and respond to patients' pain experiences would seem to be an important component of a therapist's clinical skills.
Chung
Denine T
DT
Advanced Education Program in Periodontics and Implant Surgery, School of Dentistry, Loma Linda University, Loma Linda, CA 92354, USA.
Bogle
Gary
G
Bernardini
Melanie
M
Stephens
Denise
D
Riggs
Matt L
ML
Egelberg
Jan H
JH
D000328:Adult; D000339:Affect / Q000502:physiology; D000367:Age Factors; D016854:Dental Anxiety / Q000209:etiology / Q000523:psychology; D003756:Dental Hygienists; D012534:Dental Scaling; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D010510:Periodontal Diseases / Q000517:prevention & control*; D010514:Periodontal Pocket / Q000145:classification / Q000628:therapy; D011369:Professional-Patient Relations; D012044:Regression Analysis; D012737:Sex Factors; D013357:Subgingival Curettage