title: Patients' experience of pain and discomfort during instrumentation in the diagnosis and non-surgical treatment of periodontitis.
abstract: BACKGROUND
  The present multicenter study aimed to survey the patients' experiences in relation to the diagnosis and non-surgical treatment of periodontitis according to current treatment routine.
  
  
  METHODS
  Patients (N = 268) treated for plaque-related periodontitis were enrolled in two groups: group 1 received primary probing of pocket depths (PD 1) and/or primary scaling and root planing (SRP 1); group 2 consisted of patients who were scheduled in the different centers for recall PD/scaling/subgingival instrumentation. Data collection included a full periodontal status, anesthesia employed, procedure time, and patient self-completed questionnaires to assess their previous and current experience of pain and discomfort during anesthesia and periodontal treatment.
  
  
  RESULTS
  Ninety percent of the patients received infiltration anesthesia during primary SRP, compared to only 2% during recall scaling/instrumentation and none during PD. Many patients (40% in SRP group 1 and 52% in the recall scaling/instrumentation group) were most bothered by the scaling procedure, while others (35% in the primary SRP patients) by the anesthetic injection. Painful experiences during previous primary PD and present SRP were highly correlated (r = 0.6).
  
  
  CONCLUSIONS
  From these results, it is evident that subgingival instrumentation causes pain and discomfort, an aspect that should be considered in periodontal therapy. Unfortunately, the use of local infiltration anesthesia to reduce pain is in itself a cause of discomfort. Attractive alternatives for anesthetic applications are much needed.
authors.affiliation: Department of Periodontology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium. daniel.vansteenberghe@uz.kuleuven.ac.be
authors.forename: Daniel
authors.initials: D
authors.lastname: van Steenberghe
authors.forename: Peter
authors.initials: P
authors.lastname: Garmyn
authors.forename: Lut
authors.initials: L
authors.lastname: Geers
authors.forename: Elke
authors.initials: E
authors.lastname: Hendrickx
authors.forename: Marina
authors.initials: M
authors.lastname: Maréchal
authors.forename: Karin
authors.initials: K
authors.lastname: Huizar
authors.forename: Ann
authors.initials: A
authors.lastname: Kristofferson
authors.forename: Karin
authors.initials: K
authors.lastname: Meyer-Rosberg
authors.forename: Guy
authors.initials: G
authors.lastname: Vandenhoven
mesh_terms: D000328:Adult; D000368:Aged; D000766:Anesthesia, Dental / Q000009:adverse effects*; D012534:Dental Scaling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification* / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000145:classification / Q000209:etiology; D010518:Periodontitis / Q000175:diagnosis* / Q000628:therapy*; D016745:Root Planing / Q000009:adverse effects*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires