title: Impact of anxiety on pain perception associated with periodontal and implant surgery in a private practice.
abstract: BACKGROUND
  There are limited data on pain perception after periodontal or implant surgery or how pain perception is affected by presurgical anxiety.
  
  
  METHODS
  Presurgical anxiety and surgical pain perceptions were measured by visual analog scale (VAS) scores and by interview of patients (N = 102) undergoing periodontal or implant therapy in a private periodontal specialty practice in Norway.
  
  
  RESULTS
  Patients reported that bad taste, receiving the local anesthetic, and excessive fluid in the mouth were the most uncomfortable experiences associated with periodontal or implant surgery. Analysis of identical responses to these questions showed that there was low intrapatient agreement for uncomfortable experiences (κ = 0.18), but there was reasonably good agreement for comfortable experiences (κ = 0.76). There were no significant differences between repeated VAS scores for pain perception (P = 0.91) or anxiety (P = 0.75) from two consecutive surgeries. There were no significant differences of VAS scores for perception of discomfort for periodontal surgery (9.9 ± 17.0) compared to implant surgery (16.7 ± 24.2; P >0.2). Presurgical anxiety scores were higher for implant surgery (45.5 ± 33.4) than for periodontal surgery (19.5 ± 28.1; P <0.01). Patients with high pretreatment anxiety scores reported that periodontal and implant surgery were more uncomfortable than patients with low anxiety scores (20.5 ± 25.6 versus 0.45 ± 1; P <0.001). VAS perception and anxiety scores did not change on first-time through fourth-time surgeries, but retreatment surgery patients recorded higher perception and anxiety VAS scores than patients undergoing surgery for the third or fourth time (P <0.01). Females recorded significantly higher anxiety scores than males (P = 0.04).
  
  
  CONCLUSIONS
  For periodontal surgery and implant treatments pain perception is affected by the level of presurgical anxiety.
authors.affiliation: fardal@odont.uio.no
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Fardal
authors.forename: Christopher A
authors.initials: CA
authors.lastname: McCulloch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000523:psychology / Q000601:surgery; D000766:Anesthesia, Dental / Q000523:psychology; D000772:Anesthesia, Local / Q000523:psychology; D000779:Anesthetics, Local / Q000008:administration & dosage; D001294:Attitude to Health; D016854:Dental Anxiety / Q000175:diagnosis / Q000523:psychology*; D003758:Dental Implantation, Endosseous / Q000523:psychology*; D005260:Female; D017823:Furcation Defects / Q000523:psychology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000523:psychology*; D010149:Postoperative Pain / Q000523:psychology; D010510:Periodontal Diseases / Q000523:psychology / Q000601:surgery*; D012086:Reoperation; D012737:Sex Factors; D013524:Surgical Flaps; D013649:Taste / Q000502:physiology
chemical_list: D000779:Anesthetics, Local