Predictors of pain associated with routine procedures performed in general dental practice.
OBJECTIVE
The objective of the study was to investigate factors that influence pain intensities associated with routine dental procedures.


METHODS
Four hundred and fifty-one dental patients self-reported pain experienced during the procedure immediately after undergoing a variety of common dental interventions and 1 day after the completion of the procedure. Pain character was measured using the McGill short-form pain questionnaire and intensity using a numerical rating (NRS) scale. Information was collected on a number of factors that could influence pain: dental anxiety was measured using the Corah Dental Anxiety Scale to categorize patients into four domains (fearless, some unease, nervous and very anxious). Dentists provided information regarding the type(s) of procedure and use of local anaesthetic (LA).


RESULTS
Seventy-five percent of patients (339/451) reported no pain during their procedure when the data were collected immediately postoperatively (NRS score = 0). Univariate analyses showed that dental anxiety, LA use and type of procedure (extractions) were significant (P < 0.05) predictors of reported intra-operative pain. However, when these factors were combined in a multivariate model, the strongest predictor of pain was dental anxiety [odds ratio (OR) = 4.98 (95% CI 1.42-17.44)] and LA use [OR = 2.79 (95% CI 1.39-5.61)]. Although the strongest predictor of postoperative pain on the next day was pain reported during the procedure [OR = 5.85 (95% CI 2.71-12.64)], LA remained a significant predictor of pain the day after the procedure [OR = 3.16 (95% CI 1.02-9.81)].


CONCLUSIONS
Dentists need to assess their patients both preoperatively for dental anxiety and intra-operatively for signs of suboptimal local anaesthesia so as to effectively align patient management and clinical techniques to control dental anxiety and produce adequate anaesthesia.
Manchester Academic Health Sciences Centre, School of Dentistry, University of Manchester, Manchester, UK.
Martin
M
Tickle
Keith
K
Milsom
Fiona I J
FI
Crawford
Vishal R
VR
Aggarwal
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000766:Anesthesia, Dental / Q000706:statistics & numerical data; D016854:Dental Anxiety / Q000453:epidemiology / Q000209:etiology; D003729:Dental Care / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D010147:Pain Measurement; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014081:Tooth Extraction / Q000009:adverse effects