Pain Assessment and Need for Analgesics after Scaling and Root Planing in Patients with Stage II and Stage III Periodontitis

Background and Objectives: The most common treatment procedure for periodontitis and gingivitis is scaling and root planing, which is perceived as a painful dental treatment. The current study aimed to assess pain perception and analgesics consumption after scaling and root planing (SRP) in patients with stage II and stage III periodontitis. Materials and Methods: Before starting the SRP, all the periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL), were measured. The anxiety level of the patients was also assessed using the modified dental anxiety scale (MDAS) questionnaire. Pain perception of the patients was recorded with the visual analog scale (VAS) after performing the SRP. Patients were asked to mark their pain level on the VAS sheet after two hours, four hours, eight hours, 24 h, and 48 h after the periodontal treatment. The following cut-off points were used for the pain intensity in the VAS: 0 = no pain, 1–4 = mild pain, 4–6 = moderate pain, and 7–10 = severe pain. Patients were advised to take analgesics if the pain was intolerable. Multivariate logistic regression was performed to conduct the association of all dependent variables and the pain perception of patients. A nonparametric Friedman test was conducted to assess pain perception at different times. Results: A total of 52 patients including 32 males and 20 females participated in the current study, with a mean age of 43.10 ± 12.33 years. Multivariate analyses showed that MDAS and analgesic consumption is significantly associated with pain perception. Other clinical variables are not associated with pain perception. The Friedman test exhibited that pain perception is significantly associated (p < 0.05) with time. Conclusions: Analgesic consumption and anxiety level are significantly associated with pain perception after SRP treatment.

[1]  Matteo Pellegrini,et al.  Latest Findings of the Regenerative Materials Application in Periodontal and Peri-Implant Surgery: A Scoping Review , 2022, Bioengineering.

[2]  E. Seyedjafari,et al.  Comparative Evaluation of the Effects of Antimicrobial Photodynamic Therapy With an LED and a Laser on the Proliferation of Human Gingival Fibroblasts on the Root Surface: An In Vitro Study. , 2021, Journal of lasers in medical sciences.

[3]  A. Scribante,et al.  Ozonized Water Administration in Peri-Implant Mucositis Sites: A Randomized Clinical Trial , 2021, Applied Sciences.

[4]  L. Abreu,et al.  Pain assessment and analgesic consumption after nonsurgical periodontal therapy , 2021, Journal of Indian Society of Periodontology.

[5]  Abanish Singh,et al.  Pain perception and dental anxiety during periodontal probing in patients visiting community oral health programme: a cross sectional study , 2021, BMC oral health.

[6]  W. Thomson,et al.  The Prevalence and Impact of Dental Anxiety Among Adult New Zealanders , 2020, International dental journal.

[7]  M. Alam,et al.  Pain Perception and Rate of Canine Retraction Through Self-Ligating Brackets and Conventional Elastomeric Ligation System: A Split Mouth Study , 2020 .

[8]  Mazia Jawaid,et al.  Pain perception of orthodontic treatment – A cross-sectional study , 2019, Pakistan journal of medical sciences.

[9]  S. Pradhan,et al.  Pain Perception after Periodontal Therapies , 2018, Journal of Nepalese Society of Periodontology and Oral Implantology.

[10]  P. Papapanou,et al.  A new classification scheme for periodontal and peri‐implant diseases and conditions – Introduction and key changes from the 1999 classification , 2018, Journal of periodontology.

[11]  M. Caltabiano,et al.  Dental anxiety in patients attending a student dental clinic , 2018, BMC oral health.

[12]  M. Alam,et al.  Effects of single-dose, low-level laser therapy on pain associated with the initial stage of fixed orthodontic treatment: A randomized clinical trial , 2018, Korean journal of orthodontics.

[13]  M. Ahmadi,et al.  Association of Anxiety with Pain Perception following Periodontal Flap Surgery , 2018, Journal of International Society of Preventive & Community Dentistry.

[14]  Mubassar Fida,et al.  Effects of low‐level laser irradiation on the rate of orthodontic tooth movement and associated pain with self‐ligating brackets , 2017, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[15]  Fu-Ying Lee,et al.  Assessment of pain perception following periodontal and implant surgeries. , 2016, Journal of clinical periodontology.

[16]  G. Genta,et al.  Probing depth in periodontal pockets: In vitro evaluation of contributions to variability due to probe type and operator skill , 2015, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[17]  L. Cooper,et al.  Clinical outcomes of three different crown systems with CAD/CAM technology. , 2014, The Journal of prosthetic dentistry.

[18]  D. Appukuttan,et al.  Utility and validity of a single-item visual analog scale for measuring dental anxiety in clinical practice. , 2014, Journal of oral science.

[19]  H. Moon,et al.  Assessment of pain and anxiety following surgical placement of dental implants. , 2013, The International journal of oral & maxillofacial implants.

[20]  C. McCulloch,et al.  Impact of anxiety on pain perception associated with periodontal and implant surgery in a private practice. , 2012, Journal of periodontology.

[21]  Sheetal Sanikop,et al.  Relationship between dental anxiety and pain perception during scaling. , 2011, Journal of oral science.

[22]  G. Humphris,et al.  The Arabic version of the modified dental anxiety scale. Psychometrics and normative data for 15-16 year olds. , 2011, Saudi medical journal.

[23]  M. Shaikh,et al.  Over dental anxiety problems among university students: perspective from Pakistan. , 2011, Journal of the College of Physicians and Surgeons--Pakistan : JCPSP.

[24]  Cenk Fatih Çanakçı,et al.  Pain experienced by patients undergoing different periodontal therapies. , 2007, Journal of the American Dental Association.

[25]  Cenk Fatih Çanakçı,et al.  Pain levels in patients during periodontal probing and mechanical non-surgical therapy , 2007, Clinical Oral Investigations.

[26]  A. Spencer,et al.  Dental fear in Australia: who's afraid of the dentist? , 2006, Australian dental journal.

[27]  L. Kennedy-Malone,et al.  Self-medication with over-the-counter drugs among elderly adults. , 2003, Journal of gerontological nursing.

[28]  R. Baht,et al.  Effect of anxiety on the experience of pain in implant insertion. , 2003, Clinical oral implants research.

[29]  A. C. Johannessen,et al.  Patient perceptions of periodontal therapy completed in a periodontal practice. , 2002, Journal of periodontology.

[30]  R. Baht,et al.  Effect of gender on acute pain prediction and memory in periodontal surgery. , 2000, European journal of oral sciences.

[31]  G. Armitage,et al.  Development of a classification system for periodontal diseases and conditions. , 1999, Annals of periodontology.

[32]  C. Gibbs,et al.  Pain threshold values during periodontal probing: assessment of maxillary incisor and molar sites. , 1998, Journal of periodontology.

[33]  Nosheen Zehra,et al.  DENTAL ANXIETY AMONG PATIENTS ATTENDING PUBLIC AND PRIVATE DENTAL HOSPITALS OF KARACHI , 2018 .

[34]  M. B. Ferreira,et al.  Factors associated with pain and analgesic consumption following non‐surgical periodontal therapy under local anaesthesia and carried out by dental students , 2018, Journal of clinical periodontology.

[35]  S. Prakash,et al.  Accuracy of probing attachment levels using a new computerized cemento-enamel junction probe , 2012, Journal of Indian Society of Periodontology.