Peri-operative endodontic pain within the Dental Practice-Based Research Network [poster]
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Objective: An estimated 16 million root canals are performed annually in the U.S. alone. Pain is often associated with endodontic involvement and subsequent root canal therapy (RCT). The ability of dentists to ameliorate pain makes this an important area for study. We present observational data on pain intensity and pain interference experienced by RCT patients. Method: A total of 62 dentists (46 generalists, 16 endodontists), practicing in five geographical areas of The Dental Practice-Based Research Network enrolled patients requiring RCT. Data collection via patient self-report occurred before, immediately following treatment, and 1 week after treatment to measure pre-operative, intra-operative and post-operative pain. Pain intensity and interference in life activities were measured using the Graded Chronic Pain Scale (0-10), while analgesic intake and adequate anesthesia were dichotomous outcomes. Results: 708 patients were enrolled over a 6-month period. Mean (S.D) pain intensity during the week prior to treatment was 3.6/10 (2.9); worst pain was 6.7/10 (3.0) with 50% experiencing severe pain (less than or equal to 7/10). Preoperatively, 65% of patients reported taking analgesics and the mean (S.D.) number of days with pain was 0.5 (1.2). Intra-operative pain was 1.1/10 (1.9) and adequate local anesthesia was reported by 91%. In the week following treatment, worst pain was 4.3/10 (1.4), and 16% of patients experienced severe pain. Post-operatively, 55% of patients took analgesics and the mean (S.D.) number of days of pain interference was 0.3 (1.0); 6% reported severe pain plus regional swelling. Conclusion: On average, patients experienced moderate amounts of pain and one-half days of pain interference during the week before treatment. The majority experienced minimal intra-operative pain and adequate anesthesia. Severe pain within the first week post-operatively was reduced, but was still reported by 1 in 6 patients.