Associations between dental anxiety and postoperative pain following extraction of horizontally impacted wisdom teeth

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Abstract

The aim of the study is to identify associations between dental anxiety and postoperative pain in patients undergoing extraction of horizontally impacted wisdom teeth.

A total of 119 volunteers provided demographic data, and completed questionnaires, the State-Trait Anxiety Inventory (STAI), Chinese Index of Dental Anxiety and Fear (C-IDAF)-4C, and the Numeric Rating Scale (NRS) for pain.

Mean SAI, TAI, and C-IDAF-4C scores were 42.5 ± 8.7, 46.4 ± 10.9, and 16.9 ± 7.2, respectively. Mean postoperative pain level score was 3.0 ± 1.8 (range: 0.3–8.4). SAI scores increased as preoperative pain levels increased (β = 1.30, 95% confidence interval [CI]: 0.62–1.98, P < .001); females had higher SAI scores than males (5.34; 95% CI: 1.74–8.95, P = .004). Multivariable analysis revealed that females, bad exodontic experience, and higher predicted pain levels were associated with higher IDAF-4C scores. SAI scores (γ = 0.611, P < .001) and TAI scores (γ = 0.305, P < .001) increased as C-IDAF-4C scores increased. Higher C-IDAF-4C scores and longer operative time were significantly associated with higher levels of postoperative pain.

Specific factors are associated with anxiety and stress, and postoperative pain in patients undergoing wisdom teeth extraction. Addressing these factors preoperatively may reduce stress and anxiety, and lead to more favorable treatment outcomes.

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The numeric rating scale for clinical pain measurement: a ratio measure?

Juliann P Kovan, Sharon Shapiro, Craig Hartrick (2003)

The Numeric Rating Scale (NRS-11) has been widely used clinically for the assessment of pain. Its use for clinical research is controversial. Reports differ as to whether or not the NRS-11 should be treated as a ratio pain measurement tool. This study compared the NRS-11 to a ratio measure for pain assessment: the visual analog scale (VAS). Simultaneous pain measurements using these 2 scales were compared in clinical situations commonly encountered in a tertiary community hospital. Whereas linear relationships were noted in laboring patients and in postoperative patients with thoracic or abdominal incisions during cough, no such correlations were noted for the same postoperative patients at rest or for postoperative orthopedic patients. The NRS-11 should not be considered to be interchangeable with the VAS. Its use for clinical research should be limited to situations where it has specifically demonstrated linear properties.

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Association between Anxiety and Pain in Dental Treatment: A Systematic Review and Meta-analysis.

C.-S. Lin, S-Y Wu, C-A Yi (2017)

Accumulating evidence has revealed that dental anxiety (DA), as a dispositional factor toward the dental situation, is associated with the state anxiety (SA) and pain related to dental procedures. However, conclusions from individual studies may be limited by the treatment procedures that patients received, the tools used to assess DA, or the treatment stages when anxiety or pain was assessed. It is unclear whether DA, at the study level, accounts for the variance in pretreatment SA. The impact of DA and SA on pain at different treatment stages has not been systematically investigated. To address these questions, we present novel meta-analytical evidence from 35 articles (encompassing 47 clinical groups) that investigated DA in a clinical group. Subgroup analyses revealed that the studies of surgical and nonsurgical procedures did not significantly differ in either DA or pretreatment SA. Furthermore, metaregressions revealed DA as a significant predictor that explained the variance in SA assessed before and during treatment but not after treatment. The findings suggest that patient DA has a significant impact on patient SA. Metaregressions revealed DA as a significant predictor that explained the variance in expected pain, pain during treatment and posttreatment pain. In contrast, pretreatment SA was a significant predictor that explained the variance in expected pain. The findings reveal that DA has a consistent impact on pain through the entire period of dental treatment. Altogether, the findings highlight the role of DA as an overall indicator for anxiety and pain, across different types of dental procedures or treatment stages. We conclude that anxiety should be assessed as a critical step not only in anxiety management for high-DA patients, but also in pain control for all dental patients.

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Is Open Access

Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification

P. Santosh (2015)

Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar.

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Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: November 2017

Publication date (Electronic): 27 November 2017

Volume: 96

Issue: 47

Electronic Location Identifier: e8665

Affiliations

[a ]School of Nursing, National Yang Ming University

[b ]Graduate Institute of Clinical Dentistry, School of dentistry, National Taiwan University

[c ]Excellent Dental Center, Taipei, Taiwan.

Author notes

[∗ ]Correspondence: Tze-Fang Wang, School of Nursing, National Yang Ming University, No. 155, Section 2, Li-Nong St, Shi-Pai, Taipei, 112, Taiwan (e-mail: fang@ 123456ym.edu.tw )

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Publisher ID: MD-D-17-02171 Accession ID: 08665

DOI: 10.1097/MD.0000000000008665

PMC ID: 5708941

PubMed ID: 29381942

SO-VID: cfa8a05b-62e5-4935-b004-63db40b61874

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This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

History

Date received : 10 April 2017

Date revision received : 12 October 2017

Date accepted : 25 October 2017

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Keywords: dental anxiety,extraction,postoperative pain,surgical difficulty,third molar

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Keywords: dental anxiety, extraction, postoperative pain, surgical difficulty, third molar

Associations between dental anxiety and postoperative pain following extraction of horizontally impacted wisdom teeth : A prospective observational study

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Most cited references 29

The numeric rating scale for clinical pain measurement: a ratio measure?

Association between Anxiety and Pain in Dental Treatment: A Systematic Review and Meta-analysis.

Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification

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