The influence of anxiety on pain perception and its repercussion on endodontic treatment: a systematic review

Farias, Zilda Betânia Barbosa Medeiros de; Campello, Camilla Porto; Silveira, Márcia Maria Fonseca da; Moraes, Sandra Lúcia Dantas de; Vasconcelos, Belmiro Cavalcanti do Egito; Pellizzer, Eduardo Piza

doi:10.1007/s00784-023-05181-1

Cited by 5 publications

(1 citation statement)

References 45 publications

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“… 24 A recent review showed that dental anxiety affects the perception of pain before and during endodontic treatment. 25 Pain is a physiological experience as well as a cognitive and emotional construct. 24 Therefore, dentists should be sensitive to patients’ perceptions and feelings about instruments and situations associated with pain.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Aversion to Visual Dental Stimuli Between Patients and Dentists: A Preliminary Study

Tanaka,

Karibe,

Kato

et al. 2024

PPA

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Purpose Fearful dental patients often cite various dental instruments or procedures as triggers for their dental fear. Thus, visual dental stimuli provoke anxiety. This preliminary study aimed to assess the level of aversion to visual stimuli in dental patients and compare it with that in dentists. Patients and Methods A total of 43 dental patients (25 women, 18 men; average age, 29.9 ± 13.3 years; patient group) and 13 dentists (4 women, 9 men; average age, 28.2 ± 2.0 years; dentist group) were included. All participants had previously undergone dental treatment. The dental fear level was assessed using the self-reported Dental Fear Survey (DFS). Thirty-two images associated with dental treatment were prepared and classified into three categories: dental instruments, dental procedures, and the dental environment. All participants rated their level of disgust toward each image on a visual analog scale with scores ranging from 0 to 100. Results In the patient group, the disgust ratings for tooth extraction, dental drilling, and local anesthesia were >60, which were significantly different from those in the dentist group (Mann–Whitney U- test, p <0.001, p =0.001, and p =0.001, respectively). The ranking order of the disgust ratings for the 32 images showed significant correlation between the patient and dentist groups (Spearman correlation coefficient, r=0.80, p <0.001). In the patient group, the disgust ratings for dental impressions and the interdental brush, dental light, and dental chair were significantly correlated with DFS scores (r=0.61, p <0.001; r=0.47, p =0.001; r=0.41, p =0.006; and r=0.40, p =0.008, respectively). Conclusion This study revealed that patients have more negative feelings toward invasive procedures than dentists. However, a significant correlation was identified between the ranking of aversion-provoking dental stimuli by patients and dentists. Furthermore, the level of aversion to several dental-related items that do not cause pain was correlated with the dental fear level.

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Section: Discussionmentioning

confidence: 99%

Comparison of Aversion to Visual Dental Stimuli Between Patients and Dentists: A Preliminary Study

Tanaka,

Karibe,

Kato

et al. 2024

PPA

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Anxiety immediately before endodontic treatment: cross-sectional quantitative analysis

Busatto,

Baldissarelli,

Pelepenko

et al. 2024

Discov Psychol

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Introduction Endodontic treatments are considered by the patients to be one of the most painful and anxiety-generating procedures and this feeling may be linked to both environmental and individual aspects. This study aimed to evaluate the degree of anxiety of patients immediately before the endodontic treatment. Methods The study design was a cross-sectional quantitative analysis where patient sampling was performed on those who met the inclusion criteria and needed endodontic treatment. The interview instruments for the investigation were a questionnaire with semi-structured questions, the Corah Dental Anxiety Scale, and a digital device for measurement of blood pressure and heart rate. The variables investigated were gender, age, whether the patient liked to visit the dentist, depression, whether the patient used medication for depression, systolic and diastolic pressure, and heart rate. Data statistical were analysed using descriptive statistics and to evaluate the association between variables Pearson’s chi-square tests were used with a significance level of 5%. Results 175 patients were included in the study and categorized as little anxious (33.7%), mildly anxious (45.1%), moderately anxious (15.4%), and extremely anxious (5.7%). There was a strong association between higher degrees of anxiety and whether the patient declared not liking to visit the dentist; no other significant correlation was found. Conclusion Endodontic patients who claim not to like to visit the dentist are more anxious. Healthcare professionals can pursue strategies to treat these patients with anxiety reduction techniques avoiding the postponement or evasion of endodontic treatments.

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Patient‐related predictors of post‐operative pain following root canal treatment: A structural model analysis

Vitali,

Mafra,

Santos

et al. 2024

Int Endodontic J

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AimThe pathways to post‐operative pain are complex and encompass factors that extend beyond the treatment protocol employed. This study aimed to identify patient‐related predictors of post‐operative pain following root canal treatment.MethodologyA total of 154 patients received a single‐visit root canal treatment for asymptomatic necrotic mandibular molars. Before treatment, dental anxiety, dental fear and sense of coherence (SOC) were measured as predictors for each patient using validated questionnaires. Other measured predictors included gender, age, previous negative experiences at the dental offices and prior root canal treatment. Post‐operative pain was assessed using the Numeric Rating Scale at multiple time‐points over 30 days. Structural equation analysis was employed to evaluate the direct and indirect effects of patient‐related predictors on a theoretical model of post‐operative pain. The irrigant solution was also included in the model, as it was the only aspect that varied in the treatment protocol (sodium hypochlorite 2.5% and 8.25%).ResultsDental anxiety (coefficient 0.028; p < .01), dental fear (coefficient 0.007; p = .02) and irrigant solution (coefficient 0.004; p = .03) exerted a direct effect on post‐operative pain. SOC exerted an indirect effect on post‐operative (coefficient 0.006; p = .01) through dental anxiety and dental fear. Moreover, previous negative experiences (coefficient 0.048; p = .04) exerted an indirect effect on post‐operative pain through dental anxiety.ConclusionsDental anxiety, dental fear, previous negative experiences and SOC are patient‐related predictors of post‐operative pain following root canal treatment. These factors should be taken into consideration in clinical practice, as patients with these characteristics may be at an increased risk of experiencing post‐operative pain.

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The influence of anxiety on pain perception and its repercussion on endodontic treatment: a systematic review

Cited by 5 publications

References 45 publications

Comparison of Aversion to Visual Dental Stimuli Between Patients and Dentists: A Preliminary Study

Comparison of Aversion to Visual Dental Stimuli Between Patients and Dentists: A Preliminary Study

Anxiety immediately before endodontic treatment: cross-sectional quantitative analysis

Patient‐related predictors of post‐operative pain following root canal treatment: A structural model analysis

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